Will Work for Food

There's not a lot of commerce in the Democratic Republic of the Congo, with the result that there's not a lot of work. The majority of people are subsistence farmers, and in many parts of the country war prevents them from doing much farming, which in turn means they struggle to find sustenance.

The main industries (they are interrelated) in the D.R.C. are mineral extraction, aid and war, and aid organizations that operate in the D.R.C. are a significant source of employment, especially outside of the country's few major cities. Every morning outside the gates of aid organizations that are actually doing work (there appear to be quite a few that simply exist in as a signboard and a caretaker, having run out of operating funds or capable managers), local men assemble, hoping to be selected to work on projects that can't be handled by the organization's full-time staff.

I shot the above photographs in Bunia, in Ituri province, at the end of a long day that looked as though it was a lot longer for the man in front of the lens. Still, he put food on the table for his family.

Effectiveness of U.N. Peacekeeping in Eastern Congo

Excellent report from the Bureau for International Reporting (which I'd never heard of) on the effectiveness (or not) of United Nations peacekeepers (the largest U.N. peacekeeping operation in the world) in the eastern Congo.

New York Times story here: http://www.nytimes.com/2008/12/11/world/africa/11congo.html

And slideshow here: http://www.nytimes.com/slideshow/2008/12/11/world/20081211CONGO_index.html

Report from Human Rights Watch here: http://www.hrw.org/en/reports/2008/12/11/killings-kiwanja-0

Superb Congo Photos by Dominic Nahr

A friend sent me a link to a showcase of absolutely superb Congo photographs by a young snapper named Dominic Nahr. I'd seen a few of these shots before, but not most of them.

The slideshow is here: http://lens.blogs.nytimes.com/2009/09/01/showcase-43/ and Nahr's own website (links to stories bottom right) is here: http://dominicnahr.com/.

He says, on the New York Times Lens blog linked above, "Congo is a place where you need long-term projects," he said. "I’d love to work on different narratives, to get at the subtlety beyond just refugees and the war. Many stories stereotype Africa, but there’s so much more there."

Patch

When's the last time you patched a car tire? I'm willing to bet you've never patched a car tire. Neither have I. A couple of weeks ago I brought my car in to AUTOBACS and paid the guys there to install a couple of new tires on the front end of my Mitsubishi, and there was no discussion of patches or retreads. [I know, I know, and I never thought I'd be driving a Mitsubishi either, but when the truck division had that our-tires-fall-off-and-kill-primary-school-students-but-we'd-rather-cover-it-up-than-issue-a-recall scandal, I got a good deal. A very good deal. And of course, the car division is not the truck division.]

Things are a bit different in the Congo. In the above photographs you can see one of the drivers or mechanics (I'm not sure which category this guy falls into, but I suspect there's quite a lot of overlap) patching a tire (if you've ever patched a bicycle tire, you know how to do it). In the other photo, you can see a load of tires ready to be loaded onto an MSF plane headed for Kisangani and Goma.

If you need it, bring it with you. If it breaks fix it. And fix it again, and again, and again, until it can't be fixed no more (at which point, if it's a tire, it can be turned into sandals, or some other useful item).

Photographs of the Congo by Finbarr O'Reilly

Photojournalist Finbarr O'Reilly spent two years in the Democratic Republic of Congo and Rwanda from 2002-2004, and recently returned to update his coverage of the ongoing conflict there. He wrote something about his recent trip here: http://blogs.reuters.com/mediafile/category/africa-blog/; there's an audio slideshow here: http://www.reuterspix.com/congo/; and I've posted a few of his shots above. His website is here: http://www.finbarroreilly.com

The Risky Business of Making Babies

There’s no shortage of work in the Democratic Republic of Congo for pediatricians. The median age of the country’s 65 million population is around 16, and the population growth rate is 3.22% (population growth in Japan, Italy, Germany and Russia is negative; population growth in Liberia is 4.5%, Ireland 1.77%, India 1.46% and the United States 0.97%).

The DRC’s myriad health problems, however, mean life is especially tough (and risky) for the country’s children. While the infant mortality rate in the United States is 6.9 deaths per 1,000 live births (and the U.S. ranks an unimpressive 29th in infant mortality statistics; Singapore ranks first at 2.0; Hong Kong next at 2.5 and Japan third at 2.8), in the DRC 88.62 children of every 1,000 live births die before reaching their first birthdays.

In addition, about 510 women die per 100,000 births, and since the average Congolese woman gives birth to more than six children, baby making is risky business.

The children, if they survive their first year, can look forward to the very good possibility that at some point in the near future they’ll need medical attention for cholera, malaria, meningitis, tuberculosis or that old Congolese standby, malnutrition.

I shot these photos in the MSF hospital in Bunia, in Ituri province, accompanying Dr. Dede Sapo Mudinga on his rounds. Bunia is quiet now, but has seen more than its share of killing during the past 10 years, and is now the base of operations for a significant United Nations peacekeeping force.

How Would You Spend $8 Billion?

I've written previously about malnutrition [http://notes-from-the-congo.blogspot.com/2009/08/let-them-eat-cake.html], but decided to revisit the subject after feeling a bit hungry before lunchtime.

Hunger and malnutrition are not the same thing, of course. Hunger is what I felt before eating a big bowl of cold soba for lunch, and the word can also be applied to describe people who consume fewer than 2,100 calories a day; malnutrition is not merely the consumption of too little food. It is a pathology caused principally by a lack of essential nutrients.

As I've written elsewhere, children (especially under two years old) are the most easily affected by inadequate diets, and when children suffer from acute malnutrition, their immune systems are so impaired that the risks of mortality are greatly increased. Malnutrition is identified in three ways: by weight for height, by measurement of mid-upper arm circumference, or by the presence of edema (bloated feet and/or face).

The fourth and fifth photographs above show feeding schedules for malnourished children. MSF provides patients with a ready-to-use food (RUF) called Plumpy Nut (third photo), the amount of which is prescribed according to the child's weight. The advantages of Plumpy Nut and other RUFs are that they deliver a lot of calories in a small package, contain the full range of nutrients needed by growing children, and come in individual packages, making them easy for children to consume (and making it easier to ensure that the malnourished children – rather than other family members – are the ones consuming them).

The World Health Organization estimates there are 178 million malnourished children around the world. In a 2006 publication, "Ending Child Hunger and Malnutrition Initiative", the World Food Program and UNICEF estimated the cost of effectively addressing malnutrition at $80/family, or $8 billion for 100 million families. On June 16, 2009, the U.S. House of Representatives approved the expenditure of $7.65 billion to respond to the swine flu pandemic, which to date has killed fewer than 3,000 people worldwide.