The construction of the outpatient clinic in Uvira, The Democratic Congo Republic (DCR). FEPADE

The Sud Kivu province has been the scene of numerous ethnic conflicts and wars and continues to be the area in eastern DCR in which armed groups are the most active. Armed conflict in this zone is characterized by serious infringements of human rights.
At present FEPADE has two modern outpatient clinics (Uvira and Fizi) which are working to improve healthcare attention in Sud Kivu. The aim of both is to encourage co-ordination at provincial and national levels to improve priority healthcare necessities.

NARRATIVE SUMMARY

Sud Kivu is experiencing enormous challenges with respect to the population's health; the situation is particularly serious in the territories of Uvira and Fizi.

The health and nutritional situation in the province of Sud Kivu is characterized by the following:

• Many children are affected by serious malnutrition related to poverty. In the province of Sud Kivu 7.4% of the children are born underweight and 55% of those aged under 5 have severe or chronic retarded development, a figure that is higher than the national average.
• Infant and child mortality continues to be higher than all the rest of the republic due to the children's critical nutritional state. Limited access to drinking water raises the incidence of disease transmitted by water and leads to greater rates of mortality and morbidity. Finally, the lack of sanitation and latrines for the elimination of excrement also augments the propagation of infectious and diarrhoeal diseases which are one of the principal causes of infant mortality.
• The territory of Fizi suffers from a lack of personnel and healthcare infrastructures. With a population of 487,945 it has barely 12 doctors and 98 nurses to provide healthcare attention. The other factor that influences the mortality of the population is access to healthcare services: only 35.9% of the homes are within a radius of 15km from a health center or outpatient clinic.
• Maternal health confronts serious difficulties and mortality continues to be critical. In addition to lack of access to healthcare services, more than 88% of the women claim to have financial difficulties and problems with transport to reach treatment, and 25% of their husbands refuse to give permission for them to be treated. For every 100,000 births 549 women lose their lives in the DCR.

At present, FEPADE has two modern outpatient clinics (Uvira and Fizi). These are working to improve healthcare attention in Sud Kivu with the final aim of encouraging  co-ordination at provincial and national levels in order to improve priority necessities  with respect to the health of the most vulnerable population.  

On the other hand, the core issue is how long these two healthcare centers can maintain their service of providing assistance free of charge or at a reduced, acceptable price for the population. Whilst the two clinics are functional and operating, they are facing considerable challenges which could hinder their helping the population. The main concern is that the medical services are no longer capable of supporting the rental charges and, at the same time, guaranteeing regular purchasing of medication and the payment of their personnel. With the passing of time the preoccupation is increasing and an adequate solution has not been found.   

For strategic reasons the FEPADE Association supports the project proposed for the construction of a building for the outpatient clinic in Uvira in the province of Sud Kivu, east DCR.