Burundi

Situation Report

Highlights

  • “Abandoning my home country and especially my family has left its mark on me”
  • Cholera outbreak in Burundi: "Fortunately, my family is cured"
  • WHO transfers six tonnes of medical material to Burundi
  • UNICEF leads efforts on Water, Sanitation and Hygiene to combat cholera
  • Burundi: Humanitarian Snapshot (October 2019)
Patients are cared for by MSF and public health staff in a treatment centre in Bujumbura © Evrard Ngendakumana. Burundi, November 2019
Patients are cared for by MSF and public health staff in a treatment centre in Bujumbura © Evrard Ngendakumana. Burundi, November 2019

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Burundi

Situation Report

Key Figures

1.77M
People in need (2019)
710K
People targeted (2019)
103K
People displaced (2019)
1.7M
Food insecure people

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Burundi

Situation Report

Funding

$106.3M
Required
$64.2M
Received
60%
Progress
FTS

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Contacts

Jutta Hinkkanen

Head of Office

Lauriane Wolfe

Public Information Officer

Annick Ndayiragije

Public Information Officer

Burundi

Situation Report
Background

“Abandoning my home country and especially my family has left its mark on me”

Since 2002, Burundi has generously hosted refugees from the Democratic Republic of Congo (DRC) and currently some 84,469 Congolese refugees reside in Burundi. Most of them have fled insecurity caused by clashes between non-state armed groups (known among the Congolese as the ‘Mai Mai’) in the North and South Kivu provinces. Of these, 36,528 are urban refugees, with the majority of them living in Bujumbura Mairie, particularly in the popular communes of Kamenge, Kinama and Buterere. The rest (57 per cent) are spread between five refugee camps in the north and eastern parts of the country.

In his thirties, married and a father of two children, Bernard* is one of them. In 2013, he fled from the DRC to Burundi to seek asylum.

Persecution and intimidation

In 2006, the Mai Mai began to force the Congolese youth to join their ranks to "fight rebels”. However, Bernard and many other young people opposed this idea. In 2010, Bernard and a group of activists began raising community awareness to encourage young people to continue their studies instead of joining armed groups. As a result, they were pursued by members of the Mai Mai.

Escape

Six years later, Bernard recalls his ordeal: "abandoning my home country and especially my family has left its mark on me". He fled his home and evaded the soldiers by taking refuge with his older sister for three months. However, eventually, he was caught and imprisoned twice. Bernard finally made the decision to escape the country to Burundi where a family friend hosted him. "He saved me", he explains.

Life in Burundi

After two months, his rescuer advised him to register with the United Nations Refugee Agency (UNHCR) and apply for asylum. "Today, I work as a teacher without much difficulty. Of course, a refugee's life is never easy, but you gradually adapt."

Today, Congolese refugees and asylum seekers continue to reside in Burundi, with the support of the Government of Burundi, through its National Office for the Protection of Refugees and Stateless Persons and the UNHCR. Together with the help of various humanitarian actors, the necessary protection and assistance services are provided to refugees that are essential to safeguard their rights and well-being.

However, under-funding and rising living costs continue to have a significant impact on refugees' and asylum seekers' access to quality basic services and their level of vulnerability. In 2020, an estimated $23,4 million will be needed to assist the refugee population in Burundi.

* Names and identifying details have been changed to protect the privacy of individuals.

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Burundi

Situation Report
Coordination
Daniel was admitted to the cholera treatment centre in Bujumbura. He was cured there. © Evrard Ngendakumana. Burundi, November 2019
Daniel was admitted to the cholera treatment centre in Bujumbura. He was cured there. © Evrard Ngendakumana. Burundi, November 2019

Cholera outbreak in Burundi: "Fortunately, my family is cured"

In June 2019, a cholera epidemic was declared in Burundi, with over 1,000 cases and 6 deaths recorded to date, mostly in Bujumbura Mairie, followed by Cibitoke in the North-West and Isale in eastern Bujumbura Rural. This is the first cholera outbreak of the year, with ten health districts affected in four provinces.

Extremely contagious, cholera is transmitted by the ingestion of bacteria of faecal origin present in dirty or stagnant water, causing diarrhoea and vomiting. Cholera triggers rapid dehydration and, without prompt treatment, can kill within hours.

"My two children became ill on Sunday and started having diarrhoea," says Sandrine, a patient at the MSF-supported cholera treatment centre in Bujumbura. "The first health centre to which I took them only diagnosed simple diarrhoea. But their condition was deteriorating rapidly, and they were brought here by ambulance. Two days later, my third child joined them there. I don't know how they all got sick. In the end, I also became ill and was admitted here.”

AN IMMEDIATE RESPONSE

Endemic throughout the strip along Lake Tanganyika and the Rusizi River, cholera affects an average of 200 to 250 people per year in Burundi. But every five to six years, the country experiences a peak in cases. For example, during the outbreak in 2013, 936 people contracted cholera in Bubanza and Cibitoke provinces, killing 17 people.

"This year, the epidemic was particularly rapid because it affected Bujumbura, the most densely populated city in the country," explains Julien Binet, MSF representative in Burundi. "Given the scale of the epidemic and the risks involved, we immediately worked with the authorities to support the treatment centres.”

MSF is the main humanitarian organization supporting the Ministry of Health and the Fight Against AIDS and local authorities in the care of cholera patients. This close collaboration has consisted of donated medical inputs, staff training, community awareness and, when necessary, the establishment of cholera treatment centres.

A NEW CENTRE IN BUJUMBURA

Today, MSF supports the three cholera treatment facilities in Burundi (in Bujumbura, Cibitoke, and Bubanza provinces). Its teams prioritise the supervision and training of national staff. The objective is to offer free patient care while building the capacity of public health staff. Faced with a disease closely linked to the lack of access to safe drinking water, MSF has also installed large capacity water tanks in Bujumbura, as well as in Rugombo and Ndava, in Cibitoke province.

