care in North Kivu, Democratic Republic of Congo: three cross-sectional surveys

Background: The province of North Kivu in the Democratic Republic of Congo has been afflicted by conflict for over a decade. After months of relative calm, offences restarted in September 2008. We did an epidemiological study to document the impact of violence on the civilian population and orient pre-existing humanitarian aid. Methods: In May 2009, we conducted three cross-sectional surveys among 200 000 resident and displaced people in North Kivu (Kabizo, Masisi, Kitchanga). The recall period covered an eight month period from the beginning of the most recent offensives to the survey date. Heads of households provided information on displacement, death, violence, theft, and access to fields and health care. Results: Crude mortality rates (per 10 000 per day) were below emergency thresholds: Kabizo 0.2 (95 % CI: 0.1-0.4), Masisi 0.5 (0.4-0.6), Kitchanga 0.7 (0.6-0.9). Violence was the reported cause in 39.7 % (27/68) and 35.8 % (33/92) of deaths in Masisi and Kitchanga, respectively. In Masisi 99.1 % (897/905) and Kitchanga 50.4 % (509/1020) of households reported at least one member subjected to violence. Displacement was reported by 39.0 % of households (419/1075) in Kitchanga and 99.8 % (903/905) in Masisi. Theft affected 87.7 % (451/514) of households in Masisi and 57.4 % (585/1019) in Kitchanga. Access to health care was good: 93.5 % (359/384) of the sick in Kabizo, 81.7 % (515/630) in Masisi, an