Building Capacity in Congo: A Life-Saving Partnership

The Democratic Republic of Congo is still a nation in crisis, reeling from years of brutal conflict and neglect, and struggling with widespread poverty, food insecurity, uneven economic development, and regional instability. As a result, the country experiences routine outbreaks of acute malnutrition that threaten thousands of lives.

Luckily, the Congolese Ministry of Health takes these problems seriously. Responsible for fielding teams of trained health workers, the Ministry of Health works in partnership with Action Against Hunger to devise and carry out strategies for grappling with nutrition crises that plague the country. And thanks to the Ministry’s dedication and professionalism, Action Against Hunger has an extraordinary opportunity to help build local capacity for the long-run.

Economic Collapse, Widespread Hunger

Rich in diamonds, gold, and nickel, the D.R. Congo has long depended on the extractive industry. But when the global economic recession caused the price of minerals to plummet, mining companies across the southern part of the country closed. The collapse of the mining sector, along with drought, conflict, and other factors, has left thousands of families without food or income.

"None of this would be possible without a successful strategy implemented by the Ministry of Health and our truly dedicated staff." —Marie-Sophie Whitney, Senior Nutrition Advisor, Action Against Hunger

“Hundreds of thousands of Congolese lost their jobs and livelihoods when the mining industry collapsed and have returned to their villages to find nothing,” says Karine Milhorgne, Desk Officer for the Democratic Republic of Congo.

Many Congolese previously engaged in the mineral industry shifted to agriculture production to eke out a living but have struggled without the appropriate skills and access to the necessary seeds and tools. In an effort to make ends meet, some farmers have been forced to sell their harvests before their crops mature, depleting their seed reserves and slashing their profit. A highly contagious plant disease has also ravaged the region’s cassava plants, a staple crop once integral to people’s diets and livelihoods.

A Malnutrition Crisis in Southern Congo

When disasters like this hit, children are most affected. They don’t have much to fall back on—especially when they are underweight and fragile to begin with—and in southern Congo, thousands of them have become severely malnourished. In fact, some of the highest rates of severe acute malnutrition ever seen in the region were uncovered late last year.

For example, in Djuma, an area inaccessible by road and served by few aid organizations, nearly one in five children was found to be suffering from acute malnutrition, double the rate from last year.

Thanks to our long-standing partnership with the Congolese Ministry of Health, Action Against Hunger, together with local health authorities, was well positioned to respond to the crisis. Over the years, we have honed a strategy that combines direct intervention on behalf of affected children with technical and logistical support for local actors. This last year alone, we treated a record 30,000 cases of severe acute malnutrition across the country by employing a community-based model that is revolutionizing care for the life-threatening condition.

Community-Based Care for Acute Malnutrition

At the community level, Action Against Hunger is training volunteer village health teams to diagnose malnutrition and refer affected children for outpatient treatment, or if they have severe medical or nutritional complications, to therapeutic Stabilization Centers for around-the-clock care. By tapping into a national program of Community Health Workers already in place, we have trained thousands of volunteers to ensure families of acutely malnourished children know where they can seek help.

In outpatient centers managed by the Congolese Ministry of Health and integrated into the local health system, nurses trained and equipped by Action Against Hunger are treating and monitoring acutely malnourished children during their weekly visits.

Now, because of a national nutrition protocol and specially-formulated Ready-to-Use Foods (RUFs) like Plumpy’nut, malnourished children can visit the outpatient centers once a week to get a medical check-up, be weighed and measured, and receive therapeutic RUFs to consume at home. In the past, all treatment for acute malnutrition required prolonged hospitalization.

Children whose condition has deteriorated to such an extent that they require hospitalization receive intensive care in therapeutic Stabilization Centers, which are set up in local and regional hospitals. After these children have recovered, they are admitted to the outpatient nutrition program for continued treatment until the target weight is reached. The vast majority of them return to full health within six weeks.

In both outpatient and inpatient centers, staff members discuss the children’s progress with their parents and teach them basic nutrition and hygiene practices to improve their health. Action Against Hunger provides technical and organizational training for the centers’ staff, equipment and therapeutic nutrition products, as well as financial support for badly underfunded hospitals and health centers to purchase medicine and other essentials. Last year, over 100 doctors and 2,300 nurses received comprehensive training on care for severely malnourished children through the program.

“None of this would be possible without a successful strategy implemented by the Ministry of Health and our truly dedicated staff, most of whom are Congolese nationals,” says Marie-Sophie Whitney, Senior Nutrition Advisor. “They understand how important it is to build trust with local health authorities, as well as affected communities. You can’t just show up one day and do the job. We’re able to work so effectively because we’ve been carefully maintaining these relationships for years.”

But success is not only measured by our rapid response to outbreaks of malnutrition, it is also determined by our ability to transfer full responsibility for the nutrition programs over to the Ministry of Health—in effect, to work ourselves out of a job. When the crisis subsides and we can eventually depart, the local health system we have strengthened will continue to support improvements in communities’ nutritional health. This is our legacy, and, with the help of committed partners, it is one that endures.