REPUBLIC OF THE CONGO

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80R01426R009800120014-0
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 38
• Document Creation Date: December 27, 2016
• Document Release Date: September 25, 2013
• Sequence Number: 14
• Content Type: REPORT

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A. General
Environmental factors affecting
1. Topography and climate
2. Socio-economic pattern
Table of Contents
Republic of the Congo
health
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Lazoie:/r.
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3. Animal and plant life 4
(1) Mosquitoes 4
(2) Flies 5
(3) Lice 5
()) Fleas 6
(5) Ticks and mites 6
(6) Other arachnids and insect pests 6
(7) Mollusks
(8) Worms 7
(9) Reptiles 7
(10)Rodents 8
(11)Mild animals 8
Nutrition 8
a. Dietary level 8
b. Food supply and distribution 9
c. Food sanitation, storage and technology 10
C. Diseases 11
1. Diseases of man 11
a. Diseases prevalent among the population 11
(1) Malaria' 11
(2) Typhoid fever 13
(3) Dysenteries 13
(4) Leprosy 14
(5) Trypanosomiasis (African) 14
(6) Plague
(7) Typhus 15
(8) Yellow fever 15
(9) Smallpox 16
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(10) Respiratory diseases 16
(11) Childhood diseases 17
(12) Dietary deficiency diseases 17
(13) Meningococcic meningitis 17
(14) Venereal diseases 17
(15) Filariasis 18
(16) Schistosomiasis 18
(17) Animal diseases transmissible to man
18
?2. Diseases of animals
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a. Prevalent animal diseases 20
(1) Trypanosomiasis 20
? (2) East Coast fever 21
(3) Babesiosis (Piroplasmosis) 21
(4) Lumpy skin disease 21
(5) Rinderpest 22
(6) Rabies 22
(7) Cysticercosis 22
? (8) Tuberculosis 22
(9) Anthrax 23
b. Other important diseases of animals 23
D. Medical organization and administration (veterinary) 23
1. Civilian 23
a. Administration 23
? (1) National 23
(2) Provincial 24
(3) Municipal 25
(4) Port and airport 25
(5) International 25
b. Legal controls 25
(1) Licensure 25
(2) Quarantine 25
(3) Inspection 26
C. Professional veterinary organizations 26
d. Veterinary research 26
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f. Emergency veterinary services
2. Military
E. Med-lgal, manpower
F. Veterinary facllities
G. Veterinary supplies and materials
H. Reference dati
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NIS 60 - Section 45
Republic of the Congo
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A. General -- The Republic of the Congo (prior to June 30, 1960, the Belgian Congo)
is one of the largest countries of Africa--about equivalent in size to the area of
the United States east of the Mississippi River. Its vast resources remained
unexploited until the beginning of the twentieth century, and since then the major
development of agriculture and livestock has been in the hands of white settlers,
chiefly Belgians.
About 47 percent of the 2,017,000 cattle population, the principal productive
segment, was in the hands of non-indigenous ranchers up to the date of independence.
Even so, requirements for livestock products over and above that of the rural
population was not met and animals or meat had to be imported. Native livestock
raisers keep animals for purposes of prestige rather than for economic productive
reasons. These animals are disease and parasite ridden, limiting their utilization
commercially.
In the decade prior to independence, veterinary services had developed rapidly.
Mile the government provided the basic disease investigation and veterinary
medicament production facilities, over half of the veterinary personnel were engaged
by private European ranchers or companies, livestock belonging to these enterprises
received excellent care and were protected against most of the serious infectious
diseases and parasites. However, during this same period, services to native
livestock raisers,progressed slowly, since the animals were of little economic worth
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and the owners had little appreciation for the benefits of modern health control,
or were even hostile toward intervention over their traditional practices.
The Belgians began, under the 10-year plan, in 1950, to augment training and
utilization of native technicians to improve native livestock conditions. This
process, in many respects, was gradually providing increased services to indigenous
livestock owners. As independence approached, in 1960, practically all the Belgian
supervisory personnel withdrew and native technicians, with the few expatriate
supervisors remaining, were often left without operational funds or salaries for
extended periods. In periodic chaotic circumstances following independence there ,
is little opportunity to carry out emergency animal health programs and almost no
possibility of establishing the necessary routine animal health procedures.
