Congo winner will face big problems

KINSHASA, Congo --In Congo's largest hospital, surgical patients die for lack of antiseptics and doctors amputate broken limbs infected before patients find money for casts. When the power goes out, surgeons operate by flashlight.

Four years after the end of a 1998-2002 war, experts say 1,000 people are still dying every day in Congo, mostly from diseases or injuries easily treated elsewhere. But the collapsing health care system is just one of the challenges the winner of last Sunday's landmark presidential runoff will face as head of a nation crippled by rampant unemployment, deep poverty, and violence in the lawless east.

Fixing it will not be easy.

Voters are choosing between incumbent President Joseph Kabila and Jean-Pierre Bemba, a former rebel chief who became vice president in Congo's transitional government. Results of the vote are not expected for days if not weeks.

Many Congolese say they want a leader who can secure the country's precarious peace -- sporadic fighting still breaks out in the militia-plagued east -- but then quickly add that what they need most are peacetime basics like health care, jobs, roads or just food.

"Normally people eat three times a day, but maybe instead we'll eat one day and not the next," said Fils Belango, a 29-year-old hotel janitor in Kinshasa.

Some "jobs" barely qualify as jobs. Men operating street-side photocopy machines make just 35 cents U.S. a day. One woman at Kinshasa's port makes a living sifting chaff from bags of corn kernels for others lucky to have to afford a full sack, earning about the same.

On the streets, children open car doors then demand payment. Armed police stop vehicles and ask for "just a little gift" to buy tea.

During the 32-year dictatorship of Mobutu Sese Seko, who was ousted in a Rwandan-backed rebel war in 1997 and died in exile, Mobutu treated the state treasury as a private bank account, dipping into it at will.

While building lavish palaces and holding elaborate banquets, Mobutu left much of the country to rot, and did little to develop the nation's vast jungled interior, where dirt roads through the bush are easily swallowed by fertile forests.

In the nearly 10 years since Mobutu's ouster, life has not gotten much better. The country the size of Western Europe has few paved roads, and even large cities can lack clean water or dependable electricity.

"Under Mobutu we had a good life. Good salaries," said 28-year-old seamstress Nathalie Mangabu. Her husband used be an electrician. Now he is unemployed.

Congo has no dependable unemployment statistics, but it is easy to find people without jobs, and many talk about the work they once did.

"I used to have a my own office, to help people pay their taxes," said Yvon Mbisi, 37, at an outdoor bar in a Kinshasa suburb. "Now it's closed, since two years." He sat with a group of about 20 friends, who all said they were out of work.

Dr. Mbwebwe Kabamba, head of emergency surgery at Kinshasa's main hospital, was hopeful a new administration could bring improvement, but like many, he was skeptical.

"We've had so many regimes ... Everyone promises, but then there's what you see in practice," Kabamba said.

For now, the world's largest U.N. force helps keep the peace in Congo and international money props up much of its infrastructure.

Congo might be able to prop up itself if it could end corruption and take advantage of its mineral wealth. The country is rich in diamonds, copper, cobalt and gold, much of which has been plundered by neighboring states and foreign businessmen.

At the 2,000-bed Kinshasa General Hospital in the capital, the list of needs is long.

"We don't have thread for sutures. We don't have alcohol to disinfect wounds. We don't have gloves," Kabamba said.

Patients arriving with potentially fatal wounds are handed a list of supplies to buy before the doctors can operate. Sometimes materials don't arrive quickly enough, and patients die.

The government stopped subsidizing hospitals more than a decade ago and many rely on aid groups. Across Congo, medical centers with collapsed latrines, and without waste removal or clean water are common, said Yvan Hildebrand, head of the Belgian arm of Medicins Sans Frontieres in Congo.

"It's the worst I've seen in terms of the collapse of the basics," said Hildebrand, comparing Congo's system to others in Africa.

Earlier this year, a study published in The Lancet, Britain's leading medical journal, said about 1,200 people are dying daily in Congo, most from easily treatable diseases.

"Their country has been ruined -- by wars, colonialism and looting by foreigners," said Mluleki George, South Africa's deputy defense minister and head of its observer mission for the vote. "The Congolese will have to be very patient."