Huge death toll in Congo

Stephanie McCrummen, Washington Post

Thursday, August 6, 2009

The frequently cited death toll from eastern Congo's long-festering conflict, a staggering 5.4 million, is an estimate based on a series of five mortality surveys conducted since 2000 by the International Rescue Committee, an aid group.

Authors of the surveys - one of which was published in the Lancet, a British medical journal - say their work has a wide margin of error because of the inaccessibility of large swaths of Congo and a lack of baseline data with which to make comparisons. Still, they have said that their data show with 95 percent certainty that 3.5 million to 7.8 million people have died since 1998 as a direct or indirect result of the conflict.

In their most recent survey, carried out between January 2006 and April 2007, workers asked 14,000 randomly selected residents in 700 villages and towns across Congo about recent deaths in their homes. Researchers calculated the mortality rates for those areas and extrapolated results for the entire nation. They then compared the findings with mortality rates for pre-conflict Congo and with average mortality rates for sub-Saharan Africa.

Deaths above those rates were deemed "excess" and were attributed mostly to economic and social consequences of the conflict in the east, which began when the 1994 genocide in neighboring Rwanda sent a flood of refugees and militiamen across the border.

Congo's death rate was estimated to be 57 percent higher than the average for sub-Saharan Africa. The rate in eastern Congo was 85 percent higher.

Yet few of the excess deaths in Congo were violent ones. Instead, the authors blame "economic and social disturbances caused by the conflict, including disruption of health services, poor food security, deterioration of infrastructure and population displacement."

Leading causes of death in the east were easily treatable conditions such as malaria, fevers, diarrhea, acute respiratory tract infections, neonatal deaths, tuberculosis, measles and malnutrition.

"In one village I visited, in 20 homes there were 20 deaths" in recent months, said Rick Brennan, one of the survey authors. "Imagine going into 20 households in your neighborhood and there being 20 deaths. ... People are dying quietly, anonymously."