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Sanjay Gupta MD

Providing Aid to Refugees Along War-Torn Darfur Border Difficult; Aid Workers In Darfur Under Attack; Raping Of Women, Young Girls, Even Children In Congo; Cholera Common In African Refugee Camps

Aired October 07, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

T.J. HOLMES, CNN ANCHOR: "Now in the News," it's not a total all clear, but they'll take. Most residents evacuated because of a fire at a hazardous material plant in Apex, North Carolina, are returning home today. City officials gave the go ahead for a phased in return about an hour ago.
A former Congressional page is expected to cooperate in the investigation of former Congressman Mark Foley. A lawyer for the now 21-year old man says he'll talk with federal agents next week. Foley resigned after his e-mails and instant messages to former male pages were made public.

Today marks five years since the launch of Operation Enduring Freedom in Afghanistan. Defense Secretary Donald Rumsfeld has written an article in today's "Washington Post." He says despite some setbacks, such as rising opium production and insurgency attacks, progress has been substantial since the Taliban's ouster.

And tension increases along the border between North and South Korea. South Korean troops fired warning shots today after five North Korean soldiers crossed into the southern side of the demilitarized zone. This comes as North Korea moves closer to its threatened nuclear test. That could happen as early as tomorrow.

Your next check of the headlines is coming up at the top of the hour. But first, "HOUSE CALL WITH DR. SANJAY GUPTA" starts right now.

UNIDENTIFIED FEMALE: HOUSE CALL heads to Africa.

(BEGIN VIDEO CLIP)

SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: You have to cross over this -- what used to be a road to actually get to some of Eastern Chad's most populated refugee camps.

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UNIDENTIFIED FEMALE: Dr. Sanjay Gupta goes to the camps and countryside to get behind the headlines.

Six months ago, she was making the rounds in Paris. Now she's risking her life in a war zone. Find out why.

And doctors tracking a disease before it becomes an outbreak. Their story and more, coming up on this special edition of HOUSE CALL.

GUPTA: Good morning and welcome to a very special edition of HOUSE CALL. I'm Dr. Sanjay Gupta, coming to you from the eastern part of the Democratic Republic of Congo.

I've been in this area of central Africa for more than a week now. We came here to report on the crisis in Darfur, but also the humanitarian calamity in surrounding countries, which much of the world doesn't even know about. War, lawlessness, lack of food, water, sanitation -- you name it -- have made parts of Chad and other parts unstable and unlivable as well.

We started our journey in Chad, traveling with an aid group, trying to get to a refugee camp near the border of Darfur.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Providing aid to refugees along the war-torn Darfur border sometimes means just getting there. That is often much more difficult than it seems. With crossed fingers, landing under runways.

As far as I can tell, this is a place civilization has forgotten. On this day, the transnational highway -- yes, this is the best road in Chad -- is suddenly flooded. It is the rainy season here in Chad and you can see rivers like this literally popping up out of nowhere, making it very difficult for cars to pass along this road.

(on camera): This is supposed to be a road right here. Two things happened. One it is difficult to get supplies into the refugee camps, but it also cuts down on some of the violence since the Janjaweed can't get to the refugees.

(voice-over): Today, we think we can make it across and continue to the Gaga camp on the Sudan border. We can't. Bad idea.

LAURA PEREZ, UNICEF, EMERGENCY COMMUNICATIONS OFFICER: During five months of the year here in Chad, there's a rainy season, which means that all the wadis (ph) and the rivers get filled with water. It makes it very difficult for us to cross those rivers, and get all our supplies to the refugee camps and to the IDPs.

GUPTA: As the UNICEF trucks we are in start to sink, we struggle to stay afloat, climbing higher and higher.

(on camera): It is often very difficult to get to some of these refugee camps. Case in point, I'm standing on top of a car, and a car that has now been stuck in a river bed. We have to cross over this -- what used to be a road to actually get to some of eastern Chad's most populated refugee camps.

(voice-over): And here is a clear example of the real daily challenges that aid organizations face. Just getting across the road proves impossible.

Finally, we give up. Without a clear idea of just how deep the water is, we wade across. It's only chest deep today, but the rainy season is still upon us. As the water gets high, the refugee camp supplies get low. Cut off. Providing aid in a war-torn area sometimes means just getting there.

PEREZ: If we don't preposition materials ahead of that rainy season, materials such as vaccinations and medical equipment and food, it's very hard for us to have access to the population that lives on the other side of the river.

GUPTA: Today, we don't even accomplish that.

(on camera): Eventually, we did get to that camp, but it was a camp teeming with refugees not just from Darfur, but also from within Chad itself. You see, Chad, according to the U.N., is one of the least livable nations in the world. Healthcare is almost non- existent. Only one doctor for every 29,000 people. So the camps, as rough as they are, offer the best hope for most people.