Regaining the level of animal health progress achieved under the Belgian regime
is dependent on internal political stability and a long transition period devoted to
intensive training of local people. Such programs require long-term support, both
in terms of financing and in providing technical assistance. Currently, this type of
assistance is provided through United Nations organizations, but as the political
situation becomes resolved a greatly expanded effort will be necessary.
B. Environmental factors affecting health
1. Topography and climate -- The Republic of the Congo is a vast section of
equatorial Africa, 904,991 square miles, approximately the size of the area of the
United States east of the Mississippi River. With the exception of a 25 mile coastal
area in the region of the Congo River delta it is completely surrounded by land. The
major part of the country lies in the Congo River Basin, a part of which is a lush
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tropical area. The major remaining area is principally typical wooded savannah or
grassland. The entire area is drained by the great Congo River and its tributaries.
Ruanda-Urundi lies directly east of the Congo and south of the equator. It is about
the size of Nest Virginia, mountainous, and the source of origin of the Nile River.
Climate in the Congo varies from the humid tropical rain belt of the equator to
one of bi-annual Alternating dryness and wetness in Katanga and the lower savannah.
The climate is not healthful either to humans or animals, and both are continuously
exposed to a host of tropical diseases as well as to many that are not peculiar to the
tropics. Continuous heavy rainfall in some areas and intermittent extended wet season
in others favor the propagation and survival of many insect vectors of disease. To
further compound the disease problem, a lack of communication facilities in many areas
allow foci of disease outbreaks to reach almost unmanageable proportion before
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attention can be brought to bear.
2. Socio-economic pattern -- Aside from the herds of a small number of European
livestock raisers, the domestic animals of the Congo are in ..the hands of natives with
no concept of husbandry whatsoever except herding, which is primarily designed to
protect the individual owners from losses due to straying, theft or predators.'.
Animals are valued in numbers, as a sign of presitge, rather than for commercial
purposes. Tribal chieftains relative importance is indicated by the size of herds.
Animals belonging to these individuals, as well as those of lesser significance in a
community, are used as dowry for wives or for special festive occasions. In Ruande
among the Nra-tutsi MWami, certain cattle herds may be regarded as "sacred," and
these animals often receive meticulous care. Generally, other herds are allowed to
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survive or die without regard to attention other than herding, since it is the
common concept that man is not intended to be a servant of beasts.
Although European settlers have introduced labor use of cattle (oxen)j few native
farmers have adopted' their use and crop fencing remains a laborious hand chore of
females.
Slightly over half the cattle population is native owned and, since these people
pursue a shifting form of agriculture, the result is a nomadic type of husbandry.
This situation is conducive to spread of diseases and, even under the recent Belgian
planning to provide health protection to tribal as well as settled herds, such fluid
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animal movement constituted a continuing problem in health control: ?
3. Animal and plant life -- The almost innumerable fauna, vertebrate and
invertebrate, of the Congo results from a generally equitable climate and environ-
ment for its perpetuation as well as a varied and luxurious flora.
(1) Mosquitoes -- Anopheline mosquitoes are common throughout the country,
with the exception of a mountainous region in the east and southeast. A. gambiae
is the most widely distributed malaria vector. A. funestus, A. moucheti and A. nili
are also principal vectors, but A. pharoensis and A. brunnipes also carry malaria
parasites. A. hancocki and A. hargreavesi may be potential vectors. A. funestus
is also a vector of Bancroft's filariasis. Other identified Anophelines are
A. aureosquamiger, A. condolor, A. coustani, A. christyi, A. distinctus, A. demeilloni,
A. implexus, A. kingi, A. obcurus, A. maculipalpis, A. paludis, A. pretoriensis,
A. rhodesiensis, A. rufipes, A. .squalnosus,A. transvalensis, A. theileri, A. vinckei
and A. welcomei.
