The recent conflict in the Congo claimed the lives of over 4 million people, yet for one geo-political reason or another, failed to capture the world's attention.

The former conflict in the Democratic Republic of Congo was the most deadly since the Second World War, a study estimated, with nearly 4 million people having died as a result of the widespread violence and instability.

Most victims were felled by treatable illnesses like malaria, diarrhoea, pneumonia and malnutrition, according to the survey carried out by the International Rescue Committee (IRC), a non-profit organisation that helps refugees. War has raged in the DRC since 1998, during which time six foreign armies and 15 separate armed groups have fought.

The IRC conducted door-to-door surveys of 19,500 homes, mostly selected at random. They asked the heads of households how many residents of their homes had died between January 2003 and April 2004, and the cause.

The study revealed that there were approximately 2.1 deaths per 1000 people per month. This was considerably higher than the pre-war level of 1.2 per 1000, and 40% greater than the sub-Saharan regional average of 1.5 per thousand. The IRC estimates that during the six years covered by the study, some 3.9 million people had died above and beyond normal death rates.

It is the worst humanitarian crisis in the past 60 years, said Richard Brennan, the IRC’s health director. “In terms of absolute numbers,” he says, “there’s nothing that comes close.”

Widespread instability

Tragically, most of the deaths could easily have been prevented, the organisation stated. “The reason people are dying in east Congo is not because they are being cut down by machetes,” says Brennan. Rather, pervasive violence and instability prevented farmers from tilling their fields, markets from getting food to the hungry, and clinics from providing basic healthcare and vaccines, he says.

Their analysis suggests that without the violence, all-cause mortality would drop to close to normal levels. There are anecdotal examples of how this has happened in some places. In 2002, for example, the city of Kisangani-Ville was just emerging from a period of heavy fighting. The mortality rate at that time, according to an earlier IRC survey, was 6.2 per 1000 per month – and for children under 5, it was 10.4. In the most recent assessment, following the cessation of violence and the deployment of UN peacekeepers, those rates had dropped to 1.4 and 2.2, respectively.

But experts note that civilians in the DRC have received little aid – about $3.25 per person per year – compared to $130 per person in Iraq or in the tsunami-ravaged areas of Asia.

“Rich donor nations are miserably failing the people of the DRC, even though every few months the mortality equivalent of two south-east Asian tsunamis ploughs through its territory,” comments Evelyn Depoortere of Epicentre, a Paris-based charity that specialises in epidemiology.

Journal reference: The Lancet (vol 367, p 44)

This article was originally published by NewScientist.com news service.

1st October 2007