Burundi: MSF Closes Second Emergency Intervention for Congolese Refugees in Musenyi

In July, Ismael and Crispin were among the many children receiving treatment for severe malaria in the paediatric unit of Gihofi District Hospital. Referred from the Musenyi refugee site— located nearly 80 kilometres away — they were treated alongside local children by the hospital’s medical staff, supported by MSF.

“The seasonal malaria peak in spring has caused a rise in severe cases, often with complications such as severe anaemia, hypoglycaemia, respiratory distress and kidney failure,” explains Dr Jean-Claude Cishahayo, head of MSF’s intervention in Gihofi.

“The only health facility at the Musenyi refugee site, run by a local association, is overwhelmed. The lack of medicines is also critical. This has led to numerous complications and, tragically, deaths.”

Strengthening Emergency Care During the Malaria Peak

Between February and April 2025, nearly 30% of children under five who were transferred from Musenyi to surrounding health facilities did not survive. This alarming mortality rate was also linked to a lack of available ambulances for medical emergencies such as severe malaria, obstetric complications, the need for blood transfusions and serious infections.

“You could arrive at the health centre at eight in the morning and not be seen until noon, even in serious cases,” said Kasongo*, a Congolese refugee living in Musenyi, in July. “If a hospital transfer is needed, you may wait for hours before an ambulance becomes available.”

In response, MSF deployed emergency teams in mid-June to support Gihofi Hospital, focusing on treating severe malaria in children and pregnant women—groups particularly vulnerable to the disease. An ambulance was also provided to facilitate transfers to and from the Musenyi site. To further bolster capacity, MSF increased the number of beds in the paediatric ward from 45 to 70.

“Our priority was to reduce mortality during the peak malaria season,” says Dr Cishahayo. “The number of severe cases has since declined, allowing us to withdraw our teams from the hospital in mid-August.”

“However, significant challenges remain—particularly in securing blood for transfusions. The cold chain required for storage is located in Rutana, approximately 30 minutes away.”

Preventive Measures for Refugees in Musenyi

Alongside hospital support, MSF also ramped up prevention efforts at the Musenyi site. During its initial emergency intervention in April, 8,000 insecticide-treated mosquito nets were

distributed to families. A measles vaccination campaign, in partnership with Burundian health authorities, immunised 8,500 children.

In early July, MSF teams returned to install mosquito repellent systems in the 116 communal sheds where families reside while waiting for smaller, family shelters. A large-scale spraying campaign was then launched in early August, applying long-lasting insecticide in order to provide more sustained protection against malaria-carrying mosquitoes. In total, 1,146 shelters were treated.

“We hope this action will reduce the risks, as there are so many cases, and many children are dying,” says Elias, a refugee living in Musenyi. “In the evening, we can’t stay outside for long—there are so many mosquitoes, like flies!”

Following the conclusion of the campaign in mid-August, MSF teams withdrew from the site, handing over medical supplies—including medicines, beds and mattresses—to the existing health facility. Its teams continue to monitor the situation and stand ready to intervene again if urgently needed. A new organisation has now stepped in to support the local association previously running the facility.

Immense Needs Persist

Despite these interventions, access to basic healthcare in Musenyi remains a pressing concern. Refugees continue to report chronic shortages of medicines and frequent delays in emergency hospital transfers.

“It is clear that this vulnerable population requires greater medical support,” warns Adélaïde Ouabo, MSF Project Coordinator in Burundi.

“MSF’s interventions in Gihofi and Musenyi were essential, but we cannot meet these immense needs alone. There is an urgent need to improve both living conditions and long-term access to healthcare.”

As violence in the DRC continues, more refugees continue to arrive in Burundi. In Musenyi—originally designed to host 10,000 people—the Burundian government and the United Nations High Commissioner for Refugees (UNHCR) have launched an expansion project to accommodate up to 30,000 individuals.

* Name has been changed for confidentiality