Virunga is a small district hospital perched on the old, hardened lava flow in one of Goma’s poorest areas. It takes in displaced people from six camps around Goma as well as those in temporary settlements or in host families. They are referred from local health centres.

It’s a fairly new compound of small, extremely cramped buildings. The volcanic eruption of 2002 destroyed up to 70 percent of its original infrastructure. It’s not particularly well equipped and although it’s clean, the conditions in the wards are shocking to a western visitor like me. Many patients are kept on floor mattresses lined up along the corridors.

Treatment isn’t free but some costs are covered through collaboration with various NGOs. The health agency Merlin, for example, covers the costs of treatment and hospitalisation of referrals from their health centres. The hospital has 130 beds, and at any one time, around 50 are occupied by older people and 20 by children under the age of five.

Older people's health needs

Displaced older people have very specific needs as well as age related illnesses such as cancers, tumours, rheumatoid. These are exacerbated by bad living conditions in the camps or temporary shelters. At Virunga, they are categorised as ‘vulnerable’ alongside displaced children under the age of five.

Dr. Louis Kamate is the medical director of Viruga hospital and is trying to set up a small project to highlight the specific needs of these two groups.

He says both age groups have weak immune systems and are prone to severe pulmonary conditions. They need complex, specialised, and often lengthy treatments and the mortality rate is high.

Dr Kamate reminds me that many older people slept outdoors for days as they fled the violence. In the camps, they continue to be exposed to rain and cold which affects their respiratory systems and also their rheumatisms.

Poor nutrition is a major problem for both groups but specifically for example, for older people who suffer from heart conditions and need a strict diet impossible to follow once discharged back into the camps. Many of the older displaced people who are hospitalised also suffer heart problems amplified by stress.

Access to clean water is poor in the temporary shelters so cholera outbreaks are also frequent.

Fire hazard

There are also many burn victims. Some escaped deliberate fires during rebel attacks on their villages and were brought in by family or friends.

Fire is also a serious hazard in the small huts of wood and twigs in the camps. Older people take longer to heal from burns and are prone to infections because their immune system is so much weaker. The impact on the hospital’s resources is considerable, with beds occupied longer and the need to provide a constant sterile environment or even finding enough clean bandages.

Reluctant to seek help

Dr Kamate tells me that older people are more reticent to seek medical help and often only arrive at the hospital once their condition is extreme. Many are worried about costs, others worry they will become a burden to their families.  Some don’t believe in modern medical treatments.

A very sick older woman I met in one of the camps told me she would not leave her UNHCR hut to get treatment for fear it would be robbed for her kitchen utensils and her only blanket.