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From page 52... ... 52 INTRODUCTION The civil war and the genocide that occurred in Rwanda between April and July 1994 killed an estimated 500,000 to 800,000 people. As a consequence, approximately 1 million Rwandans were internally displaced and 1.2 to 1.5 million fled to neighboring countries. Read the entire page →
From page 53... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 53 In spite of this spectacular action, the situation remained unchanged in the camps until the emergence of the Alliance des Forces Démocratiques de Libération du Congo-Zaire (AFDL) movement in September 1996 in South Kivu. Read the entire page →
From page 54... ... 54 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE Methods Surveillance System From the first days of the intervention of the international agencies, emphasis was put on mortality and morbidity data collection. As the ground where most refugees settled was hard volcanic rock, the digging of graves was almost impossible, and dead bodies were left along the roads and tracks or in public places. Read the entire page →
From page 55... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 55 delivered during a mass vaccination campaign against meningitis, and from the vaccine coverage evaluated during a subsequent vaccine coverage survey. Retrospective Mortality Surveys Population retrospective mortality surveys were conducted in Katale, Kibumba, and Mugunga camps from August 4 to August 14, 1994. Read the entire page →
From page 56... ... 56 T A B L E 2 -1 C om pa ri so n of C ru d e M or ta lit y R at e E st im at es D er iv ed f ro m D ea d B od y C ou nt a nd f ro m P op u la ti on S u rv ey s, G om a to Z ai re , J u ly A u gu st 1 99 4 P er ce nt ag e of P op u la ti on Su rv ey P er io d E st im at ed C ru d e M or ta lit y R at e D yi ng D u ri ng t he P er io d Su rv ey o r C ou nt (J u ly 1 4 to ) Read the entire page →
From page 57... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 57 Surveillance and survey data were consistent. Depending on population estimates, 6 to 10 percent of the refugees who arrived in Goma between July 14 and July 18, 1994 died within a month after their arrival. Read the entire page →
From page 58... ... 58 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE ment, and killings, and were denied adequate protection and assistance. In mid-December 1996, groups of refugees who had been forced out of the camps in Eastern Zaire and had since been missing, resurfaced at Tingi Tingi, Shabunda, and Amisi camps, in Maniéma province, where they received assistance until those camps were also attacked on February 28, 1997. Read the entire page →
From page 59... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 59 MORTALITY IN THE CAMPS ALONG THE UBUNDU-KISANGANI RAILWAY By the end of February 1997, the AFDL forces reached Tingi Tingi, and most of the refugees fled to the west, in the direction of Ubundu and Kisangani. In late March 1997, the first groups of refugees reached Ubundu, 100 kilometers south of Kisangani. Read the entire page →
From page 60... ... 60 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE tion made the living conditions in the camps particularly difficult, and, as expected in those conditions, the estimated mortality rates were extremely high. By mid-April, 1,581 deaths had been officially registered since the beginning of the month (the CMR was 11.6 to 12.4 per 10,000 per day) Read the entire page →
From page 61... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 61 while in Kivu with their age and sex, the date of departure from the camp in Kivu, the names of the places where the family stopped for at least several days and, for each of those places, the members of the family present and the events explaining the absence of the other members. The following events were documented: death (by illness, accident or murder) Read the entire page →
