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Tuesday, 22 January, 2002, 12:18 GMT
Medical emergency in Goma
boy lava
A boy walks near a lava flow in Goma
The DR Congo has one of the most broken-down health systems in Africa, leaving it poorly placed to cope with any medical catastrophe.

However, the devastation wrought by a decade of war means that several aid agencies were on the scene long before the volcano sent thousands fleeing Goma.

With only 2,000 Congolese doctors covering 50m people in the country, life expectancy is only 45.

Outbreaks of polio, plague, cholera, meningitis and measles are regular, in addition to a mounting Aids crisis.

While the streams of lava and the explosion of the petrol station on Monday have produced a number of burns victims, aid agencies' main concern is an outbreak of infectious disease among those displaced by the disaster.

Many of these still have no proper access to safe drinking water or sanitation.

While a large number remain over the border in Rwanda, others either stayed in Goma or have chosen to return quickly.

Some are using neighbouring Lake Kivu for washing and a source of drinking water, and experts fear outbreaks of cholera or dysentery.

Both of these cause vomiting and diarrhoea, and are dangerous because they can cause progressive dehydration.

Poor sanitation makes it easier for the bacteria which cause these diseases to be passed on to other people.

Burns cases

Fortunately, Goma is one of the few places in DR Congo which has a general hospital - and this is still fully functional, despite the volcanic eruption.

A relatively small number of people have been taken to hospital because of burns - either from the lava or among those caught by the petrol station explosion on Monday, reports Medicins Sans Frontieres (MSF).

Some patients were burned on the feet as they tried to get to their homes on the opposite side of the lava flows.

In a developed country, a number of treatments are available to improve the chances of burns patients.

These include skin grafts, in which skin from other parts of the body is removed and used to cover badly burned areas.

Rehydration serum

MSF has provided "burns kits" to Goma general hospital - each containing dressings and medicines for up to 100 patients, and believe these will be enough.

These can reduce the chances of burns becoming infected.

MSF is also supplying anaesthetics to relieve the suffering of burns patients, and special serum to help rehydrate them.

However, without skin grafting, it is difficult to help patients with "full-thickness" burns, in which all the layers of skin have been burned away.

Goma General Hospital is also treating some patients who are suffering severe respiratory symptoms due to the volcanic fumes.

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