Collaborative Medical Engagement and Needs Assessment in the Democratic Republic of the Congo: A Preliminary Report from Muanda

Abstract

Abstract. The Democratic Republic of the Congo is the second largest and fourth most populous country in Africa. More than two decades of ongoing conflicts have degraded its healthcare system. A broad range of tropical diseases, along with opportunities for collaborative medical engagements (CMEs), are prevalent. However, reports from such events in this country are sparse. In June 2013, a CME was conducted in the western town of Muanda. Twenty-two hours of didactic sessions were collaboratively presented, and 158 patients were collaboratively evaluated. Durable dental and respiratory equipment, infrastructure improvements, and training opportunities were the top needs identified by the providers. Whether the regional referral hospital received sustainable benefit remains under investigation. However, the approach and needs assessment described herein provide a framework for future engagements or assistance. This CME established a precedence of medical partnership in the region because it led to the largest multidisciplinary joint collaboration in the history of the Democratic Republic of the Congo.With a population of more than 65 million persons, the Democratic Republic of the Congo is the fourth most populous nation in Africa and nineteenth most populous nation in the world. It is the second largest country in Africa and eleventh largest in the world, but a lack of infrastructure, including roads, makes travel throughout the country difficult.1 For much of the past two decades, this country has been torn by conflict. The Second Congo War left almost six million people dead in one of the most violent conflicts in the world and prompted security sector reform and professionalization of the military in the Democratic Republic of the Congo.2 Even today, conflicts continue in the eastern provinces of the country. 3As in all nascent states engaged in or recovering from conflict, access to healthcare had been limited throughout the Democratic Republic of the Congo in areas free from conflict, as well as those still engaged in it.3,4 These fragile states are often far from achieving health-related Millennium Development Goals, and improving health in these settings is a high priority. 5,6 This effort often requires a combination of relief and health system strengthening from governmental and nongovernmental partners. To direct relief in a timely and relevant manner, needs assessments must be performed before any decision to provide aid had been made. However, in these unstable states, needs assessments are often difficult to complete. 5Opportunities in the Democratic Republic of the Congo for assistance and collaborative engagement are plentiful, but because of difficulties inherent in performing these engagements, data and reports from such are sparse. In June 2013, we conducted a collaborative medical engagement (CME) type event outside the western town of Muanda. Muanda was chosen because, compared with Kinshasha or eastern Democratic Republic of the Congo, it provided a low risk/high yield opportunity because of ...