(voice-over): So happy, in part because they have no idea what they do not have. Life in Jaba (ph) refugee camp. Their smiles conceal a startling fact. This conflict has raged so long, an entire generation of children knows only the life of refugees.

They were born into it.

(on camera): No doubt it is not easy to take care of people in a refugee camp, but here's where it gets really difficult. This is a structure built specifically to take care of malnourished children. For example, Achte Djouma here, who is two years old and weighs less than ten pounds. Her mother knows she doesn't have a very good chance of survival, but they're doing the best they can, trying to get her to eat as much as they can.

(voice-over): Just for comparison, an average 26-month-old in the United States weighs 27 pounds, almost three times what Achte weighs. And here, even a slight cough in a young baby can become life-threatening.

We've seen so much abdominal breathing here. She's not even using her lungs to actually breathe. That's a sign that she's really struggling to try and get some air. She's in respiratory distress. There's no breathing machine here, there's no breathing machine there. So what happens to a child like this?

DR. HENRY MURAMBO, DJABAL REFUGEE CAMP: Well, we do our best. We use what we have here. Nothing much more than what we have.

GUPTA: Without some way to help this baby, it is unlikely she will survive. But in this refugee camp, she's been given at least another day.

But sometimes some of the best treatments are anything but elaborate. Cereals and oils mixed together, part of a nutritional plan funded by UNICEF.

It helped little Achte, who in just days gains a few ounces. Good news. But as they get older, if they survive to get older, it will get even harder still.

(on camera): It's over 100 degrees here today, but this is part of what life is like in a refugee camp typically. They have to live off the land. They take these seeds, for example, and pound them into a paste that they can eat. Sometimes they'll take these stalks after they harden and actually use them to build the huts.

It is not an easy life for so many of the children that you see here, but it's a necessary one for the time being. They're praying that they can get back to Sudan, but that doesn't look like it's happening any time soon.

(voice-over): They want to return to a place they've only heard about, but never known -- their homeland.

(on camera): Their homeland is Sudan, but their home is Chad. Constant turmoil drives out hundreds of thousands of people. And coming up, Jeff Koinange goes inside Darfur to see the ravages of war, close up. Stay with us.

(END VIDEOTAPE)

UNIDENTIFIED FEMALE: On the front lines of starvation, abuse, and war. The life of an aid worker in Darfur. What makes them stay?

And later, tracking an outbreak. How camp doctors struggle to stop disease.

(COMMERCIAL BREAK)

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GUPTA: Welcome back. The crisis in Darfur, after three years in assigned peace deal, things don't seem to be getting any better. There are about 200 refugee camps sustaining the people fleeing the relentless violence. And aid workers now themselves are under attack. They're still trying to do what they can.

CNN Africa correspondent Jeff Koinange has the story.

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(BEGIN VIDEOTAPE)

JEFF KOINANGE, CNN AFRICA CORRESPONDENT (voice-over): They have come from comfortable surroundings far away at enormous risk to themselves. Anne Mellet and Balginder Heer are part of a fast- disappearing breed in this region, foreign aid workers.

ANNE CECILE MELLET, ACTION AGAINST HUNGER: Just we have to continue the treatment.

KOINANGE: Six months ago, Malay was a pediatric nurse, making the rounds in one of Paris' leading hospitals when she was offered an overseas assignment. She said yes even before she learned her destination would be Darfur. MELLET: From my side it was a new beginning to all my life change completely.

KOINANGE: In her native French, she comforts a young malnourished girl named Yasmena. Don't worry, she tells Yasmena and her mother, it won't hurt. Yasmena is 13-months old and weighs just 15 pounds. That's what 6-month-old babies should weigh.

What Yasmena really needs is an intravenous drip to build her up. The best they've got here is some high protein milk and an old plastic cup.

And then there's the constant danger lurking both within and outside these refugee camps.

(on camera): Here's an interesting statistic for you. Ever since a peace deal was signed five months ago, 12 aid workers have been killed -- all of them Sudanese nationals. That's more aid workers than in the entire history of this conflict. The foreigners, too, are feeling vulnerable that they could very well be next.

31-year-old Balinda was a researcher into tropical children's disease for nearly a decade in London. She wanted to put her research into practice and she chose to do it here. Her parents tried to talk her out of it.

BALGINDER HEER, ACTION AGAINST HUNGER: Of course, you know, this is a conflict zone. It is dangerous. It's not as bad as people may imagine. It can be just as dangerous, if not worse, in some of the big major capitals around the world like New York and London.

