Bringing Basic Health Services to DR Congo: Project AXxes

The condition of life in the Democratic Republic of Congo is among the most fraught in the world, especially for those living in the eastern part of the country bordering Rwanda, Burundi and Uganda.  Roving rebel militias throughout much of the area guarantee insecurity; people must move constantly to avoid attacks.  Sometimes water and basic food resources are non-existent or very limited.  Women have been made special targets of gender-based violence by military and gangs of non-military alike, which include the some of the highest incidence of rape ever recorded. 

For many living in the Congolese hinterland, basic health services are difficult to access; for those in these intermittently conflicted regions, constant movement to avoid militia contact means that many children are not vaccinated and normally avoidable maternal and child morbidity is an ever-present specter. 

Into this difficult situation stepped IMA World Health in 2006 as lead of a USAID-supported multi-agency consortium tasked with providing basic health services.  From 2001 to 2006 IMA had rolled out the successful SANRU III (rural health) project and was seen by the US and Congolese governments as ideally placed to carry on the work of health provision in eastern Congo. 

Project AXxes provides health care to more than eight million people, primarily women and children, in 57 health districts in the ‘post-conflict’ areas of the east.  Many hundreds of thousands of people who would not have accessed any health care at all have benefited from the AXxes work.  Without the long-term collaboration with the Protestant Church of Congo (ECC), this remarkable health delivery system would not have been possible; the headquarters of the ECC in Kinshasa also serves as the project HQ and seconded staff from the ECC has been leaders in AXxes, and SANRU III, from its inception.   

Total funding of $60 million has been allocated over the course of the past four years and the project has been implemented by the IMA-led consortium which includes ECC, World Vision, and Catholic Relief Services.  Management of a disparate group of independent and expert organizations is not an easy task, but the imperative towards unity and consensus is strong with regard to eastern Congo.  Debate and dialogue are always followed by concrete solutions, knowing that the health of a very vulnerable population is at stake. 

Project AXxes provides primary health services, such as safe delivery of babies, vaccinations for children and pregnant women, and diagnosis and treat­ment of disease, including life-threatening diarrhea, HIV, and tuberculosis. 

Women traumatized by gang-rape and other gender-based abuses are of special concern to the project and both counseling and surgery are available in participating health facilities, and community outreach activities include women’s rights advocacy.

In the past year more than 230,000 women were attended in childbirth (women who without this help would most likely have given birth alone or with an untrained relative); more than 365,000 children received treatment for pneumonia; and 180,000 insecti­cide-treated bed nets were distrib­uted to combat malaria and other mosquito-borne diseases.

Training is as essential as health service delivery because it builds long-term and sustainable technical capacity among local health care workers.  In the past year Project AXxes has provided training in many different subjects to more than 7,100 doctors and nurses.