Geographies of Abandoned Spaceports

The relevance of this research stems from the ongoing problem of peaceful transition of power in the Democratic Republic of the Congo (DRC), which negatively impacts the country's socio-political development. The object of this research is the peaceful transition of power in the DRC. The subject of this research is the specific features of the process of peaceful transfer of power in the DRC at the present stage. The goal of this research is to identify the factors influencing the implementation of a peaceful transition of power in the DRC. Particular attention is paid to solving such problems as identifying the factors that contributed to the successful process of the first peaceful transfer of power in the DRC, presenting the FCC-CACH coalition as a manifestation of the unfinished transition of power, determining the role of external forces in the issue of peaceful transition of power in the DRC, and assessing the prospects of maintaining F. Tshisekedi in power after 2028. The research methods used were historical and comparative to compare the existing conditions for the implementation of the peaceful transition of power in the DRC from 1990 to 2021, event analysis for a detailed study of the actions of political actors who facilitated or hindered the process under study, and content analysis for a detailed examination of Congolese legislative texts. The scientific novelty of the study lies in identifying specific features that facilitate and hinder the process of peaceful transition of power in the DRC, based on an analysis of the intra-Congolese historical experience of power transfer and the influence of the international community on this process, as well as in forecasting the possible nature of the transition of power in the DRC in the future. The author concludes that in the history of the DRC, a genuine peaceful transition of power only occurred in 2019, but it was incomplete. Some of the main problems impeding a peaceful transition of power in the DRC are, firstly, the lack of desire on the part of the Congolese authorities to facilitate the transfer of their responsibilities, secondly, the disunity of the Congolese opposition, and thirdly, the presence of major conflicts within the DRC. The international community also plays a significant role in this issue. The possibility of a peaceful transition of power after 2028 appears realistic only if the international community opposes F. Tshisekedi's constitutional reform.

Between Rhetoric and Action: The Politics, Processes and Practice of the ICC's Work in the Democratic Republic of the Congo (DRC)

The Ebola virus disease (EVD) epidemics analysis from the Democratic Republic of the Congo (DRC) and West Africa showed an increased frequency in the intervals between outbreaks and the unpreparedness of the local health system including the community in the response thereto. This study describes the level of DRC community preparedness for EVD and other epidemics in order to judge its potential involvement in epidemiological surveillance at the Health Zone (HZ) level. A secondary analysis was conducted on the data collected during the evaluation of the DRC epidemiological surveillance system, carried out from December 2015 to May 2016 in 32 HZs of the 16 provinces at risk of EVD. Data were collected using semi-structured interview with leaders of the Health Area Development Committees (HADC), village chiefs as well as by focus group with the women of the community. Those respondents were sampled through a purposive sampling strategy. Community preparedness was explored in terms of community organization, knowledge of epidemiological surveillance, and knowledge of EVD. Data were transcribed verbatim in French and analysed using thematic analysis. Some results were tabulated and summarized as proportion. A total of 72 communities were studied. The study showed that the community participates in epidemiological surveillance through the HADCs. The HADC members and community health workers (CHWs) conduct case searches in the community and case referrals to the health centres. The majority of CHWs and community members were unknowledgeable of epidemiological surveillance and very few had received training for epidemic prone diseases. Few knew how to actually describe the steps of a case search. The study also noted that the level of knowledge of the population on EVD in the communities visited was not optimal with a lot of erroneous data and a perception that could be harmful for epidemiological surveillance and outbreak response. The study showed that the population as a whole claimed to participate in epidemiological surveillance only through sensitization and the passing on of information. These study results show that the community at the local level in the DRC is not optimally prepared for EVD and other epidemics. These results suggest a strengthening of community preparedness in the DRC more extensively for diseases with epidemic potential through sensitization and social mobilization, in particular by strengthening the capacity of the teams of health centres, health committees and CHWs in terms of training, technical guides and simple prevention materials.

