War, Disease Create Quiet Crisis in Congo

The International Rescue Committee counts 5.4 million deaths in Congo since civil war erupted in 1998. But 2 million have died since the relative peace of 2002. Dr. Richard Brennan, a study author, says most of those deaths come from treatable diseases.

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SCOTT SIMON, host:

A regional war ended in the Democratic Republic of Congo in 2002. But since then, two million people have died, mostly from disease and malnutrition. Let me repeat that, two million people. It is at least four times as many people who've died in Darfur. The crisis has received a good deal of more publicity. The Congo figure comes from a recent study published by the International Rescue Committee.

Dr. Richard Brennan is one of the authors of the report, and he joins us in our studios.

Dr. Brennan, thanks very much for being with us.

Dr. RICHARD BRENNAN (Health Director, International Rescue Committee): Thank you.

SIMON: In the study, you call the war in the Congo and the time since then as the world's deadliest crisis since World War II.

Dr. BRENNAN: That's correct. Between 2000 and 2007 now, we have done five mortality surveys in the Congo. And we have been able to document that people have died at a very significant rate. And we have been able to make estimates that 5.4 million people have died since the war, August 1998, started.

In making those estimates, we have always erred on the side of being conservative. And we have used our very well-accepted methodology to document that and to document the consistent trends over that period of time.

SIMON: Why are people dying?

Dr. BRENNAN: Well, early on, they were dying from violence and what we would call the indirect consequences of conflict. In fact, the vast majority, well over 90 percent, have died from infectious diseases, malnutrition. What happens with conflict with war zones, clinics stop operating, markets stop functioning, farmers can't till their land, parents can't feed their children nutritious food, and so the most deaths are actually due to these easily, preventable and treatable diseases like malaria, pneumonia, diarrhea.

SIMON: But why the lack of progress in the five years or more that the war has been ended?

Dr. BRENNAN: Well, it's complex. Although the war officially ended in the December 2002, there have been several ongoing conflicts in the east, most notably in recent times the escalation of violence in north Kivu province, where a general has been fighting against other militias and, in fact, the Congolese government.

The other important point to note is that the war and the subsequent conflicts came on the end of decades, of economic decline and political decline. So the entire infrastructure of Congo is being completely disrupted. The economy is being in disarray for years.

SIMON: Why do you think people aren't paying as much attention to Congo? It's a question you must have run through your own mind.

(Soundbite of laughter)

Dr. BRENNAN: Many, many times. There are several reasons. Perhaps, most obviously, is people are dying dramatically. They're not dying acutely. The Rwandan genocide was very violent. The Asian tsunami, people died very dramatically. In Congo, people are dying quietly, day in, day out, year in, year out, of very common causes. So that doesn't grab the attention of the media. That doesn't grab the attention of the men or the women in the street.

I think also of the fact that Congo, in the eyes of our political leaders in the West, doesn't represent a major, political, economic or security interest. It's a complex situation to explain to people, you know, how can we have been having these mortality rates elevated for such a long period of time. And also, there hasn't really been a constituency for Congo, like there has been for Darfur, for example. We don't have a champion in the media, for example. We don't have a politician that's taken this on as a cause. We're ever hopeful that someone will take it on as a cause, but we have obviously got a bit of work to do in that regard.

SIMON: What would the rest of the world contribute?

Dr. BRENNAN: Well, their concern, their moral support, their resources.

SIMON: Well, let's get to the resources part because moral support sometimes won't do much or anything.

Dr. BRENNAN: Well, that's right. It was more of a sort of a general comment. So let me take the issue of security. We do have a peacekeeping force out in the east that goes by the name of MONUC, U.N. peacekeeping troops.

SIMON: How many troops are committed?

Dr. BRENNAN: Right now, about 17,000 for an enormously vast area. Congo itself is the size of Western Europe. Compare that with 60,000 troops in Kosovo, a tiny province in the former Yugoslavia that one could drive around in a day.

Perhaps one of the encouraging findings from our survey was that in areas where they were - we actually did document decline in mortality. Gives us a sense of what's achievable. But it's also important to note that the Congolese government has the key role to play here. They've got to protect their own civilians and reform their own army and police.

SIMON: But in addition to perhaps greater security, what kind or resources are we talking about? Can you begin to put even a dollar - dollar, pounds or euros figure?

Dr. BRENNAN: Sure, sure. If we add all the humanitarian assistance and development assistance that the international community gave in 2007, we're up to about $18 per person per year, about half of what's required to provide just basic vaccinations, bed nets and simple treatment for the common infections.

And given the fact that the resources fall short of what's required, I think we all have to accept the fact that recovery from a protracted conflict, particularly when it comes on the heels of decades of economic and political disruption, is itself a protracted process. This is going to take years for this to turn around.

SIMON: Dr. Richard Brennan, health director for the International Rescue Committee, thank you.

Dr. BRENNAN: Thank you very much.

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