KOINANGE (voice-over): She's also constantly aware that women here face an unusually great risk of being raped. She spends her nights in a protected compound, a 20 minute drive away.

HEER: Of course, when you hear about incidents like this, it has a huge shock waves through the NGO and the U.N. agency communities. Very traumatic. And it has a huge impact, and direct impact on the work that we do and how people feel here.

KOINANGE: Both admit what they do out here in the middle of nowhere in Africa is not suitable to everyone.

MELLET: We have nothing, no tools. We have nothing to work with them. So with what we have, we try to do our best.

HEER: Sometimes it can be very hard, especially when you lose a child. It can be very, very difficult.

KOINANGE: There are more than 14,000 aid workers in Darfur alone. And only 1,000 of them are foreigners. The risks are huge. So are the rewards.

Jeff Koinange, CNN, Abushak (ph) refugee camp in north Darfur.

(END VIDEOTAPE) (BEGIN VIDEOTAPE)

GUPTA: Jeff, myself, my colleague Anderson Cooper are covering this crisis as much as we can. And there's more than we have time for here today. So make sure to read the blogs as well at CNN.com/AC360.

There's some behind the scene stories, remarkable ones, like the mother I talked to whose life was tragically saved by the death of her baby daughter. There's also Jeff's account of trying to get into Darfur. Read them, send us your comments as well. We will be back with more HOUSE CALL after the break.

(END VIDEOTAPE)

UNIDENTIFIED FEMALE: Still caught in the crossfire. Trying to heal the wounds of war in the youngest of victims.

First, this week's medical headlines in "The Pulse."

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JUDY FORTIN, CNN CORRESPONDENT (voice-over): It's almost flu season and a new survey reveals some Americans may not take precautions. The National Foundation for Infectious Diseases reports fewer than half of 1,000 adults questioned said they would get a flu shot.

About a third of American teens don't meet standards for physical fitness. University of South Carolina researchers came to the conclusion after testing more than 3,000 12 to 19-year olds for respiratory and heart health.

New evidence that cancer patients undergoing chemotherapy really do experience chemo brain. UCLA doctor say a mental fog and forgetfulness can linger for up to 10 years after treatment. A study of breast cancer patients shows chemotherapy causes changes in the brain's metabolism and blood flow.

Judy Fortin, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

GUPTA (on camera): One issue that cannot be ignored in this conflict is the raping of women, young girls, even children. The outrage that it goes on unchecked, no justice to be had. Only fear to live with. And beyond the mental toll and physical injury is the lifelong risk of possibly getting HIV.

(voice-over): You're looking at a secret compound in a remote village, safe refuge for these girls who can now sing their power and peace. Not long ago, they were outcasts. Most left for dead. They were a part of rebel militia groups, recruited involuntarily as fighters, couriers, mostly as sex slaves. They are now recovering.

We filmed them in the most unobtrusive way possible. They don't want their faces to be shown.

(on camera): What is the worst thing that you saw happen either to yourself or to somebody that you knew?

"Seeing the dead bodies of her friends", she tells us. This girl says she was a human shield, sent to the front lines of a war. Another girl tells me that she was raped by several men and that her boyfriend was killed. Another adds, "we were all raped, every single one of us", she says.

When they sat down with me, all five say this is the first time they have spoken openly.

UNIDENTIFIED FEMALE (through translator): After I was kidnapped, one week later, I was sent to the front with a weapon. I fought for four years.

GUPTA: Talking, they believe, will help work through their demons. The staff at the center encourages it, but they take it even one step further.

Take a look at this. It's almost incredible. These girls are actually acting out what happened to them. Girls, shot at point-blank range. Crackling water bottles flying through the air. I'm told they represent bombs or grenades. And lots and lots of dead bodies, all tossed in a heap.

How do we not...

JENNIFER MELTON, SOCIAL WORKER: Retraumatize?

GUPTA: Retraumatize.

MELTON: I think it, again, that's another thing that's very individually based, that you allow them the time, you allow the opportunity.

Each person does that at their own -- at their own timing. For some people, they want to talk about it immediately. For other people, you might sit and visit with them on 10 visits at their home. And then that's when they'll start coming out. So I think it's about having patience and perseverance.

UNIDENTIFIED FEMALE (through translator): I had been kidnapped and felt hopeless. Then I heard about a center like this and wanted to find it. I wanted to restart my life. I wanted hope.

GUPTA: So how do you offer any sort of hope to outcasts? Girls who are so unimaginably damaged? Geraldine Bagone (ph) is a social worker at the center. To her, the answer is even more simple. Yes, it is important to share their pain and offer support. But in Congo, you can't survive unless you have some sort of training, a skill set. For some, a sewing machine could mean a bright new future. Learning to sew, pure delight.

