As fighting continues between dissident general Laurent Nkunda and the Congolese army, displaced Congolese have packed into squalid camps that are plagued with growing health problems. Humanitarian workers are racing to stem the spread of diseases including cholera and malaria. Noel King has more in this report from Kibaya, DRC.
When the town of Kibaya in Congo's volatile North Kivu province was overrun with 20,000 civilians fleeing violence, the town was simply unprepared to cope with the influx of people.
The health center employed a single nurse, who could see only three patients per day.
The few medicines available had passed their expiration dates.
And in a town where cases of chronic diarrhea were spiraling, only three packets of rehydration salts were available.
Bob Kitchen is an emergency response team coordinator with the International Rescue Committee.
"There's one water spring that serves the indigenous population of 20,000 plus the additional IDP population," he said. "Basically, it's a large puddle with thousands of people walking into the water to get water out. Every single site within there that we tested the water, it was heavily contaminated with fecal matter. So it's bad, bad, bad."
Water contamination is rampant because only five percent of Kibaya's 40,000 residents have access to latrines.
As a result, chronic diarrhea and suspected cholera cases are on the rise.
Congo's camps for the displaced are just as bad. Aid agencies have provided chlorination points and large containers full of fresh water.
But in the overcrowded camps, many people say they do not have access.
Bosco Machumpenze is an elected leader at Mugugna Two camp, which hosts some 15,000 displaced people outside the North Kivu capital, Goma.
He says the children are sick and they have diarrhea. The women have no water to cook with. The only thing to do is go down to Lake Kivu to get water.
Humanitarian workers say the collection of water from dirty sources, including Lake Kivu, and the character of the soil in Goma, have compounded the problem of cholera.
Louis Vigneault is a spokesman for the United Nations Office for the Coordination of Humanitarian Affairs in Goma.
"Especially in this region there's been a history of cholera being a major problem," he explained. "Because the soil is basically only lava, it's not porous so all bacteria or disease will stay on surface and propagate, especially with people going to the lake to get water."
The United Nations High Commissioner for Refugees says cholera broke out in North Kivu's IDP camps in early October.
More than 400 cases were identified in October, but because the testing process is long and expensive, many more cases may have gone undiagnosed.
Woman and children are particularly susceptible to illness.
Nuraka Jeduka is the mother of two-day old twins. Her babies were born two months prematurely, and she is worried about their health.
She says she fled her home to come to Kibaya when she was pregnant; and her stomach hurt all of the time. She says she is having trouble sleeping now and she is worried about how her babies will survive.
To combat the spread of disease, some aid agencies are undertaking creative measures.
Jasons Snuggs, an emergency response co-coordinator for environmental health with the International Rescue Committee, spoke to VOA in Kibaya during one of Congo's frequent heavy downpours, about a technique called rain guttering.
"Quite simply, on a traditional roof, which is made out of corrugated sheeting, we install a piece of bamboo which is split in half, and when it rains it fills up with water," he said. "We direct it into a container that people have."
Using rain gutters, Snuggs said each roof can drain off as many as 50 liters of relatively fresh water per day.
The challenges of working during Congo's rainy season are immense.
The IRC evacuated new mother Nuraka Jeduka and her infant twins to a larger hospital that same day.
But a downpour turned roads into muddy rivers and the family's car slowed to a crawl: clear evidence that rain is both a blessing and a curse in eastern Congo.