12/21/22, 10:24 AM Peace through health in DR Congo — Peace Insight

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Peace through health in

DR Congo
‘Peace through health’ (PtH) is a relatively new
movement in the world of peacebuilding, but
according to a new study of an organisation in the
Democratic Republic of Congo (DRC), it’s one that has
potential to make a real impact in regions affected by
conflict. Healing Africa? Reflections on the peace-
building role of a health-based NGO operating in
Eastern Democratic Republic of Congo, by Nicole
D’Errico, Chris Wake and Rachel Wake was published
this year in the journal Medicine, Conflict and
Survival, and looks at the work of the organisation
HEAL Africa. Chris Wake kindly agreed to discuss the
article with Insight on Conflict, and Nicole D’Errico
generously provided the photos used.
Ruairi Nolan
28 Sep 2010

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12/21/22, 10:24 AM Peace through health in DR Congo — Peace Insight

‘Peace through health’ (PtH) is a relatively new

movement in the world of peacebuilding, but
according to a new study of an organisation in the
Democratic Republic of Congo (DRC), it’s one that
has potential to make a real impact in regions
affected by conflict. Healing Africa? Reflections on
the peace-building role of a health-based NGO
operating in Eastern Democratic Republic of
Congo, by Nicole D’Errico, Chris Wake and Rachel
Wake was published this year in the journal
Medicine, Conflict and Survival, and looks at the
work of the organisation HEAL Africa. Chris Wake
kindly agreed to discuss the article with Insight on
Conflict, and Nicole D’Errico generously provided
the photos used.

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12/21/22, 10:24 AM Peace through health in DR Congo — Peace Insight

The premise for ‘peace through health’ (PtH) is a rather simple one.
As the authors point out in their article, “war, by definition, is a public
health problem, [so therefore] it follows that part of the solution lies
in the hands of public health practitioners.” Practitioners of PtH have
also developed an elegant parallel between the treatment of conflicts
and the treatment of diseases, as “both relate to the management of
risks”, according to Chris. “You can take measures to reduce the
likelihood of a disease breaking out (‘primary’ care); you can treat its
immediate effects ('secondary') or provide rehabilitation afterwards
('tertiary'). The same can also be said for responding to violent
conflict. It’s an analogy that can probably be taken too far, but it’s
useful when thinking about the potential role of the healthcare sector
in peacebuilding activities.”

But if the theory behind Peace through Health can be readily

understood, “there is a lack of detailed case-studies to demonstrate
whether it can really be effective or not on the ground. So we decided
to investigate in more depth an organisation that puts these ideas into
practice.” Chris had previously written on the conflict in DRC and
given its burgeoning reputation for branching out into the
peacebuilding field, HEAL Africa seemed a natural choice for study.
Rachel and Chris travelled to Goma in Eastern DRC in 2009 to carry
out a short piece of field research. Here they met Nicole, who was
working full-time with HEAL Africa and became their co-author.

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12/21/22, 10:24 AM Peace through health in DR Congo — Peace Insight

There are few places in the world more in need of both better
healthcare and greater peacebuilding efforts than DRC. According to
the International Rescue Committee, over 5.4 million people have
died in DRC since 1998 and the start of the Second Congolese War; and
almost half of these are children under the age of 5. In fact, the
majority of deaths are not victims of direct violence but have died
from preventable diseases, because of the near-total collapse of the
health system and the chronic insecurity that has left hundreds of
thousands of people internally displaced. HEAL Africa is based in
Goma, the largest city in the east of the country, the region which has
seen the most devastating impacts of the war. Originally opening as a
hospital offering training to Congolese doctors (under the name
“Doctors on Call for Service”), HEAL Africa’s staff realised than many
health gains from their work would be lost without peace. They
therefore expanded their mandate and started a number of
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12/21/22, 10:24 AM Peace through health in DR Congo — Peace Insight