UNIDENTIFIED FEMALE (through translator): I am happy to move on and forget what happened. I am very happy to be here and receive the training and activities like sewing.

GUPTA: The center has learned that teaching girls to sew and then taking those goods to markets like this are crucial steps to rebuilding hope and confidence and getting the girls safely out on their own.

But that, too, takes time and patience. For now, the lost girls will talk and talk and act out their past until sewing and singing lets them find themselves again.

(on camera): And more from the Democratic Republic of Congo after the break.

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UNIDENTIFIED FEMALE: The anatomy of an outbreak.

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UNIDENTIFIED FEMALE: It's one of the biggest concerns because it spreads so rapidly with people living in very difficult conditions.

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UNIDENTIFIED FEMALE: The overwhelming task of tracking disease in a camp overrun with people.

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GUPTA (on camera): Welcome back to a very special edition of HOUSE CALL, reporting from the eastern part of the Democratic Republic of Congo. Earlier this week, I visited the Getty (ph) camp, home to more than 50,000 displaced Africans. It's been hit by a dangerous outbreak of cholera. That's a disease that's rare in the industrial world, but I found that it's all too common here.

(voice-over): Early July, an 8-month-old baby in eastern Congo suddenly falls ill. She would soon be known as patient 0. She came from the Kukedy (ph) community along Lake Albert. Her family was so alarmed, they walked 60 kilometers to the Getty refugee camp.

Of course they didn't know it, but when they took her sick baby to Getty, the largest refugee camp in Congo, she was infected with a deadly bacteria. Locals call it torguat (ph). And it scares them. The rest of the developed world knows it as cholera. Is cholera your biggest concern as -- working for a medical organization?

LAURA SNOXELL, MEDAIR PROGRAM OFFICER: Definitely. Cholera is one of the biggest concerns because it spreads so rapidly with people living in very difficult conditions.

GUPTA: UNICEF reports 125,000 cases here in sub Saharan Africa last year. That's a sharp rise, because with so much contaminated water, the bacteria can spread quickly, like here, at Getty.

SNOXELL: There's been a big outbreak of cholera because there are about 50,000 people living in very cramped conditions, without proper toilets or access to clean water.

GUPTA: Quickly, there would be several deaths. Victims die from dehydration. The number of infected cases jumped to 109.

But then Dr. Blaze Gaya, the only doctor for this 50,000 refugee camp begins to fight back. This is his home. These are his people.

First, he separates the infected from the healthy.

(on camera): This may be the most important room when it comes to containing a cholera outbreak. This is an isolation center. Now before you go in there, you got to wash your hands with this bleach like substance. And then you actually go over here as well. And before you walk into the center, you got to clean your feet just by dipping it into this bleach like substance. Come on, let's take a look.

As you can see, the room is now empty, but this room at one time held lots of cholera patients, who were been isolated from the rest of the camp.

Take a look at one of these gurneys look like. It's not particularly nice. It has a little hole in there for people because they have such bad diarrhea. It's important to get them antibiotics. It's important to give them fluids. And it's also important to keep very specific records like these.

(voice-over): Now there are no fancy computers to keep track, but they do have this book, "Cholera Epidemiology". They actually get the job done.

(on camera): Take a look inside this book. July 8th, the first case of this most recent outbreak.

(voice-over): That's patient 0, the baby girl. Tracing every single case is really important. The best treatment is often these rehydration salts and antibiotics, such as Doxycycline.

Also key, making the right diagnosis. There are many water borne illnesses here, so signaling out the disease in a teeming camp of brutalized refugees is a huge challenge. (on camera): It is difficult to imagine how one takes care of refugees in a place like this. Take a look at this medical center here. This is the wall that is riddled with bullet holes. Rebels came here and took the beds, they took the refrigerators, they took the solar panels. There is no electricity here anymore.

And most importantly for cholera patients, this is a laboratory that used to have two microscopes, which were also stolen. Instead, you just have slides which are still waiting to be read.

(voice-over): Despite everything, the relief agencies working in this camp have made enormous progress in halting the epidemic and by tracing it back to where it began.

(on camera): So as you can see, a cholera outbreak can potentially be dealt with.

The desperation we have witnessed is unforgettable. Yet, many people will forget about this part of Africa. They're going to go on with life and forget about the people and the faces they have seen today.

A final word to you is try not to do that. Remember, what's happening in this part of the world, some call it a genocide. I don't care so much for terms. What we know, though, is that people here are suffering and need your help.

Thanks for watching. I'm Dr. Sanjay Gupta in the Democratic Republic of Congo. Stay tuned now for more news on CNN.

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