Mortality in the DRC

Summary of published research¹

IRC mortality survey team in transit

Since 2000, the International Rescue Committee (IRC) has documented the humanitarian impact of war and conflict in the Democratic Republic of the Congo (DRC) through a series of five mortality surveys. The first four studies, conducted 2000 - 2004, estimated that 3.9 million people had died since 1998, arguably making DRC the world's deadliest crisis since World War II. Less than 10% of all deaths were due to violence, with most attributed to easily preventable and treatable conditions such as malaria, diarrhoea, pneumonia and malnutrition. The fifth and latest survey covered the period from January 2006- April 2007. It used a three-stage cluster sampling technique to survey 14,000 households in 35 health zones across all 11 provinces, resulting in wider geographic coverage than any of the previous IRC surveys. The key findings and conclusions were as follows:

IRC survey team travelling by boat

More than four years after the signing of a formal peace agreement, the DRC's national crude mortality rate (CMR) of 2.2 deaths per 1,000 per month is 57% higher than the average rate for sub-Saharan Africa and is unchanged since the previous IRC survey in 2004. As with previous surveys, mortality rates are significantly higher in the volatile eastern provinces than in the west of the country. In addition, mortality rates have risen significantly in the centre of the DRC. Based on the results of the five IRC studies, an estimated 5.4 million excess deaths have occurred between August 1998 and April 2007. An estimated 2.1 million of those deaths have occurred since the formal end of war in 2002.

For the period covered by the survey, the only region to record a significant reduction in mortality since 2004 was that encompassing the five eastern provinces. This improvement coincided with a reduction in the risk of violent death, as well as a more robust United Nations (UN) peacekeeping effort by MONUC², the international force in the DRC. Nevertheless, the CMR in this region is still 2.6 deaths per 1,000 per month, a rate that is 85% higher than the sub-Saharan average.

Surveyor questions a woman during the DRC mortality survey

Only 0.4% of all deaths across the DRC were attributed directly to violence. As with previous IRC studies in the Congo, the majority of deaths were due to infectious diseases, malnutrition and neonatal- and pregnancy-related conditions. Increased rates of disease are probably related to the social and economic disturbances caused by conflict, including disruption of health services, poor food security, deterioration of infrastructure, and population displacement. Children, who are particularly susceptible to these easily preventable and treatable conditions, accounted for 47% of deaths, even though they constituted only 19% of the total population.

The persistent elevation of mortality more than four years after the official end of the 1998-2002 war provides further evidence that recovery from conflict can take many years, especially when superimposed on decades of political and socioeconomic decline. These data are consistent with those from other conflictimpacted states. Sustained and measurable improvements in key indicators, such as mortality, will require committed national and international engagement for many years.

¹Dr Coghlan. B et al (2007). Mortality in the DRC: an ongoing crisis. International Rescue Committee and Burnet Institute. Available from http://www.theirc.org/resources/2007/2006-7_congomortalitysurvey.pdf

²Mission des Nations Unies en République Démocratique du Congo.