programmes that would normally be considered peacebuilding

activities. As with their healthcare work designed to combat disease
and physical injuries, their peacebuilding programmes can be said to
operate at three different levels – primary, secondary and tertiary.
HEAL’s community-level programmes seek to reduce the risks of the
onset of conflict via 'primary' interventions, through for example
working to alleviate inter-ethnic tensions or to create meaningful
employment opportunities. At the ‘secondary’ level, HEAL Africa
works to provide direct treatment for victims of the conflict in DRC,
for example through providing surgical treatment to rape victims and
trauma care to others affected by conflict. In 2008, ‘in-patient’ care
was provided for more than 3,000 people suffering from different
health problems generated during the conflict and mass migrations.
At the ‘tertiary’ level, HEAL Africa works to rehabilitate people and
communities from the effects of conflict, such as through intervening
to help resolve land disputes from the conflict. Their ‘Gender and
Justice’ legal assistance programme helps victims of rape bring their
cases to court, aiming to contribute to an end to impunity for sexual
violence.

HEAL Africa’s holistic approach to peacebuilding is well suited to the

Congo, according to Chris: “DRC is often defined as ‘post-conflict’, but
in fact it is not that simple, and there are significant areas suffering
from conflict today or which may be impacted by new forms of
conflict in the future – in some senses it could be defined as a region
that is post-conflict, mid-conflict and even pre-conflict all at once."

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The authors avoid making large claims for the achievements of HEAL
Africa, noting that measuring success in peacebuilding is notoriously
difficult and that “in the case of HEAL Africa, there are few systematic
studies available on the outcomes of its projects, making an
assessment of their ‘success rate’ very difficult to gauge”. However,
they do identify four reasons to explain why HEAL Africa might have
managed to branch out into peacebuilding work apparently so
successfully:

1. they have managed to build a reputation for

neutrality, working with a range of ethnic
groups in the region;

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2. their health work gives them tremendous

access to remote communities, Internally
Displaced People’s camps and the local
population in Goma;

3. their health work gives them a great degree of

legitimacy in the eyes of the local population, a
rare commodity in conflict situations;

4. being based around a permanent hospital run

by local staff, HEAL Africa has a long-term
presence in the region, unlike some external
peacebuilding efforts.

The authors also identify some limitations to the HEAL Africa model.
In particular, as healthcare remains its core area of work, its other
peacebuilding functions are sometimes cut back when there needs to
be a trade-off between hospital treatment and other peacebuilding
programmes, which can be frustrating for its staff. Overall though,
the article paints a hopeful picture of the potential for healthcare
professionals to proactively go beyond their traditional roles to make
a valuable contribution to effective peacebuilding projects in local
communities.

As noted above, Chris had previously written on the conflict in DRC;

his 2008 essay Bringing the Local Back Into The DRC’s ‘Post’ Conflict
Transition: What Role Should Local Solutions Play In Bringing Peace
To The Congo? (pdf) was one of the winning essays in RUSI’s Nelson
Mandela Essay Competition. In this Chris argued that, given the
limitations of national-level efforts to end the violence in DRC, more
attention should be paid both to the local causes of violence and to
local-level solutions to conflict. Did his experiences studying HEAL
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Africa reinforce his belief that local conflict resolution should play a
key role in DRC? “My time in Goma definitely emphasised the
relevance of local conflict drivers in the context of the DRC, and
showed me how grassroots groups can make a really important
contribution in combating those local dynamics. The situation in DRC
is extremely complex, and there is of course a need for stable,
accountable government and both national and regional level
peacebuilding. But the work of organisations such as HEAL Africa in
local communities will be crucial to an improvement of the current
situation in DRC because so many of the key causes of the conflict
there originate at local levels”.

Ruairi Nolan, Insight on Conflict, 6 October 2010

[linked page_id="9390"] Photos supplied by Nicole D'Errico. Most photos
are from the 'Safe Motherhood' and 'Nehemaiah' programmes of HEAL
Africa.

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Ruairi Nolan Ruairi is Peace Direct's Head of Research and

Engagement.
Read more from Ruairi Nolan

Locations
Democratic Republic of the Congo

Disclaimer: The views expressed in this article are those of the author and do not represent the
views or position of Peace Direct.

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