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Over 29 species of Aedes have been identified in various areas. A. aegypti
is the chief vector of yellow fever and is incriminated in transmission of dengue or
"break-bone fever." Possibly important as vectors of sylvan yellow fever are
A. africanus, A. vitatus, A. luteocephalus and A. simpsoni.
Culex species, C. quinquefasciatus and (C. fatigans) are known vectors of
Bancroft 'a filariasis. Numerous others have been identified.
(2) Flies -- At least 13 species of tsetse flies (Glossina spp.) have been
identified in the Congo. The principal vector of trypanosomiasis (sleeping sickness)
is G. palpalis. G. brevipalpis, G. fusee, G. morsitans, G. pallidipes, G. fusci-
pleuris, and G. sererini have been incriminated vectors of human or animal
trypanosomiasis.
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Simuliidae (black flies) are troublesome pests in the Congo. In addition to being
extremely troublesome to livestock, S. damnosum, which transmits the filarial work,
Onchocerca volvulus is widespread. S. neavi and S. dentulosum are also present.
Chrysops dimidiata and C. silacea transmit Ioaiasis to large segments of the
population in some areas.
Culicoides grahami and C. austeni have been reported and may be vectors of the
filarial nematode, Acanthochelonema perstans. Culicoides spp, also transmit
African horsesickness.
Phlebotomus (sand flies), vectors of leismaniasis, are common.
(3) Lice Pediculus corporis has been a suspected vector of typhus fever
and P. capitis (head louse) and Phthirus pubis crab louse) are also commonly found.
Lice have been occasionally incriminated in the transmission of relapsing fever.
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(4) Fleas -- Xenopsylla brasiliensis and X. cheopis (rat fleas), are
abundant on rodents and are also found in native dwellings. In the Lake Albert
region, X. cheopis has been implicated in plague outbreaks, and is the vector of
murine typhus in scattered areas. X. nubicus has been isolated around Leopoldville.
Dog and cat fleas, Ctenociphalides canis and C. felis are common. The chigger or
sand flea, Tunga penetrans, is a widespread nuisance.
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(5) Ticks and mites -- Ornithodoros moubata is responsible for transmitting
the spirochete Borrelia duttonii, the organism causing relapsing fever (tick-borne)
in areas around Leopoldville and in the eastern plateau country. Other tick vectors,
in order of density and disease transmitting importance to man or animals, are
Amblyomma variegatum, Boophilus decoloratus, Rhipicephalus sammineus, R. simus,
R. evertsi and Haemaphysalis leachi.
Sarcoptes scabiei (the itch mite), is prevalent throughout the country.
(6) Other arachnids and insect pests -- Several species of spiders, several
venomous, occur. Among those identified are Scodra griseipes, Heterocrates didymus,
and Phoneyusa bidentata.
Many venomous scorpions have been identified, including Buthus trilineatus,
B. hottentota, Babcurus xentririmorphus, B. jacksoni, Isometrus maeulatub, Lychas
elver, L. burdoi, Pandinus viatoria, P. carimanus and Opisthacanthus africanus.
Large centipedes, probably poisonous, are Scolopendra morsitans, S. subspinipes
and Ethmostigmus trigonopodus. Cimex henipterus and C. lecturlaris (bedbugs) are
common in native dwellings.
Dorylus ants are destructive and sometimes dangerous pests in forest regions.
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Locust Nomadacris septemtasciata) and Locusta migrataria often destroy crops and
vegetation.
(7) Mollusks -- A number of fresh water snails are implicated in the trans-
mission of schistosomiasis. Various races of Planorbis (Elomphlaria) alexandrina
are intermediate hosts of Schistosoma mansoni. Physopsis africanus globosa is an
intermediate host for S. hematobium and S. intercalatum. Limnaea natalensis and
Physopsis africana are incriminated in Fasciola gigantica (liver flukes) of domestic
and wild ruminants.
(8) Worms -- Animals and humans are infested with a great variety of pathogenic
and non-pathogenic worms in the Congo. Among the more important aret Wuchereria
bancrofti, Onchocerca volvulus, Loa loa, Dracunculus medinensis, Necator americanus,
Echinococcus granulosus, Trichinella spiralis Taenia saginata, Ascaris lumbricoides
and Trichuris trichiura.