The Reducing Enteropathy, Undernutrition, and Contamination in the Environment (REDUCE) program focuses on identifying exposure pathways to faecal pathogens for young children in the Democratic Republic of the Congo (DRC) and on developing scalable interventions to reduce faecal contamination from these pathways. A prospective cohort study of 690 participants was conducted to investigate the association between hand, food, and environmental faecal contamination and diarrhoeal disease prevalence among young children in Walungu Territory, South Kivu, DRC. A total of 1923 hand rinse, soil, food, object, surface, stored water and water source samples were collected during unannounced spot checks after baseline enrolment and analysed for Escherichia coli. Caregiver reports of diarrhoea were obtained from children<5years at a 6-month follow-up. E.coli was detected in 73% of child and caregiver hand-rinse samples, 69% of soil samples from child play spaces, 54% of child food samples, 38% of objects and surfaces children were observed putting in their mouths, 74% of stored water samples, and 40% of source water samples. Children<5years with E. coli on their hands had significantly higher odds of diarrhoea at the 6-month follow-up (odds ratio: 2.03 (95% confidence interval: 1.05, 3.92)). The cohort study findings from the REDUCE program have shown that child hand contamination is associated with diarrhoeal disease in rural DRC, and that there is high faecal contamination in child plays spaces and food. These findings provide evidence demonstrating the urgent need to provide clean play spaces for young children and interventions targeting hand hygiene to reduce paediatric exposure to faecal pathogens.

PG-2 Evidence of increased HIV cases in greater Kinshasa urban health zones: Democratic Republic of Congo (2017–2018)

The subject of the study is the operations of the United Nations in maintaining peace. The focus is on the relationship between Russia and the Democratic Republic of the Congo (DRC). The article discusses how the Russian Federation can assist the UN Organization Stabilization Mission in the DRC (MONUSCO) in fulfilling its peacekeeping role in the DRC, which is located in the Great Lakes region. Its aim is to analyze the changing role, motivations, and potential impact of Russia's involvement in UN peacekeeping activities in the DRC. The report examines how the renewal of Russia's strategic engagement with the DRC may affect the operational effectiveness of MONUSCO's peacekeeping efforts. The theories used are postcolonialism, which analyzes the rhetoric of anti-colonialism and realism, explaining the motivations of both sides in their pursuit of power and resources. The methodology is qualitative and interpretative. Interviews were conducted with 2 African diplomats, 3 Congolese and 2 Russian analysts. Research articles and media sources were analyzed. Thematic analysis was used; identifying, analyzing, and reporting patterns in data sets. Discourse analysis was also employed; examining the influence of language on power and the perception of relations. Limitations include objective data on human rights violations and triangulation of data sources. Findings: Russia has had a significant impact on modern African thinking, which values mutually beneficial relationships, leading to the emergence of "Nkrumahists." Tangible benefits include annual exchanges in culture, technology, military-technical agreements, and diplomatic support. The conclusions suggest that mutually beneficial and symbiotic relationships between Russia and the DRC are fundamental to lasting peace in the DRC. The study reveals both positive and negative perceptions of Russia in its peacekeeping endeavors. Geopolitical rivalry and operational risks contradicted the Russian experience in counter-terrorism and intelligence sharing. Recommendations include active media coverage to combat negative perceptions, enhancing the capabilities of DRC forces, and intelligence sharing. The UN is preparing a Framework Programme to guide Russian involvement. The scientific novelty lies in the presentation of a paradigmatic case of a hybrid intervention model in the 21st century, combining old-world realpolitik with corporate business models and hybrid peacekeeping tactics. The Russian peacekeeping presence in the DRC is necessary, as the UN has not provided it. The beneficiaries of the research are the UN, Russia, and the DRC.

