Rwanda: Relief in sight for Goma chaos as airlift takes off

Liz Hunt,Medical Correspondent,Agencies
Saturday 23 July 1994 23:02 BST
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AMERICAN transport planes began taking off from Germany late last night, as the international effort to save thousands of Rwandan lives finally kicked into second gear.

Two of the giant C-141 aircraft were flying to the teeming refugee encampment near Goma in Zaire, and a third was sent to Entebbe, Uganda, which is to be the hub of the expanded US relief effort. President Bill Clinton on Friday ordered the military into swift action to help prevent what he said 'could be the world's worst humanitarian crisis in a generation'.

A top priority, Mr Clinton said, would be provision of safe drinking water to replace contaminated water from Lake Kivu. He said that 20 million oral rehydration packages would be delivered.

The British government announced yesterday that it would give a further pounds 6.5m to aid agencies helping refugees on the borders of Rwanda, which will take Britain's total aid to the region to pounds 40m. The European Commission will on Wednesday grant humanitarian aid of pounds 60m.

The US has now pledged or given pounds 133m, and additional funding has come from countries including Ireland ( pounds 3.25m), New Zealand (about pounds 400,000) and Australia ( pounds 1m). Israel has also joined the international aid effort, announcing yesterday that it would send a field hospital to provide medical aid to the Rwandan refugees. Six air force planes carrying medical supplies were to fly to Rwanda tonight.

Despite these offers, the UN High Commissioner for Refugees deplored the lack of world action. 'We are just screaming at every government and we are completely desperate, because there is no way we can do anything with the current situation,' said a spokeswoman. 'We need help in a practical form at once. It is more vital than money because we do not have time to go shopping.'

The UNHCR welcomed the American round-the-clock airlift, but criticised other countries thought to be doing too little, too late. UNHCR spokesman Rupert Colville said that although the US and Germany had sprung into action with plans to improve transport logistics and drinking-water supplies, there had been no response to UNHCR appeals for sanitation equipment.

The Goma camps need at least 60,000 latrines; at present sanitation is non-existent. So far no government has volunteered to provide or maintain latrines. The US planes will carry water-purification equipment and fork-lift trucks to handle relief cargoes arriving in coming days.

A host of diseases is spreading around the camps, including dysentery and measles. Aid workers said confusion reigned among the sprawling masses of refugees, a million of whom fled to Goma 10 days ago, making it difficult to distribute food even after it was flown into the remote region.

The French charity, Medecins Sans Frontieres (MSF), said yesterday a plane had left Bordeaux carrying 35 tons of equipment to combat the cholera outbreak. The cargo, including water-pumping and purifying equipment, is destined for a camp of about 500,000 refugees in Bukavu, which MSF said could be affected by the cholera which has killed thousands of people in Goma, 75 miles to the north.

'Tens of thousands of people have left Goma to move to Bukavu, and it is almost certain that they will bring cholera with them,' a spokesman said. His fears have proven justified. Last night in Bukavu, Trevor Page, a spokesman for the World Food Programme, said six cholera cases had been discovered in the camp.

The tragedy of the cholera outbreak ravaging the refugees is that the disease is easily treated with a simple remedy that costs less than 50p a day.

Oral rehydration salts replace the vital minerals and fluids lost in violent diarrhoea and vomiting, which are characteristic of the disease. Cholera is caught simply by drinking water or eating food infected with fecal matter. But without rapid access to the salts, the disease exacts a deadly toll.

In victims weakened by malnutrition and exhaustion, cholera can strike and kill within five hours.

The bacterium colonises the lower gut, attaching itself to the intestinal wall and secreting a potent chemical that triggers an outflow of water and electrolytes (salts such as potassium and sodium) from the cells. Victims can lose up to a litre of fluid an hour in the form of diarrhoea known as 'rice-water stools' because of their appearance.

As dehydration continues, the face becomes cold to the touch and appears withered, and painful cramps develop as the soft tissues shrink. Blood pressure falls. Eventually the extensive fluid loss puts the body into hypovolaemic (low- volume) shock, and blood vessels become blocked with coagulating blood cells.

If the fluid is not replaced, the kidneys shut down and death follows soon after. The disease can persist for up to seven days, until infected intestinal cells are shed and replaced.

As fears of RPF retribution persisted yesterday, France rejected a UN appeal for its troops to remain in south-west Rwanda protecting the 'safety zone'. It said it would keep troops in Goma to deal with the refugee exodus.

Sadako Ogata, head of the UN refugee agency, had appealed to France to extend its humanitarian military intervention in Rwanda beyond a 22 August deadline.

The aid organisation Care has announced plans for an unprecedented relief effort in Goma. Readers who wish to contribute should contact 071-379 5247 for credit card donations and inquiries. Or they may send cheques or postal orders to: Care Rwanda Appeal, 36-38 Southampton St, London WC2E 7HE.

The British medical emergency relief organisation, Merlin (0892 540040), is appealing for funds and for medical volunteers to assist at an orphanage it has set up near Goma, where more than 2,000 children are already in its care.

Credit card pledges of help may also be made to the Disasters Emergency Committee on 0345 222333, and cheques payable to Rwanda Emergency Appeal may be sent to PO Box 999, London EC4A 9AA.

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