(9) Reptiles -- Poisonous snakes, probably of as wide a variety as.exists
in the world, are found in the Congo. They include terrestrial, aquatic and arboreal
species. The more common and poisonous ones are:
Scientific name
Bitis arientans
B. inorata
B. nasicornis
B. gabonia
Causus rhombeatus
Z7-11Chtensteini
Atractaspis congica
A. irregulairg-----
Naja nigricollis
N. melanopleuca
21apechis guentheri
Dendroaspis angusticeps
D. jamesonii
Athens nit schei
A. squamiger
Tiammophis sibilians
(Colubridae family)
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Common name
puff adder
Cape puff adder .
rhinoceros viper
gaboon viper
night adder
Lichtenstein's adder
male viper
_black burrowing viper
black-necked cobra
black cobra
Guenther's cobra
tree cobra
tree cobra
tree snake
tree snake
tree snake
rear-fanged tree snake (boonslang)
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The non-poismous constrictor, Python sebae, is also found.
Crocodiles (Crocodilus) are common, as are tortoises, lizards, chameleons.
(10) Rodents -- A number of species of rats and other rodents have been
identified in the Congo.
Scientific name Common name
Rattus rattus domestic rat
R. alexandrinus domestic rat
R. frugivorus domestic rat
R. wroughton domestic rat
R. norvegicus brown rat
R. kijabius domestic rat
Arvicanthus Sbyssinicus domestic rat
Mastomys coucha ugandae domestic rat
M. natalemsis domestic rat
Cricetomys gambianus wild rat
gtomys tropicalis elongis wild rat
ryptomys lechei wild rat
Tatera nigrita beniensis gerbil
The plague bacillus has been demonstrated in R. alexandrinus, R. kijabiUs, A. abytsinicus,
and EL coucha ugandae. The latter is frequently found in native dwellings and is a
major link in domestic to wild rodent transmission.
(11) Wild animals -- The savannah is inhabited by the larger carnivora such
as lion, leopard, hyena and jackal, which may be dangerous to man. Hyena and jackal
are involved in perpetuation of rabies. Numerous species of monkeys exist in the
forests and are linked with several arthropod-borne diseases of man. Wart hogs are a
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reservoir of African swine fever,
4. Nutrition
a. Dietary level -- The daily per capita food consumption in the Congo is
similar in quantity and quality to that of other areas in west equatorial Africa.
large share of the daily intake, estimated recently at 2,630 calories per capita, is
derived from starchy root crops and plantains. Such a basic diet is notoriously poor
in protein requirement; and this condition reflects in considerable malnutrition.
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pee rig. U.1."')G, pp. 42 & 4y, Pito %ay, OUC U1
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In addition to the imbalance in major food elements, minerals and vitamins are
inadequate, further complicating the nutritional problems. Figure
shows the food supply and intake as of 1956. Although this and other estimated food
consumption survey material indicate at least an acceptable caloric intake for a
tropical area, there are wide discrepancies in the food sources of calories. However,
nearly all reports indicate major proportion of calorie source is cassava followed by
plantains or bananas. The combined intake of animal protein (meat, fish, milk and
eggs) accounts for only 2 percent of the caloric intake. Food consumption habits in
the Congo vary amongst the numerous tribes. kgreat many of these customs are
maintained as traditions, although in urban districts their characteristics have
altered through contact with European culture.
b. Food supply and distribution -- The major part of the Congo and Ruanda
food is produced and consumed locally, in season. The chief imported food item is
flour, which provides nearly one-half the calories provided by imported food. A
marked fluctuation in diet related to seasonal availability of certain foods produces
unfavorable nutritional levels. One of these periods, known as "the hungry months,"
precedes the summer-fall harvest season.
A great many of the deficiency conditions are related to low soil fertility in
areas where stable agriculture has not yet occurred. Certain specific deficiencies
are related to low consumption of animal protein. Food of this category is high in
price and not readily available to the lower income segments of the population.
Various reports in 1961-1962 indicate localized famine conditions resulting from
the turmoil. There is some evidence that some of these reports have been
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exaggerated.