Malaria remains a major global public health problem causing over 400,000 deaths annually, mainly among children in sub Saharan Africa. The Democratic Republic of Congo (DRC), the second largest and the fourth most populated country in Africa, is one of the most malarious countries in the world. An estimated 97% of its 71 million inhabitants live in high transmission areas. Together with Nigeria, DRC accounts for about 40% of the total estimated malaria cases worldwide, and for more than 35% of the total estimated malaria deaths. The national malaria control programme (NMCP) is committed to reducing malaria and the associated morbidity and mortality in DRC through the implementation of specific proven interventions. The aim of this thesis was to contribute to the improvement of malaria control activities in the DRC, through the provision of new evidence on the epidemiology of malaria and key control interventions, to support evidence-based policy making.&#13;\nKinshasa, the capital of DRC, has been expanding very rapidly in the past 20 years (going from an estimated 3 million inhabitants to a current estimate of 10 million) and available evidence has shown that urbanization had a significant impact on the ecosystems and disease patterns, including malaria. However, in the context of scaling up of interventions, data on malaria distribution in Kinshasa are scarce; the latest epidemiological study was conducted in 2000. We conducted two cross-sectional surveys to update malaria risk stratification in Kinshasa, identify factors contributing to the distribution patterns, and update information on malaria control activities. Geo-referenced data for key parameters were mapped at the level of the health area (HA) by means of a geographic information system (GIS). The overall standardized malaria prevalence was 11.7%, showing a decline compared to previous studies. The spatial distribution showed higher malaria risk in the peri-urban areas compared to the more urban central areas. Compared to the Demographic and Health Survey 2007 (DHS-DRC, 2007), coverage of malaria control measures showed considerable progresses in a pattern inversely proportional to the malaria risk distribution: low LLIN coverage in the peri-urban areas and higher coverage in the centre of the city. The analysis of drivers of malaria in both children less than five years and individuals aged older than five years highlighted the variation of the effect of age and reported history of fever by level of endemicity. In low endemicity strata, a shift in the peak of malaria prevalence towards the older age groups was observed, while the history of fever in the last two weeks increased the risk of malaria in all age groups and regardless of the level of endemicity. Individual use of LLIN was associated with reduced risk malaria infection among children less than five years. The risk of malaria was lower among children less than five years of the wealthiest socio economic group. This risk map constitutes a strong basis for the planning of malaria control interventions in Kinshasa.&#13;\nFollowing the publication of the results of two large open-label randomized controlled trials (SEAQUAMAT, AQUAMAT) that demonstrated the benefits of injectable artesunate over quinine in the treatment of severe malaria, and in line with the updated WHO guidelines, the NMCP changed the policy for treating severe malaria in children and adults from injectable quinine to injectable artesunate in 2012 A transition period of 3 years was set, including the need for operational research to support the national deployment. We conducted an operational comparative study of quinine and injectable artesunate for the treatment of severe malaria (MATIAS study) with the aims of assessing the operational feasibility of this introduction, providing national cost estimates, and assessing the acceptability of the new drug among both health care providers and patients. Our findings showed that all the operational parameters measured (time to discharge, interval between admission and the start of intravenous treatment, personnel time spent on patient management, and parasite clearance time) were equal or in favour of injectable artesunate. The mean total cost per patient treated for severe malaria in hospitals and health centres was also lower with injectable artesunate. There was a high acceptability by both health care providers and patients. These findings support the rapid scale up of injectable artesunate in the country. &#13;\nMass distribution campaigns of LLIN are accepted as the best approach to rapidly increase coverage and use. To promote correct and consistent use of distributed LLIN, the WHO recommends the integration of door-to-door visits with “hang up” activities into mass distribution campaigns. Integrating hang-up activities requires obviously additional human and financial resources. Since published data on the effects and cost of door-to-door visits with hang up activities on LLIN use are scarce, more evidence is still required to optimize the efficiency of national LLIN programmes. We used a LLIN mass distribution campaign in the province of Kasai Occidental that used two different approaches, a fixed delivery strategy and a door-to-door strategy including hang-up activities, to evaluate comparatively household LLIN ownership, access and individual use, and examine factors associated with LLIN use. We also compared the two delivery strategies with regard to the LLIN coverage achieved and the cost of implementation. Results showed that the mass distribution campaign was effective at achieving high LLIN ownership and use. Having sufficient numbers of LLIN to cover all residents in the household was the strongest determinant of LLIN use. Compared with the door-to-door strategy, the fixed delivery strategy achieved a higher LLIN coverage at lower delivery cost, and seems to be a better LLIN delivery option in the context of DRC. &#13;\nInformation on the number and distribution of malaria cases and deaths is fundamental for the design, implementation and evaluation of malaria control programmes. In many endemic areas, health facility-based data remain the only consistent and readily available source of information on malaria. Because of known inherent limitations, this source of date can underestimate the total burden of disease by a considerable fraction. In DRC, the use of rapid diagnostic tests has been expanded since 2010, leading to a marked increase in suspected malaria cases receiving a diagnostic test. Together with other management measures, this should improve the quality of the incidence rates obtained through the Health Monitoring Information System (HMIS). Based on household survey data, the Malaria Atlas Project (MAP) of the University of Oxford has produced estimates of clinical incidence of malaria for the years 2000-2015 for all African countries, providing something like a reference value on incidence rates. We compared the malaria incidence rates obtained from the HMIS data in the DRC from 2010 to 2014 to the MAP modelled incidence rates for the same time period, in order to assess the relative reporting of the HMIS system. Our preliminary results showed that due to the expansion of parasitological diagnosis, the number of confirmed malaria cases reported and hence the fraction of incident cases captured by the HMIS data had increased substantially over time. By contrast, the number of incident malaria cases predicted by the MAP model had progressively decreased. Because of inconsistencies in reporting, it has been difficult to establish trends in malaria morbidity, but the unchanged high values of test positivity rates suggest malaria transmission remains high and stable over time.&#13;\n