The latest cholera treatment centre opened in early October in Bujumbura. Set up by MSF in two weeks, this 50-bed centre has become the city's principal treatment facility.

"My daughter arrived at the centre very weakened, with ringing in her ears, vomiting and diarrhoea," explains Chany, whose three-year-old daughter, Shemsu, left the centre several days ago. "Thanks to the care provided in the centre, it only took her a few days to get back on her feet.”

AWARENESS, A KEY ISSUE

Raising public awareness in Burundi is fundamental to combating the spread of the epidemic. Although challenges in water, sanitation, and hygiene remain, simple and effective measures can prevent contamination. MSF-supported community health workers continue to inform communities on preventative measures, how to recognize the first symptoms, and what to do if in doubt. "My whole family has caught cholera," says Zacharia, who left the Bujumbura treatment centre on 14 November, after a week of rehydration and care. "Fortunately, everyone returned home cured. Today, we know in the family that handwashing can save our lives. But everyone should know that"

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Burundi

Situation Report
Feature
 WHO transfers six tonnes of medical equipment to the Government of Burundi. WHO 2019
WHO transfers six tonnes of medical equipment to the Government of Burundi. WHO 2019

WHO transfers six tonnes of medical material to Burundi

The World Health Organization (WHO) has transferred six tonnes of medical equipment to the Government of Burundi to support its preparedness for and response to potential epidemics and health emergencies, including Ebola Virus Disease (EVD).

This donation was supported by the United States Agency for International Development, the Department of International Development of the Government of the United Kingdom and the United Nations Central Emergency Response Fund. This equipment will further help Burundi in its preparedness efforts against a potential EVD case.

Since the declaration of the tenth EVD outbreak in the Democratic Republic of Congo in August 2018, Burundi has proactively engaged in preparedness activities to ensure an effective response to a potential EVD outbreak. Divided into kits, this equipment will enhance health control surveillance at 15 border entry points as well as infection prevention and control in health centres and hospitals of the 21 priority districts. The equipment consists of:

• Individual protection kits including Tyvek suits and aprons • Furniture such as storage cabinets, beds and mattresses • Medical devices such as autoclaves for sterilizing medical equipment • Liquid soap for hand washing • Medication

In the same vein, WHO has just provided the Ministry of Health and the Fight Against AIDS with over 93,600 doses of Artemether-lumefantrine, now the first-line therapy for treating malaria, in its efforts to respond to the ongoing outbreak that began in May 2019. This support comes in addition to initiatives launched by the Ministry of Public Health and the Fight Against AIDS, such as intra-house spraying, distribution of long-lasting insecticide-treated mosquito nets (which will begin in December 2019) and raising awareness on prevention methods.

WHO has also deployed an expert support team to assess the magnitude of the outbreak and the factors that have sustained it since the start of 2019 with a view to recommending preventative and responsive measures. The mission, deployed in the most affected provinces, includes experts in entomology, monitoring and evaluation, case management and data management.

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Burundi

Situation Report
Coordination
 A water point installed by UNICEF in Cibitoke province. UNICEF 2019
A water point installed by UNICEF in Cibitoke province. UNICEF 2019

UNICEF leads efforts on Water, Sanitation and Hygiene to combat cholera

In partnership with the Burundian Red Cross, civil protection and the international NGO "WeWorldGVC", in coordination with Doctors Without Borders and the Ministry of Public Health and the Fights Against AIDS, UNICEF is leading Water, Sanitation, and Hygiene efforts to help combat the cholera epidemic and improve Burundi's preparedness for a potential EVD outbreak. This intervention focuses on access to water (by trucking), water quality control, household disinfection in all regions, distribution of hygiene kits, and hygiene promotion by training community leaders.

As a result, just over 200,000 people now have access to safe drinking water (through trucked water and household water treatment). A further 12,000 households have been disinfected; and over 90,000 people have been trained in essential hygiene practices and cholera prevention, including 2,450 schoolchildren in six primary schools and one secondary school.

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Burundi

Situation Report
Visual

Burundi: Humanitarian Snapshot (October 2019)

Burundi: Humanitarian Snapshot (October 2019)

View the pdf here - Burundi: Humanitarian Snapshot (October 2019)

Epidemics | Since the start of October there has been a marked uptick in the number of cholera cases with over 400 new cases compared to the 200 that were reported in September. This is the first cholera epidemic declared this year, and is affecting the northwest provinces of the country, although there were a handful of cases in January from the epidemic declared at the end of 2018. From 1 June to 1 November, a total of 1,050 cholera cases including 6 deaths were recorded. While in October the number of EVD cases in DRC declined, the Government of Burundi and its partners continue preparedness activities. Between August and October, 4,300 frontline healthcare workers, border and immigration officials in priority health districts were vaccinated against EVD. Advocacy is ongoing to acquire additional vaccines to cover all 6,000 frontline workers. Internally Displaced Persons | According to the latest DTM, the number of IDPs stands at 103,000, a 39 per cent reduction in comparison to July 2018. Repatriation | In October, 2,292 Burundians were voluntarily repatriated from Tanzania. The top three needs of returnees are 1) household items, 2) access to land, and 3) shelter. Refugees | According to UNHCR, there are currently 82,139 Congolese refugees in Burundi with an average 600 new refugees arriving every month. Natural Disasters | Recurrent climatic hazards exacerbate the vulnerability of Burundians. This year 18,000 people have been victims of natural disasters. These disasters account for 77 per cent of the 103,412 displaced people.

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