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0. Food sanitation, storage and technology -- A general lack of food sanitation,
storage or technological development, results in seasonal fluctuation in availability
of different types of food. lack of storage, except for a few imported foods in
major city areas is general. Rural families do have small granaries or storage units,
but losses from spoilage and pests may approach one-third of the crop. Storage of
root crops is less serious, for these can be harvested throughout the year and left
in the ground until needed.
Since the beginning of the ten-year plan the Belgians have sought to increase
supplies of animal protein by encouraging fish farming, whereby continuous supplies
of fresh products can be available. EXperimental fish flour production is underway
in the Congo and Buanda-Urundi, and a high protein product quite well received for
admixture to local diets may become available on a wider basis.
The veterinary services have been encouraging livestock improvement, feeding and
management. The country is still not self-sufficient in livestock products but a
potential for adequate production exists.
Food sanitation in the larger cities, where the foreign population supports
modern marketing, conforms reasonably well to European standards. Inspection and
sanitary handling of perishable products, including meat, milks fish and vegetables,
is carried on although the latter may be contaminated. Meat and fish refrigeration
units, including some fish freezing facilities, are maintained.
The native population is continuously exposed to contaminated foods. Meat
is grossly parasitized and may often deteriorate under tropical conditions.
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C. Diseases
1. Diseases of man -- The Congo and Ruanda-Utundi, like other newly developed
nations of tropical Africa, are confronted by a massive array of diseases and parasitic
conditions. Many of these are peculiar to the tropics, but many are also problems
' common to temperate, I., zones as well. Headway had been made during recent years in
establishing disease incidence data useful in planning and developing health programs.
However, consolidation of data, partly accumulated by private organizations, missions
or government services, has never been accomplished. This, of course, under the
unsettled condition and where the United Nations is largely responsible for operations
of health programs, makes effective medical and health care planning difficult.
Despite the difficulties, epidemiological data accumulated -in the past and that being
currently collated, provide bases for studying the incidence and spread of disease.
Post-war natural population increase rates have risen over prewar by over 4 per
thousand. A large part of the population increase has been due to lowered infant
mortality rates, particularly in the cities. Although the attitude towards illness
and death has traditionally been one of complacency, the increasing extra tribal
population is taking advantage of disease preventive measures which contribute to a
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steadily increasing population.
a. Diseases prevalent among the population
(1) Malaria -- Malaria is hyperendemic in lowl
agpreaches
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epidemic proportion at higher altitudes. At elevations over 5,500 feet it has not
been reported and anophalene vectors have not been found in some areas of the
eastern highlands. Malaria incidence is highest at the end of rainy seasons.
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Before European influence reached the Congo, this disease probably cause&
devastating losses anong the natives. In recent years, the incidence has fluctuated
and it has been reported that a gradual increase from 297,630 cases (864 deaths) in
1952 to 945,000 eases (2,333 deaths) in 1958. About 5 percent of the cases occurred
in Europeans. Leopoldville province reports the majority of cases followed by
Katanga, Kasai and Equateur provinces. In endemic regions, nearly 100 percent of the
children acquire infection before they are 10 years of age. Plasmodium falciparum
is the predominant infectious agent in Europeans and natives. P. malariae is common
in native children in endemic areas. P. vivax and P. ovale are encountered less
frequently.
Antimalaria campaigns in various regions during the past years have included use
of larvacides, disinsectization of houses and aerial dusting or spraying. In addition
to these insect control measures, large-scale distribution of antimalarial drugs
through hospitals, dispensaries and nutrition centers has been undertaken.
In 1958, the Director General of Medical Services set a Service for the Coordination
of Malaria Control in the Belgian Congo and Buanda-Urwndi (Service detEtude et de
Coordination de lutte antipaludique au Congo beige et Ruanda-Drundi-SECIA). .The
purpose of this organization was to: 1) determine the exact prevalence of malaria;
2) to carry out malarial research; 3) to coordinate activities of all agencies
interested in antimalarial work; ?4) to provide a clearing house for malaria
information, operations and research activities.
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Since independence, in 1960, the World Health Organization (WHO) has attempted to
carry on much of the antimalaria work. Shortages of personnel, unsettled political
conditions and lack of transport have seriously curtailed. programs underway prior to
independence. This situation applies particularly to mosquito control projects. In
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Ruanda-Drundi malaria control has been much more effective.