This article sets the reasons for the brutal violence against women. It focuses on three field sites providing insight into Mai-Mai motivations and their attitudes toward sexual violence. According to most sources, 5.5 million people have died since the beginning of the war in the Democratic Republic of the Congo (DRC) in 1994, and rape is used as a weapon of destruction. More than 15,000 rapes were reported in the DRC in the last year--accounts of these rapes include descriptions of horrific acts, such as mutilation and the killing of unborn children. The sexual violence is so severe in the DRC that some have described rape in the country as the worst in the world. Sexual violence has long lasting consequences and far-reaching impacts on individual survivors, their families, and their communities in the Democratic Republic of the Congo.

Several developing countries, including the Democratic Republic of the Congo have adopted HIV NET 012, i.e. a single dose of nevirapine to mother (200 mg at labour onset) and baby (2 mg/kg within 72 h of birth), because of the accessible cost of nevirapine and its supposedly easy use in MTCTP programs [2]. The protocol can nonetheless prove complex to apply in rural regions of Africa and must be evaluated. This article aims to present the difficulties encountered in implementation of this protocol at the Oicha General Reference Hospital, in the northeastern region of the Democratic Republic of the Congo. The study took place time from December 2002 through December 2004. During the study period, 94 women were identified as HIV positive at the prenatal clinic of Oicha Hospital. Of the 94 HIV positive women: 59 (62.8%) received antiretroviral prophylaxis and 35 (37.2%) did not receive nevirapine despite their identification at the prenatal clinic. Among these 35 women, 26 (27.7%) of the expected women arrived fully dilated and thus went directly to the delivery room. Nine (9.5%) of the expected women who delivered at the Oicha maternity were not administered the product by the midwives. For administration of nevirapine to the mother: 33 pregnant women out of 59 (55.9%) received nevirapine within the time recommended - within two hours of the onset of contractions. Twenty four of 59 women (40.7%) did not receive the nevirapine within the time recommended, but within an average delay of 11.00 hours. For 2 of 59 women (3.4%), the hour of administration of the nevirapine was not specified. For administration of nevirapine to the child: 48 of 101 children (47.5%) received nevirapine within the recommended period, i.e. in the 24-72 hours after birth. 52 of 101 children (51.5%) received the nevirapine in an average of 2.9 hours of birth. This is the proportion of the children whose mothers arrived at the maternity ward ready for delivery. Only 1 child (1%) received the nevirapine later than the recommended period, 13.9 hours later. Applying as simple a protocol as the HIV prophylaxis program with nevirapine in African rural areas encounters difficulties.