From page 62... ... 62 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE But this was also the case in the entire population of Ndjoundou (Table 2-2) , and in the initial group reconstituted from the information collected during the survey (Figure 2-6) Read the entire page →
From page 63... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 63 The trip of the refugees through Zaire was reconstituted from the interviews. Each family had its own itinerary, but four gathering places were clearly identified: Shanje (for the refugees coming from the Bukavu area) Read the entire page →
From page 64... ... 64 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE TABLE 2-3 Distribution of the Events Occurring Among Rwandan Refugees During Their Flight from Kivu to Congo-Brazzaville, Ndjoundou, Congo-Brazzaville, July 1997 95 Percent Confidence Events N Percentage Interval Event Explaining the Absence: Disappearance 1857 59.5 57.8-61.2 Death: Murder 615 19.7 18.3-21.1 Illness 24 0.8 0.5-1.1 Accident 12 0.4 0.2-0.7 Spontaneous Return 33 1.0 0.7-1.5 Repatriation 34 1.1 0.8-1.5 Present: Present in Ndjoundou 530 17.0 15.7-18.3 Present in Another Camp 16 0.5 0.3-0.8 Total 3121 100.0 N/A xx TABLE 2-4 Proportion of the Refugee Population Killed or Disappeared by Place, Ndjoundou, Congo-Brazzaville, July 1997 Killed Disappeared 95 Percent 95 Percent Confidence Confidence Place Population N Percent Interval N Percent Interval Mugunga 211 33 15.6 11.2–21.0 57 27.0 21.3–33.3 Sake 447 55 12.3 9.5–15.6 136 30.4 26.3–34.8 Shanje 1597 84 5.3 4.2–6.4 512 32.1 29.8–34.4 Walikale 686 38 5.5 4.0–7.4 28 4.1 2.8–5.8 Tingi-Tingi 1557 43 2.8 2.0–3.7 104 6.7 5.5–8.0 Ubundu 1336 17 1.3 0.8–2.0 207 15.5 13.6–17.5 Obiro 665 46 6.9 5.2–9.0 136 20.5 17.5–23.6 Ikela 397 4 1.0 0.3–2.4 22 5.5 3.6–8.1 Boende 224 32 14.3 10.2–9.3 25 11.2 7.5–15.8 Ingende 209 0 0.0 N/A 2 1.0 0.2–3.1 Wenji 954 130 13.6 11.6–15.9 288 30.2 27.3–33.2 Unknown 133 340 Total 615 1857 xx Read the entire page →
From page 65... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 65 0 20 40 60 80 100 10 /1 12 /1 1/1 2/1 3/1 4/1 6/15/1 7/111 /1 Attack of the camps in Kivu Attack in Ubundu and Obiro Attack in Wenji 1996 1997 Pe rc en t o f t he p op ul at io n re m ai ni ng Sep Oct Nov Dec Jan Feb Mar April May 0 25 50 75 100 125 150 R at e pe r 1 0, 00 0 pe r d ay Crude < 5 1996 1997 FIGURE 2-8 Average crude and under-five daily mortality rates per month, Rwandan refugees, Ndjoundou, Congo-Brazzaville, July 1997. FIGURE 2-7 Evolution of the size of the reconstituted group of refugees from Kivu over time, Ndjoundou, Congo-Brazzaville, July 1997. Read the entire page →
From page 66... ... 66 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE DISCUSSION Mortality rates are the most useful health indicators for assessing the seriousness of emergency situations. Two methods are recommended for measuring mortality in a refugee population (both were used for the Rwandan refugees in Zaire) Read the entire page →
From page 67... ... DOMINIQUE LEGROS, CHRISTOPHE PAQUET, AND PIERRE NABETH 67 might not be representative of the overall situation. Short recall period also allows fewer events (deaths) Read the entire page →
From page 68... ... 68 MORTALITY AMONG RWANDAN REFUGEES IN ZAIRE To our knowledge, the retrospective mortality survey conducted in Ndjoundou camp in Congo-Brazzaville was the first of this type in a refugee setting. Since then, the same method has been used to document the exodus of Kosovar refugees in Albania and Montenegro in 1999 (Brown et al., 2000; Physicians for Human Rights, 1999) Read the entire page →

From page 52...

... 52 INTRODUCTION The civil war and the genocide that occurred in Rwanda between April and July 1994 killed an estimated 500,000 to 800,000 people. As a consequence, approximately 1 million Rwandans were internally displaced and 1.2 to 1.5 million fled to neighboring countries.