(2) Typhoid fever -- Typhoid fever is endemic in all parts of the Congo.
It is less common in Ruanda-Urundi. Sporadic outbreaks, partidularly in dry seasons,
occur along major trade routes. In many instances, typhoid and paratyphoid infections
are not differentiated. Nbere they- are, paratyphoid.B and C are more frequently
incriminated than A. In 1950, 1,800 cases and 61 deaths were reported and, in 1959,
1,528 cases and 75 deaths. Since 1960, outbreaks have been reported in various
localities frequently. The population is becoming more vulnerable to these diseases
as a result of a breakdown in vaccination programs. Systematic vaccination was once
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an enforced procedure among government and certain industrial personnel.-7
(3) Dysenteries -- Bacillary dysentery is common among the Congolese and
occurs not infrequently in the white population. An average of over 1,000 Europeans
and 6,000 natives suffer from this disease annually, and the case fatality-rate is
0.2 percent in the former and 2.4 percent in the latter groups. Shigella dysenteriae
and S. paradysenteriae have been reported periodically.
Amoebic dysentery is endemic throughout the area. Incidence is particularly high
in Leopoldville, Kivu and Orientale province's. Infection is spread particularly
among the natives, because of fly prevalence, lack of sanitary facilities and almost
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.complete ignorance of basic hygiene.
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(4) leprosy -- Over a quarter of a million cases of leprosy had been
reported in 1957. The disease is estimatedtto affect 3 percent of the population.
Over a course of a few years prior to 1960, a gradual decrease in the annually
reported cases began to occur. This is believed to be the result of intensive
treatment begun in 1953. The lepromatus variety accounts for 10 percent of the
cases and tuberculoid cases approach 90 percent.
In 1959, about 20,000 persons in advanced lepromatus stages or with serious but
curable skin lesions, were confined in leprosaria or agricultural villages maintained
by the government, the Red Cross or missions.
Sulfones and diphenyl thiourea are providei to patients, but the Congolese often.
fail to continue treatment after skin lesions disappear. A correlation study between
leprosy and B.C.G. vaccination was begun in 1960, since there was an apparent 50 per-
1/11/12/13/27/36/41/53/
cent decline in leprosy in a limited area of mass vaccination.
(5) Trypanosomiasis (African) -- Trypanosomiasis, or sleeping sickness,
is endemic in about half the total area of the Congo. Human trypanosomiasis in the
Congo is caused by Trypanosome gambiense, vectored: by the tsetse fly Glossinapelpalis.
Other tsetse fly species capable of transmitting human trypanosomiasis have also been
identified, and a, few cases of sleeping sickness caused by T. rhodiense have been
reported. Besides the relatively large numbers of people (336 deaths in 1957)
affected, this disease causes serious economic losses through its effect on animals
and by preventing habitation of potentially productive land.
The Belgians had accomplished considerable useful research on the disease and
inaugurated several campaigns of chemoprophylaxis which, in 1959, had reduced the
1/ 3/ 11/ 14/ 15/ 27/ 41/
incidence significantly in endemic areas.
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(6) Plague -- Sylvatic plague is enzootic in several foci around
Lake Albert and lake Edward. Sporadic cases occur elsewhere. From 1952 to 1958 an
average of 28 human cases a year were reported with an average case fatality rate of
60 percent. Several species of rats, which have been identified as reservoirs of
Pasteurella pestis, harbor the flea vectors. The Belgian Congo government had
established antiplague units in the health service. These units, operating as
mobile teams, carried.out antiplague measures which included disinsectization, rodent
destruction, hygiene extension work in villages and clearing of rank vegetation
around villages. This was followed by repeated systematic immunization of
11/ 27/ 34e/ 41/48/
inhabitants in enzootic areas.
(7) Typhus -- Both louse-borne and murine typhus have been reported
periodically in. the Congo. Louse-borne typhus is endemic: in Ruanda-Brundi and in
the Kivu region. Murine typhus foci have been found in a number of areas along
11/ 27/ 34e/ 41/
the Congo Basin, with the majority of cases in Kivu Province. ?