Striking Iron: The Art of African Blacksmiths

In the Democratic Republic of the Congo (DRC), the prevalence of mental health issues could be greater than in other low-income and middle-income countries because of major risk factors related to armed conflicts and poverty. Given that mental health is an essential component of health, it is surprising that no systematic evaluation of mental health in the DRC has yet been undertaken. This study aims to undertake the first systematic review of mental health literacy and service provision in the DRC, to bridge this gap and inform those who need to develop an evidence base. This could support policymakers in tackling the issues related to limited mental health systems and service provision in DRC. Following Cochrane and PRISMA guidelines, a systematic (Web of Science, Medline, Public Health, PsycINFO, and Google Scholar) search was conducted (January 2000 and August 2023). Combinations of key blocks of terms were used in the search such as DRC, war zone, mental health, post-traumatic stress disorder (PTSD), anxiety, depression, sexual violence, war trauma, resilience, mental health systems and service provision. We followed additional sources from reference lists of included studies. Screening was completed in two stages: title and abstract search, and full-text screening for relevance and quality. Overall, 50 studies were included in the review; the majority of studies (n = 31) were conducted in the Eastern region of the DRC, a region devastated by war and sexual violence. Different instruments were used to measure participants’ mental health such as the Hopkins Symptoms Checklist (HSCL-25), The Harvard Trauma Questionnaire, Patient Health Questionnaire (PHQ-9); General Anxiety Disorder (GAD-7), and Positive and Negative Symptoms Scale (PANSS). Our study found that wartime sexual violence and extreme poverty are highly traumatic, and cause multiple, long-term mental health difficulties. We found that depression, anxiety, and PTSD were the most common problems in the DRC. Psychosocial interventions such as group therapy, family support, and socio-economic support were effective in reducing anxiety, depression, and PTSD symptoms. This systematic review calls attention to the need to support sexual violence survivors and many other Congolese people affected by traumatic events. This review also highlights the need for validating culturally appropriate measures, and the need for well-designed controlled intervention studies in low-income settings such as the DRC. Better public mental health systems and service provision could help to improve community cohesion, human resilience, and mental wellbeing. There is also an urgent need to address wider social issues such as poverty, stigma, and gender inequality in the DRC.

The Kivu Ebola epidemic began on 1 August 2018, when four cases of Ebola virus disease (EVD) were confirmed in the eastern region of Kivu in the Democratic Republic of the Congo (DRC). The disease affected the DRC, Uganda, and is suspected to have also affected Tanzania, though the Ministry of Health there never shared information with the WHO. The outbreak was declared ended on 25 June 2020, with a total of 3,470 cases and 2,280 deaths. Other locations in the DRC affected included the Ituri Province, where the first case was confirmed on 13 August 2018. In November 2018, it became the biggest Ebola outbreak in the DRC's history, and by November, it had become the second-largest Ebola outbreak in recorded history, behind only the 2013–2016 Western Africa epidemic. On 3 May 2019, 9 months into the outbreak, the DRC death toll surpassed 1,000. In June 2019, the virus reached Uganda, having infected a 5-year-old Congolese boy who entered with his family, but this was contained. Since January 2015, the affected province and general area have been experiencing a military conflict, which hindered treatment and prevention efforts. The World Health Organization (WHO) has described the combination of military conflict and civilian distress as a potential "perfect storm" that could lead to a rapid worsening of the situation. In May 2019, the WHO reported that, since January of that year, there had been 42 attacks on health facilities and 85 health workers had been wounded or killed. In some areas, aid organizations have had to stop their work due to violence. Health workers also had to deal with misinformation spread by opposing politicians. Due to the deteriorating security situation in North Kivu and surrounding areas, the WHO raised the risk assessment at the national and regional level from "high" to "very high" in September 2018. In October, the United Nations Security Council stressed that all armed hostility in the DRC should come to a stop to address the ongoing outbreak better. A confirmed case in Goma triggered the decision by the WHO to convene an emergency committee for the fourth time, and on 17 July 2019, the WHO announced a Public Health Emergency of International Concern (PHEIC), the highest level of alarm the WHO can sound. On 15 September 2019, some slowdown of cases was noted in the DRC. However, contact tracing continued to be less than 100%; at the time, it was at 89%. In mid-October the transmission of the virus had significantly reduced; by then it was confined to the Mandima region near where the outbreak began, and was only affecting 27 health zones in the DRC (down from a peak of 207). New cases decreased to zero by 17 February 2020, but after 52 days without a case, surveillance and response teams confirmed three new cases in mid-April. As a new and separate outbreak, was reported on 1 June 2020 in Équateur Province in north-western DRC, described as the eleventh Ebola outbreak since records began; after almost two years the tenth outbreak was declared ended on 25 June 2020, with a total of 3,470 cases and 2,280 deaths.

