Just US$30 a month buys innovative health care for Kinshasa refugee families

News Stories, 24 December 2009

© MONUC/Myriam Asmani
Rwandan refugee Clementine Uwimana, 30, with baby Malaika, who is named after the UNHCR community services assistant who oversaw Clementine's pregnancy.

KINSHASA, Democratic Republic of the Congo, December 24 (UNHCR) About to give birth to her first child, Clementine Uwimana, a 30-year-old Rwandan refugee walked to the nearest hospital, just five minutes from her home in the Congolese capital. But when complications meant she had to head to a major referral hospital, St. Joseph, for a Caesarean section, she didn't hesitate to jump in a taxi, because she had health insurance.

"If it was not for the heath insurance I get from UNHCR, I could have died that night as I did not have any money," Clementine said later, cuddling her baby, Malaika named after the UNHCR community services assistant who had helped her through every step of her pregnancy after her boyfriend deserted her.

In what may be the only scheme of its kind in the world, close to 1,500 refugees in Kinshasa are covered by a health care plan administered by the Bureau Diocésain des Ouvres Médicales, or BDOM. Under the plan, set up in 1978, and now covering some 2 million people, or about one-fifth of Kinshasa's population, UNHCR pays US$30 a month for each refugee family, up to seven or eight people.

UNHCR joined the BDOM system this year after a thorough evaluation of refugees' complaints about the quality of medical services they had been getting. Now, for US$6,000 a month, UNHCR is able to provide medical insurance for 1,444 refugees in the Democratic Republic of the Congo capital.

© MONUC/Myriam Asmani
Lusillaho Pascal, 41, a refugee from the Republic of Congo, has received effective treatment in Kinshasa for his diabetes under the health insurance programme.

"Now that half of all refugees are living in cities, we are having to look at more innovative ways of delivering services to them," said Paul Spiegel, head of UNHCR's Public Health and HIV Section. "The health insurance programme in Kinshasa may be one example we will want to consider duplicating for refugees in other major cities."

For Clementine, not having to worry about her health is a major relief, after having fled genocide in her homeland, Rwanda, in 1994. Her parents were killed and, at the age of just 15, she had to become a mother to her four younger brothers in exile. Thanks to UNHCR education and health care programmes, and her own hard work, she said, "I struggle less."

Like Clementine, refugees in Kinshasa are assigned to health centres near their homes for primary care and can be referred to St. Joseph for more complicated treatment.

© MONUC/Myriam Asmani
Medical staff at St Joseph, which is taking part in the health insurance programme. 'We are very satisfied about our collaboration with UNHCR. The most common cases we have, among the refugees, are viral or bacterial infection especially affecting young women,' said one doctor at St. Joseph.

A doctor at St. Joseph, Thierry Bankanda, observed that "with the new system, refugees are more satisfied to receive medical treatment as it is more efficient, with less bureaucracy and more focus on the health of the patients."

He added that the health insurance makes it easier for the hospital to handle refugees and "refugees don't feel discriminated [against] in comparison with the Congolese when they come to the hospital to receive treatment. They enjoy the same rights."

The pay-off has been profound for 41-year-old Lusilaho Pascal, a refugee from the Republic of Congo for 10 years, who moved from a refugee camp to the capital in search of proper treatment for his diabetes.

At first he wondered whether he was any better off, as he spent two hours every day getting to hospital, with all his money going on transport. Now the BDOM-covered health centre is within easy reach, his diabetes is controlled by medication, and his condition has improved remarkably.

"The health centre where I am going now is very near my house, only 10 minutes on foot," said Lusilaho, who takes a pill every day after breakfast. "I don't feel discriminated against at the hospital I am treated like the Congolese in terms of service received. Now my life has completely changed."

By Francesca Fontanini in Kinshasa, Democratic Republic of the Congo




Urban Refugees

More than half the refugees UNHCR serves now live in urban areas

Public Health

The health of refugees and other displaced people is a priority for UNHCR.

Health crisis in South Sudan

There are roughly 105,000 refugees in South Sudan's Maban County. Many are at serious health risk. UNHCR and its partners are working vigorously to prevent and contain the outbreak of malaria and several water-borne diseases.

Most of the refugees, especially children and the elderly, arrived at the camps in a weakened condition. The on-going rains tend to make things worse, as puddles become incubation areas for malaria-bearing mosquitoes. Moderately malnourished children and elderly can easily become severely malnourished if they catch so much as a cold.

The problems are hardest felt in Maban County's Yusuf Batil camp, where as many as 15 per cent of the children under 5 are severely malnourished.

UNHCR and its partners are doing everything possible to prevent and combat illness. In Yusuf Batil camp, 200 community health workers go from home to home looking educating refugees about basic hygene such as hand washing and identifying ill people as they go. Such nutritional foods as Plumpy'nut are being supplied to children who need them. A hospital dedicated to the treatment of cholera has been established. Mosquito nets have been distributed throughout the camps in order to prevent malaria.

Health crisis in South Sudan

UNHCR/Partners Bring Aid to North Kivu

As a massive food distribution gets underway in six UNHCR-run camps for tens of thousands of internally displaced Congolese in North Kivu, the UN refugee agency continues to hand out desperately needed shelter and household items.

A four-truck UNHCR convoy carrying 33 tonnes of various aid items, including plastic sheeting, blankets, kitchen sets and jerry cans crossed Wednesday from Rwanda into Goma, the capital of the conflict-hit province in eastern Democratic Republic of the Congo (DRC). The aid, from regional emergency stockpiles in Tanzania, was scheduled for immediate distribution. The supplies arrived in Goma as the World Food Programme (WFP), with assistance from UNHCR, began distributing food to some 135,000 displaced people in the six camps run by the refugee agency near Goma.

More than 250,000 people have been displaced since the fighting resumed in August in North Kivu. Estimates are that there are now more than 1.3 million displaced people in this province alone.

Posted on 6 November 2008

UNHCR/Partners Bring Aid to North Kivu

UNHCR/Partners Bring Aid to North Kivu

Since 2006, renewed conflict and general insecurity in eastern Democratic Republic of the Congo's North Kivu province has forced some 400,000 people to flee their homes – the country's worst displacement crisis since the formal end of the civil war in 2003. In total, there are now some 800,000 people displaced in the province, including those uprooted by previous conflicts.

Hope for the future was raised in January 2008 when the DRC government and rival armed factions signed a peace accord. But the situation remains tense in North Kivu and tens of thousands of people still need help. UNHCR has opened sites for internally displaced people (IDPs) and distributed assistance such as blankets, plastic sheets, soap, jerry cans, firewood and other items to the four camps in the region. Relief items have also been delivered to some of the makeshift sites that have sprung up.

UNHCR staff have been engaged in protection monitoring to identify human rights abuses and other problems faced by IDPs and other populations at risk across North Kivu.

UNHCR's ninemillion campaign aims to provide a healthy and safe learning environment for nine million refugee children by 2010.

Posted on 28 May 2008

UNHCR/Partners Bring Aid to North Kivu

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