(8) Yellow fever -- Yellow fever occurs sporadically throughout the
Congo nearly every year. In 1958, the disease reached epidemic proportion with
75 cases reported. Twenty-three deaths occurred before the disease was brought
under control through mass vaccination, quarantine and an extensive disinsectization
program. This outbreak was thought to originate from the jungle reservoir, and the
vector Aedes aegypti is abundant throughout the Congo. Other Aedes species incriminated
in monkey to monkey and monkey to man transmission are also present. International
Convention regulations are reportedly enforced at sea and airports. Belgian authori-
11/ 12/ 13/ 27/ 33/ 112/ 41/
ties required vaccination of all white residents.
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(9) Smallpox -- Under Belgian supervisions extensive mass vaccination in
the decade prior to independence reduced the incidence of smallpox considerably. In
1958, a total of 598,526 first vaccinations and 3,782,473 revaccinations was reported.
Until 1960 laboratories in the Congo produced required vaccine.
The predominant type of the disease in the Congo has been the mild variola minor,
11/27/34e/41A3A4/47/
but, in 1959, 36 deaths among 334 cases of variola major occurred.
(10) Respiratory diseases -- Respiratory diseases account for a large
proportion of infant deaths. Pneumonia is prevalent, particularly among laborers.
Acfatality rate averaging 5.1 percent for the country as a whole was reported in
1957. .A great number of pneumonia conditions run their course in rural areas
without being reported.
Tuberculosis incidence surveys, utilizing both tuberculosis testing and
radiography, have been extensive in rural and urban areas in the past few years.
Still the exact. prevalence is not known. 'Whereas the disease was originally largely
urban, it has progressed into rural areas as a result of sick workers leaving their
jobs to return to their native villages. Fairly large B.C.G. vaccination programs
have been carried, out in some areas. Treatment and diagnostic facilities are still
inadequate. In comparing the number of new cases each year (6,660 in 1957) to the
number of treatment centers (18) with 997 beds, it is obvious that proper care and
segregation of non-arrested cases leaves much to be desired.
Influenza is endemic and occasionally epidemic in the Congo. In 1958, over
46,000 cases were reported.
11/ 27/ 34f/ 41/
Bronchitis is not an uncommon cause of debility in some areas.-- --
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(11) Childhood diseases -- Whooping cough, measles and mumps are endemic
and sometimes epidemic. A substantial increase of about 30,000 cases of measles in
the early 19501s to over 72,000 oases in 1959 has occurred. Recently, 1958-1959,
an average of 32,000 cases of whooping cough have been recorded. About 12,000 cases
of mumps are recorded each year.
Diphtheria is comparatively rare and, although scarlet fever is infrequently
reported, Dick test surveys show 93 percent of children acquire immunity by two
11/ 12/ 27/ 41/
years of age.
(12) Dietary deficiency diseases -- A number of nutritional diseases are
reported from all parts of the country. Kwashiorkor is probably the most serious, and
undoubtedly results in a greater number of deaths (555 in 1957) than any of the other
malnutrition conditions. Avitaminosis is common. Ben-ben, pellagra, rickets and
scurvy are serious but less frequently reported than the first two mentioned diseases.
A major share of the nutritional diseases is a fault resulting from unbalanced diets
1/13/27/28/34e/35/37/46/49/
as frequently or more frequently than from shortage of foods.
(13) Meningococcic meningitis -- Leopoldville and Kasai provinces particularly
report meningococcic meningitis as common among Congolese. An average of 575 cases per
year (1953 through 1959) have been reported. In the past ten years the percent of death
27/ 4-1-/
rate has been reduced considerably through the therapeutic use of sulfonamides,
(14) Venereal diseases--Annannual average of 71,954 cases of syphilis, among
the Congolese and 85 among-airopeans occurred over a period from 1952 to 1957. The annual
average of 146,834 cases of gonorrhea among the Congolese and 639 among Europeans was
reported for tge period of 1953 to 1957. Treatment, initiated by the Congo Red Cross, is
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provided at various hospitals and dispensaries. Since most natives discontinue
11/ 27/ 41/
?????=?? ailmo
treatment as soon as acute symptoms subside, control is difficult.