Despite a generally valiant effort on the part of the United Nations (UN) since 1999 to bring peace and stability to the Democratic Republic of the Congo (DRC), the country continues to be destabilised by rebel forces. These armed movements pose a constant threat to the fragile transition in the DRC, and security in the country is continuously undermined. This article examines rebel forces in the DRC from two perspectives. Firstly, it examines such movements as a manifestation of sub-national terrorism. Secondly, it examines armed movements from the perspective of so-called ‘ungoverned spaces’. The view taken in this article supports the scholarly insight and argument that in countries such as the DRC, armed movements and militias are filling power vacuums that are the result of the inability and lack of military capacity of weak states to fight these movements effectively. Specifically, the eastern and north-eastern parts of the DRC have been major conflict zones where sub-national terrorists employ terror as a strategy. In this context, the DRC is severely affected by terrorism – a phenomenon in the DRC that is intimately linked to the failure to effect sustained development and to consolidate accountable and effective governance.

The Kivu Ebola epidemic[note 1] began on 1 August 2018, when four cases of Ebola virus disease (EVD) were confirmed in the eastern region of Kivu in the Democratic Republic of the Congo (DRC).[2][3][4] The disease affected the DRC, Uganda, and is suspected to have also affected Tanzania, though the Ministry of Health there never shared information with the WHO.[5] The outbreak was declared ended on 25 June 2020, with a total of 3,470 cases and 2,280 deaths.[6][7] Other locations in the DRC affected included the Ituri Province, where the first case was confirmed on 13 August 2018.[1] In November 2018, it became the biggest Ebola outbreak in the DRC's history,[8][9][10] and by November, it had become the second-largest Ebola outbreak in recorded history,[11][12] behind only the 2013–2016 Western Africa epidemic. On 3 May 2019, 9 months into the outbreak, the DRC death toll surpassed 1,000.[13][14] In June 2019, the virus reached Uganda, having infected a 5-year-old Congolese boy who entered with his family,[15] but this was contained. Since January 2015, the affected province and general area have been experiencing a military conflict, which hindered treatment and prevention efforts. The World Health Organization (WHO) has described the combination of military conflict and civilian distress as a potential "perfect storm" that could lead to a rapid worsening of the situation.[16][17] In May 2019, the WHO reported that, since January of that year, there had been 42 attacks on health facilities and 85 health workers had been wounded or killed. In some areas, aid organizations have had to stop their work due to violence.[18] Health workers also had to deal with misinformation spread by opposing politicians.[19] Due to the deteriorating security situation in North Kivu and surrounding areas, the WHO raised the risk assessment at the national and regional level from "high" to "very high" in September 2018.[20] In October, the United Nations Security Council stressed that all armed hostility in the DRC should come to a stop to address the ongoing outbreak better.[21][22][23] A confirmed case in Goma triggered the decision by the WHO to convene an emergency committee for the fourth time,[24][25] and on 17 July 2019, the WHO announced a Public Health Emergency of International Concern (PHEIC), the highest level of alarm the WHO can sound.[26] On 15 September 2019, some slowdown of cases was noted in the DRC.[27] However, contact tracing continued to be less than 100%; at the time, it was at 89%.[27] In mid-October the transmission of the virus had significantly reduced; by then it was confined to the Mandima region near where the outbreak began, and was only affecting 27 health zones in the DRC (down from a peak of 207).[28] New cases decreased to zero by 17 February 2020,[29] but after 52 days without a case, surveillance and response teams confirmed three new cases in mid-April.[30][31][32] As a new and separate outbreak, was reported on 1 June 2020 in Équateur Province in north-western DRC, described as the eleventh Ebola outbreak since records began;[33] after almost two years the tenth outbreak was declared ended on 25 June 2020, with a total of 3,470 cases and 2,280 deaths.[34][7]

Ebola virus vaccine receives prequalification