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Impressions of Burundi

Tuesday November 7, 2006

Taja McKinney

This is not the Africa in travel brochures with safaris and delicious wine. This is the Africa where heavy loads are carried on undernourished heads, babies on backs and rifles in the hands of teenage boys. Here, in the torrential rain, barefoot children hide under banana leaves. The soil runs deep red as if the blood of the hundreds of thousands of people who have died here from starvation and civil war have drenched the earth of this small nation to its core.

Burundi, a small country in size, is densely populated with seven to eight million people. Food production, mainly subsistence farming, is struggling to keep up with the population growth and degradation of the soil. There is almost no farm equipment, and in order for farmers to get their products to market, they must carry what they can on their heads or the back of a bicycle for miles. On average, each woman gives birth to nearly seven children, many of whom do not survive to adulthood. Currently 48% of Burundi?s population is under the age of 15 and a staggering 66% is undernourished. Life expectancy is dropping and presently lingers around 40 years ,so it is not surprising that Burundi ranks 171st ? towards the bottom ? on the UN development index.

International Medical Corps (IMC) has been working in Burundi for over 10 years, providing essential services, which aim to support the strained health systems and build self-reliance so that when IMC leaves, the government can cope better with the needs of its population. Since 1995 IMC has been training community health workers and traditional birth attendants, implementing school feeding programmes and supplementary and therapeutic feeding centres.

IMC?s main office is in the capital, Bujumbura, next to Lake Tanganika, just south of the Equator. It is heavily militarised: soldiers and policemen with rifles are stationed every few feet along the road. Shooting can often be heard at night as armed men loot the city. For people?s protection, a curfew from 11.30pm to 6.00am has been enforced.


IMC also has health programmes in Rutana, for some of the most marginalised people in the country. In one community we visited, almost 70 people were living in small shelters in southern Burundi. Stepping into their world is like stepping back in time thousands of years. These communities do not even have mud shacks to live in, but build basic round huts made from straw. The men hunt small game in the nearby brush and the women must trek more than six miles to find clay to make basic pots that they sell for 20 cents.

We stopped at a nearby school to inspect the progress of a kitchen being built by IMC to provide supplementary feeding for schoolchildren. Many children are not able to attend school because they have to work. Providing food is one method of trying to improve children?s health and increase the attendance rate.

We spent part of the morning packing up seven types of seed before proceeding to a community where ?model mothers? trained by IMC were relaying skills such as healthy cooking using local ingredients, disease prevention, and nutrition to groups of other mothers in their communities. When we arrived at a shaded area in the banana grove we were greeted by many smiling people who were singing and dancing. Soon we were handing out seeds, shovels and hoes to the women in the group. Surrounded by curious children, we felt an overwhelming sense of hope in the community.


Malnourishment, particularly caused by lack of protein, brings on oedema in the feet, legs and faces of sick children, along with ghastly swelling as fluid builds up under the skin, turning it purple and blistery. In the therapeutic feeding centres there are hundreds of children who are dying or would be dead if not for the essential nutrient-rich milk provided by IMC. Children are referred to the feeding centres if their height?to-weight ratio is low enough to warrant 24-hour care. Crowded rooms hold more than 50 mothers, each with one or sometimes numerous malnourished children in need of immediate attention. There is little in the rooms, often only a cot, a mosquito net and the constant cries of hungry babies.

IMC?s recovery rate hovers around 84%. Thankfully, malnourished children can be treated and sent home after a few weeks. Children with malaria and other diseases that are harder to treat, however, are often not brought in early enough. The most severely ill children are so weak they can barely move on their own. Their skin is stretched around bone, a protruding stomach and a disproportionately large head.


One hour north-east of Bujumbura, high in the hills among vast banana plantations, lies Muramvya. We drove 4x4 trucks along potholed dirt roads to mobile health clinics that provide outreach to the community. Using illustrated poster boards, IMC community health workers explain critical topics such as malaria prevention, sanitation and nutrition. Due to the high illiteracy rate, drawings and face-to-face interaction are the most effective ways to convey this information. A small mud hut houses a clinic where people can receive consultation and vaccinations. A line of brightly dressed mothers and infants extends far along the road; it will take most of the day for patients to be seen, so everyone waits patiently.

The community is incredibly supportive of IMC?s work. Our truck became stuck while trying to cross the dirt road. Villagers surrounded us within seconds and began to push. When we rode along the same track 15 minutes later men were already fixing it. They smiled and waved as we passed by. I smiled back, grateful that human emotion transcends both language and culture and allows us to communicate basic emotions such as gratitude to all people.

Established in 1984 by volunteer doctors and nurses, International Medical Corps is a global humanitarian non-profit organisation dedicated to saving lives and relieving suffering through healthcare training and relief and development programmes

To find out more, visit the IMC website at

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