Kinshasa's central market is throbbing with life, trade, bantering and colors. Women sit behind tiny stalls in the midday heat, trading and selling manioc, peanuts, grubworms and locusts, eggplant and bright orange tomatoes. In a country where the majority of goods are imported from its former colonizers, the Democratic Republic of Congo (DRC) is lucky to have Bas-Congo Province, a peaceful, thriving, breadbasket of trade, and Kinshasa's biggest provider of produce. The Bas-Fleuve region of Bas-Congo Province rests at the mouth of the great Congo river, making it the doorway to the country, its link to the outside world through the ocean, the river and the train. But unfortunately such links also make the province one of its biggest transmitters of HIV/AIDS.
Throughout the kleptocratic dictatorship of Mobutu Sese Seko and his successor Laurent Desire Kabila, the Congo (formerly Zaire), was eaten away, its riches disappearing into the Swiss bank accounts of its leaders. The "independence" wars of 1996 and 1998 stripped the country of the little infrastructure that still functioned, including the health system, and approximately 3.3 million people have died as a direct or indirect result of the armed conflict, according to IRC's extensive mortality survey.
HIV/AIDS is rapidly becoming one of the leading causes of death in Congo, with an estimated HIV infection rate of 10 percent, according to the health ministry. (For comparison, HIV infection rates elsewhere in Africa range from 1 percent in Somalia, 8 percent in Tanzania, to 20 percent in South Africa.) The government estimates AIDS has orphaned almost one million children. In Bas-Fleuve, these rates have been noted at an average of 25 percent, and as high as 59 percent in some zones. Its location as a key trade route to Kinshasa is suspected to have facilitated the spread of HIV, whereas other parts of the country cut off of mass travel by road and boat have suffered less infection.
Blood Screening Program
Hospitals and health centers have very few means to ensure universal precautions of blood infection control, and over half of Bas-Congo province blood transfusions are not tested for HIV. In Kinkozi health zone, 507 transfusions were documented from January to September 2001, none of which were tested for HIV. Then from December 2001 to March 2002, the health zone received test kits from MSF-Belgium, and tested all transfused blood: 36 percent of tests came back positive. In Boma health zone, of 930 transfusions conducted from January to September 2002, only 148 samples were tested, showing a 59 percent HIV prevalence rate.
The most common blood transfusion recipients are women and children, unknowingly infecting themselves and their families in an attempt to get well. A local doctor, asked how he felt about giving untested blood transfusions to his patients, replied, "They will die if they don't receive blood. It is a hard moral call, but with blood, their lives are extended, if only for a little while. What else can we do?"
With funding from the Canadian government International Development Agency, the IRC will conduct a 12-month blood screening program in ten of the most affected health zones in Bas-Fleuve to ensure safe blood transfusions for HIV/AIDS, hepatitis and other diseases. IRC will work at hospitals in the ten zones to train staff, raise awareness, and ensure use of universal precautions and provide test kits, building local capacity to conduct laboratory tests and increase knowledge among local health workers.
"As a doctor, I feel very strongly this is one of the most basic and crucial services we can provide to save lives," said IRC medical coordinator Pascal Ngoy, currently in Boma working with local health authorities to start up the project.
