[Health care organization and health in a region of Zaire].

Kampene is a roughly 10,000 inhabitants village in Kivu, eastern region of Republic of Zaire. The equatorial rainforest in river Zaire basin surrounds it, far from the main and most crowded roads. Climate is warm and wet, rainfalls constant throughout ten months a years. Eighty seven per cent of the population of Kampene and of its administrative district (around 100,000 inhabitants) work in agriculture. Most of the remainder gets by on mineral search and mining (tin, cassiterite, gold). Health facilities and their organisation should be set up as according to Zaire Health Planning, worked out of 1977 Alma Ata Conference's guidelines on Primary Health Care, but actually they are hard to be implemented because of the wide territory, of the scattered settlements to be served, because of infrastructure and funds shortages. High children death ratio (roughly from 104 to 200/1000 altogether, short mean lifetimes and generally morbidity are caused by: parasitoses (malaria, filariasis, gut worms, bilharziosis, amebiasis), bacterial infections (breast feeding babies' toxic enteritis, tuberculosis, salmonellosis, shigellosis, gonococcosis, tetanus, epidemic meningitis), viral diseases (measles, poliomyelitis, virus B hepatitis, AIDS), protein-energy malnutrition, obstetric pathology (uterus fractures, ectopic pregnancy, obstructed labour). The management of Kampene Hospital is taken over by a Zaire-Italian team, according to the "Progetto Socio-Sanitario a Kampene", project carried out by Centro Volontari Marchigiani, a not-governmental organisation recognized and financed by Italian Foreign Office. The utilization of Kampene hospital wards has been investigated throughout 20 months (since 1/1/1986 to 31/8/1987) by working some parameters out: numbers of admissions, numbers of hospital days, man length of stay, bed occupancy rate, turnover index for bed. The utilisation of outpatient clinic has been investigated by means of the number of outpatients and outpatients per health operator ratio. Moreover the death rate for each ward has been appraised. These data show that wards and outpatient clinics are largely utilized; but a better redistribution of beds from Gynecology to Medicine and Pediatrics wards is suggested. The importance of a steady health team on the run stands out. Moreover the data stress the high death rates both of measles epidemics and protein-energy malnutrition (21.4% so far). In conclusion mother-child clinic is not yet satisfactory and should be better developed; protein-energy malnutrition urges food supply and deeper food consumption education projects to be supported.