A previous IRC survey found that nearly four million people have died from war-related causes in Congo since 1998–making it the world’s deadliest documented conflict since WW II. The new study about to be released shows the numbers steadily rising.

Part 1  l  Part 2  l  Part 3: Misoke

At the crack of dawn, the mortality survey team led by IRC’s Maxim Bushiri starts interviewing people about their health status, deaths in the households and the types of disease the people of Misoke suffer from. The early morning mist is still rising as the team splits up and, note pads in hand, begins to knock on doors. The team is using a technique called proximity sampling, with interviewers moving from one household to the next nearest household until the pre-determined quota of 20 households is reached.

Meanwhile, I walk over to the local clinic in Misoke, a simple brick building with a corrugated iron roof. The nurse, Ngegele Masasa, tells me that it is equipped to deal with minor ailments only. If someone here is seriously injured or stricken by the many lethal tropical diseases so common here, there is a real risk that they will die before they receive treatment. The last IRC mortality study from 2004 showed that life-saving interventions such as immunizations, antibiotics and transportation to medical centres for surgery are unavailable to millions of people in war-torn Congo, due to ongoing insecurity and a widespread breakdown of the overall health infrastructure. Less than two percent of deaths were directly due to violence; the vast majority was caused by preventable and curable diseases, such as malaria, diarrhea, pneumonia and malnutrition.

The shelves of the Misoke clinic are virtually empty of medication, except for the most basic painkillers. A handful of patients lie in the ward on simple and dirty bamboo stretchers. A young man, hooked up to a drip bottle with saline solution, grimaces in pain.

“He fell ill with malaria and self-medicated with quinine,” Ngegele Masasa says. “But he overdosed and now he is very sick.”

Like in Misoke, clinics and hospitals in most rural areas across Congo are in a serious state of disrepair and neglect. The IRC’s health teams in Congo describe operating theaters with leaking roofs, dirty wards and unskilled health staff. The few drugs in the dispensary are often out of date. Disposable syringes are used several times and ‘sterilization’ often means washing surgical equipment in cold water and soap. Health facilities without support from humanitarian groups are in the poorest condition.

Outside I meet Idumbo Mokina, a 47-year old villager. He tells me that his sister Ngalia Laini was rushed to the clinic last year after becoming ill with headaches and cramps.

“They kept her overnight,” he says. “In the morning, they told us that it was meningitis and that we had to take her to the clinic in Moga, 12 hours walk from here. So I made a stretcher and organized a group of 17 villagers to carry her. After four hours on the road she died. She was 45 years old.”

Ngalia’s fate is frighteningly common. The 2004 survey showed that more than 1,000 people die every day in excess of what is considered normal mortality. As many as one in 15 women die as a result of complications of pregnancy and child birth, compared to the United Nations estimate of only one in every 2,800 in the developed world. And almost half of the casualties in Congo, according to the 2004 study, occur among children under five.

Sitting in the shade of her mud hut, a middle-aged woman called Therese Tchausi tells me that four children living in her household died in the past two years.

“They had high fever. The nurse told us it was from malaria, measles and diarrhea,” she says shaking her head. “This is life here in Misoke.”