Democratic Republic of Congo: Cholera in the wake of a gold rush
The number of residents has surged in the quiet lakeside village of Lomera, which is now struggling to manage sanitation amid overcrowding.
In early May, Doctors Without Borders/Médecins Sans Frontières (MSF) launched an emergency response to a cholera outbreak in Lomera, South Kivu, where a gold rush and poor sanitation has fuelled the rapid spread of the disease.
Our teams have worked around the clock to provide care and improve the community’s access to clean water, vaccinating more than 8,000 people and treating more than 600 patients.
The discovery of gold changed a town overnight
Until recently, Lomera was a quiet lakeside village, barely known to most residents of South Kivu, Democratic Republic of Congo (DRC). That changed overnight last December when gold was discovered in its hills.
The rush for gold – intensified by economic insecurity caused by clashes between the M23/AFC armed group, the Congolese army (FARDC) and their Wazalendo militia allies – has turned Lomera into a magnet for thousands of people seeking work and safety.
In less than a year, the number of residents exploded from 1,500 to more than 12,000 people. The village is now sprawling with mineshafts and makeshift shelters in the chaos.
“We live in tough conditions without much space, but we put up with it because we need to earn a living,” says Chiza Blonza, who left his farm behind in Walungu, about 90 kilometres away, to work the mines.
Dangerous conditions set the stage for an epidemic
Every day, more people arrive, crowding into already packed shelters – sometimes 20 in a room. It was only a matter of time before disaster struck.
“Everything that could possibly fuel a cholera outbreak is here,” says Mathilde Cilley, MSF project medical advisor. “We’re seeing severe overcrowding, barely any clean water, open defecation on the hills and a total lack of waste management.”
Cholera is endemic in this part of the DRC, and Lake Kivu is contaminated by the bacteria, but an epidemic of this scale is unusual. The first 13 cases in Lomera were reported on April 20. Within two weeks, that number soared by over 700 per cent to 109 cases – a likely underestimated figure. Today, the town accounted for 95 per cent of cholera cases in the Katana health zone, an area home to more than 275,000 people.
“While insecurity is a factor, the closure of airports in Bukavu and Goma has had an even greater impact, severely restricting our ability to deliver lifesaving aid. International cuts to humanitarian funding have also limited the availability of medical supplies.”
Muriel Boursier, MSF country director in Bukavu
MSF was the main international organization to respond, launching a rapid emergency intervention on May 9. Teams worked around the clock to contain the epidemic.
In just four days, MSF vaccinated more than 8,000 people – though limited supplies meant only single-dose regimens were administered, instead of the recommended two.
More than 600 people have been treated for cholera at a temporary 20-bed cholera treatment unit set up by MSF, with many arriving in critical condition.
Sanitation measures are key to stopping the spread of cholera
“The vast majority of our patients work in the mines, where they use contaminated lake water to separate gold from the earth, exposing themselves to the bacteria,” says Théophile Amani, an MSF doctor in Lomera. “Tough manual labour and high levels of alcohol consumption mean many are already dehydrated even prior to getting infected.”
After treatment, patients receive hygiene kits – buckets, water purification tablets and soap – and vital health education from MSF staff on how to prevent future infections.
Bonheur Maganda, originally from Kabamba, is among MSF’s patients. He came to work in the mines to provide for his children and says that many of his colleagues had also fallen ill.
“Without MSF, many of them would have died,” he says. “The health promotion officer explained the importance of washing my hands with clean water and being careful with food. I will share this advice with others.”
MSF teams also installed a lakeside water treatment facility and distribution point, delivering around 60,000 litres of clean water daily. A hundred latrines and 25 supervised handwashing points were set up across the settlement, including at restaurants and public gathering spots.
Contact tracing and preventative treatment for people exposed to cholera have been crucial in containing the spread.
Investment in water and sanitation systems is the key to future safety
MSF’s emergency response will soon be handed over to other partners, but there is a critical need for long-term solutions to guarantee continued access to clean water.
“Without significant investment in water, sanitation and hygiene infrastructure, outbreaks like this are likely to persist on a regular basis,” warns Muriel Boursier, MSF country director in Bukavu. “At present, the nearest well is three kilometres away. International partners and local authorities must step up and implement sustainable solutions.”
Given the constant flow of people moving in and out of Lomera, more vaccine supplies will also be needed to protect the community.
“South Kivu – and eastern DRC as a whole – are facing major logistical hurdles in getting essential medical supplies, including vaccines, medicines and equipment, to where they’re needed most,” adds Boursier.
“While insecurity is a factor, the closure of airports in Bukavu and Goma has had an even greater impact, severely restricting our ability to deliver lifesaving aid. International cuts to humanitarian funding have also limited the availability of medical supplies. We urge governing authorities and international partners to do everything possible to help restore access and support the sanitary response to the wide range of health emergencies impacting the region.”
Responding to cholera outbreaks remains a central priority for MSF in DRC. In 2024 alone, MSF teams treated more than 15,000 cholera cases nationwide, working alongside local health authorities and communities to save lives and stop the spread of disease.
