So much need, so few resources

The Congo’s tragedy is not just that it is one of the world’s neediest countries. As a colony of Belgium and after independence, many parts of this vast country thrived.
“Kasongo once had some of the best medical facilities in the whole country,” said Auriol Miller, country director in the Democratic Republic of Congo for the humanitarian agency Concern. Today, with a population of 46,000, there are five cars and the broken and rutted streets are watched over by abandoned factories. Maniema province, where Kasongo is located, once produced enough food to feed all of the country.
This is the story of three Congolese infants in the countryside a few kilometers northeast of Kasongo.
There is hope in Kasongo. But the region has been “dying a slow death by decline,” Miller said. She has overseen a new therapeutic feeding program for under-5-year-old children at the Kasongo General Reference hospital, which in the 1950s was home to the Congo’s most advanced primary healthcare program.
Overall, 11.7 percent of children under 5 in the area suffer from malnutrition. There is little employment or resources for the adults.
Twenty percent of households consume only one meal a day, consisting of meager food lacking in nutrition. This decline from its status as the larder of the Congo is yet another bitter irony of Kasongo.
Concern’s Miller and a team of experts surveyed a previously uncharted region of Maniema province on Tuesday, driving into the jungle to areas that until a few weeks ago were being looted by Mai Mai rebels.
The team passed through more than 25 isolated villages, some of which still bore the marks of Mai Mai militia incursions: houses and medical centers were torched and goods stolen. They visited a collection of wicker huts 15 minutes deep into the jungle by foot, where villagers said they would flee with their possessions when the Mai Mai rebels approached. Kalashnikov-toting soldiers, some of them no more than 14 or 15, guarded sections of the road,.
In each village, crowds of children erupted on to the streets, greeting the team with happy shrieks and waves. Miller and her colleagues were looking specifically for malnourished children, and they found them.
Among each crowd of children and adults who came to greet the team were infants suffering extreme levels of malnutrition. The condition is striking here pandemically — many of the children were reasonably healthy and not hungry. But in one village, as the children danced and sang and played noisily on makeshift musical instruments, several children were spotted in the crowd being held by anxious parents. They were examined by Moise Kabongo, Concern’s nutritionist, who is based in Kasongo.
“These are the most difficult situations,” said Miller. “Because they obviously want you to take the kid to help him or her.” Indeed, in two villages, from within the excited crowd of meters and greeters, anguished parents held out limp infants, beseeching the team to help them.
Teams such as Concern’s must make the heart-wrenching decision as to whom they can help. Some children are deemed not ill enough. And resources are still severely limited, with the therapeutic feeding program in Kasongo only a few months old and already its capacity overflowing.
One mother presented her year-old child, so ill from malnutrition that Miller said the baby probably had at most two days of life left. The mother was told that she could travel back to Kasongo with the team and receive medical help for her and the child — mothers and children are placed in a special ward and gradually fed until both have become well.
It is a process of careful feeding by experts that can take as long as one month.
But this mother could not leave. Her husband was far away and could not be contacted to let him know that she was going to Kasongo. Besides, she had other children at home, and it would take time to arrange for someone else to look after them. She stayed. The fate of her child remains unknown. Two other children were encountered: Asande, the 1-year-old child of Safi, who is 19, and Yohali, 2 months old and carried by her 40-year-old father, Munganga. Yohali’s mother gave birth to her in the forest during one of the rebel incursions. Two weeks after, the mother died.
Both infants were in dire need of medical attention, and so the parents agreed to come to Kasongo with the Concern team. The 45-kilometer drive took over four hours on a road that frequently dwindled to a cragged and riven track.
As the sun set over Kasongo, parents and children were driven into the grounds of the Kasongo General Reference hospital and admitted to the therapeutic feeding program. For Yohali, with no mother, a wet nurse would be found. Asande and Yohali are two: the region certainly contains hundreds of other malnourished children.
“This is what is difficult,” Miller said. “On the one hand, this is absolutely what your job is about. But yet it isn’t even a drop in the ocean of need.” On the return journey to Kasongo she added: “But if you save even one life, you must do it.” Pausing to consider what the team had seen and what had been achieved, she said, “You can only be overwhelmed by the courage of these people.”
At Kasongo General Reference hospital, as his daughter was being checked into the feeding program, Munganga placed both his hands on his heart and said “asante” — it is the Swahili word for “thank you.”