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Exhausted relief workers fear they are seeing the start of a severe
cholera epidemic among the one million Rwandan refugees here, who are
already dying in droves.
At a place called Munigi, a few miles north of this border town, where
at least 200,000 refugees have camped, medical workers today were
administering their sparse supplies of intravenous solution to scores
of men, women and children lying on the ground who had been diagnosed
as having cholera.
Dr. Jacques de Milliano, president of Doctors Without Borders, whose
staff was treating the sick at Munigi, predicted an outbreak of 10,000
to 20,000 cases and said at least half of those who contracted the
disease would die. The first cases of what he had diagnosed as cholera
appeared on Tuesday, he said. Blood samples have been sent to Paris
for testing.
Ethically, you have to consider it cholera,
Dr. de Milliano
said. We cannot wait for laboratory tests when people are dying like
flies.
A highly communicable disease, cholera is a serious form of bacterial
dysentery that results in vomiting and diarrhea and potentially fatal
dehydration. It spreads quickly in crowded, unsanitary conditions like
those in the encampments here, where tens of thousands of people are
crowded into small spaces, with no latrines and no clean water.
To treat a serious outbreak, fresh water or rehydration solution is
necessary immediately. Dr. de Milliano said that up to two million
gallons of water would be needed daily. This is in addition to the
more than one million gallons of water that relief workers here had
already said were needed. Today, about 50,000 gallons of water
arrived.
Dr. de Milliano said also that 60,000 liters of intravenous fluid (a
liter is slightly larger than a quart) would be needed every day. To
bring in that much would require three huge Hercules cargo planes
working around the clock loaded with nothing but intravenous fluid, he
said. He also said there was an urgent need for medical teams, field
hospitals and vehicles.
Dr. de Milliano said he feared that efforts to treat a widespread
outbreak of cholera would fail, given the demands already being placed
on the relief community here.
Dr. de Milliano said that on Tuesday a child was examined and
suspected of having measles. If it is measles, thousands of children
will die,
he said.
Hundreds of refugees have died already, from a variety of
causes. There were 13 bodies lying on the half-mile-long road that
runs from the center of Goma, past the Gran Lac Hotel to Lake
Kivu. Beside a low evergreen hedge on the road to the airport, 31
bodies were waiting to be picked up. The effort to dispose of the dead
has overwhelmed the Zairians, so French soldiers come by in trucks to
pick up the bodies for burial.
The dead were everywhere on the volcanic rocks, lying where they
dropped: a woman and son who had died together; a lone young man; two
young men, one maybe 15, without any clothes, the other perhaps in his
30's; a woman.
A baby lay a few feet away. She was alive, but it was hard to imagine
she could survive for long. Elsewhere there was a nine-month-old
curled up on the rocks, sucking her thumb. She was alone. So were many
other emaciated children.
Many of the living were on the verge of death, and some died while a
reporter was in the camp.
Agencies 'Were Ill Prepared'
At present, less than 10 percent of what is needed to provide food and
shelter for the refugees is coming in, said Panos Moumtzis, a
spokesman for the United Nations High Commissioner for Refugees. It
is really appalling,
he said. All the humanitarian agencies were
really ill-prepared to respond to a crisis of such magnitude.
The relief effort has also been hampered by conflicts between the
French military and the relief organizations over access to the
airport, and by an inadequate response from the international
community in terms of money and supplies. Today, 19 relief flights
arrived, the most that have landed in a single day since the refugee
crisis began.
Although the influx of refugees has stopped in this area, it continues
70 miles south of here, around the Zairian town of Bukavu. In the last
48 hours, 400,000 refugees have fled into the Bukavu area from
southwestern Rwanda, where the French have established a safe
haven. There are at least one million more on the road toward Zaire,
Mr. Moumtzis said.
Mr. Moumtzis said that the refugee crisis in the south was caused by
broadcasts over a radio station operated by partisans of the former
Government, which was dominated by members of the Hutu tribe. He said
that as recently as Monday the station was telling Hutu to flee the
French zone because the station claimed the French would no longer
protect them from the Rwandan Patriotic Front, the Tutsi-dominated
rebel army which has declared a new Government.
We can just tinker around the edges,
said Osei Kofi, a spokesman for
Unicef here. Where else in the world did you get one million refugees
in five days?
Mr. Kofi said.
We need an Ethiopia-type operation,
he said, referring to the
international response to the famine there in 1984. We need the Royal
Air Force, the Canadian Air Force, the Australian Air Force.
He said
these organizations could not only bring in needed supplies but that
they could also distribute them and provide medical assistance, as
they had done in Ethiopia.
Relief agencies continued to plead for a political response to the
refugee crisis. Before, that meant stopping the war. Now, it means
stopping broadcasts of the former government radio station, but even
more, it requires creating the conditions inside Rwanda so that the
refugees, most of whom are Hutu, will feel it is safe to go home.
This is a humanitarian crisis without any humanitarian solution,
Dr. de Milliano said. There has to be a political solution.
He added
his voice to those who have been calling for a substantial United
Nations force to be sent to Rwanda to ensure protection for the
refugees.
Standing alongside the row of bodies on the airport road, 24-year-old
Emmanuel Twagiramungu, said, They have died from hunger, and we will
too.
He said he would like to go home. A crowd of refugees who had
gathered agreed. But, he said, We need U.N. soldiers to protect us.
At Munigi, where the suspected cholera cases were being treated,
Dancilla Mukandutiye stood near a blanket that covered the body of her
12-year-old daughter. The girl had become sick on Tuesday, and her
father had brought her here today for treatment. When they arrived,
the girl died, said Mr. Mukandutiye. A few feet away was the body of a
dead woman. No one around knew who she was.
Mrs. Mukandutiye is seven months pregnant, but she doesn't know if the
baby is still alive. She last felt it kick six days ago, the day she
fled her village.
If only I had the chance I would go back home, because the ones I
left behind, the ones who have been killed, have suffered no more than
we are here,
she said.