(15) Filariasis -- Various types of filariasis have been reported from
many parts of the country. Bancroft's filariasis and onchocerciasis cases occur most
frequently in Kasai and Orientale province. As many as 85 percent of the population
in some areas where the black fly vector of onchocerciasis is prevalent may be infected.
1/11/12/13/27/41/
Loiasis is most common in Equateur and Leopoldville provinces.
(16) Schistosomiasis -- Intestinal and urinary schistosomiasis is an
important problem in the Congo. Schistosoma mansoni and S. intercalatum are widely
distributed with major foci in Katanga and Equateur provinces. Over 47,000 cases
were reported throughout the Congo in 1957. Urinary ,,schistosomiasis, caused by
S. haematobium, is principally confined to two foci, one in Katanga and the other in
the Bas-Congo district of Leopoldville. Both forms of this parasitism are apparently
11/ 12/ 13/ 27/ 41/
increasing among the Congolese.
(17) Animal diseases transmissible to man -- Rabies is reported from
localities throughout the country. Both dogs and jackals are sources of infection.
The actual number of human cases is confused, since, in the average annual 48 reported
human cases in the period 1952-1957, only 26 average annual deaths occurred. It may
be that the reported cases actually represented individuals exposed, but it is not
known whether or not exposure was defined by definitive diagnosis of the rabies in
the attacking animal. Rabies control, including vaccination and elimination of stray
dogs, is generally poorly supported. Serious outbreaks in animals are periodically reported
from several provinces and Ruanda-Urundi.
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Brucellosis, caused by both Brucella meletensis and B. abortus, is sporadically
reported in Europeans and Congolese, particularly in Orientale and Leopoldville pro-
vinces. Brucella abortus affects as much as 20 percent of some dairy herds and is
considered common in dairy herds around Kivu province and adjacent Ruanda-Drundi.
Anthrax in animals has been reported in all Congo provinces except Leopoldville
and in Ruanda-Drundi. The intensity of animal vaccination in the latter area and
some Congo provinces indicates a possibility of some human health significance, but
no information is available on the number of cases among people.
Cysticercosis is rampant in animals throughout the Congo and Ruanda-Urundil where
investigations have been carried out. Surveys from slaughterhouses indicate bovine
infection rates of 54 to 90 percent and porcine rates of 12 to 16 percent. Considering
the meat eating habits of the natives, particularly on festive occasions where raw or
partially cooked meat is often consumed, both the infestation with the adult beef or pork
tapeworm must be-of considerable importance in man. Somatic cysticercosis in man from
. -3/15/22/24/27/
???/?=. ??=????
ingestion of the eggs of Taenia solium is a result of insanitary habits.
2. Diseases of animals -- The massive array of animal diseases and parasites is
tribute to the durable resistance of the native cattle to their effects. The survival
of imported breeds under European management attests to the efficiency of the animal
health programs carried out by the Belgian supervised veterinary services. Wildlife
reservoirs of animal diseases are as great or greater in this area than in any other
region of Africa. Despite the multiplicity of problems due to diseases in raising
livestock, a progressive increase in numbers had occurred over the past two decades.
1/3/15/23/28/34a/34b/
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a. Prevalent animal diseases
(1) Trypanosomiasis Trypanosomiasis is the most complex and important
livestock disease in the Congo and Ruanda..Utundi. At least four species of trypano-
somes and 13 species of Glossina (tsetse flies) are involved in the various formh of
this disease among animals in the area. Although the pathogenicity varies with the
trypanosome species infecting animal$, all are serious disturbing factors in the
ecological aspects pertaining to development of the livestock industry here asswell
as in,other,areas of Africa.
Certain tsetse fly infested areas of the Congo and Ruanda-Urundi are rendered
uninhabitable as a result of trypanoSomiasis and even normal grazing or market
movement of livestock is restricted.
The solution to the trypanosomiasis problem of the area lies in tsetse fly
control and eradication. The West Afriaan Institute for Trypanosomiasis Research,
located in Kaduna A10-31N - 7-26E), Nigeria, and the Commission for Technical
Cooperation in Africa South of the Sahara (CCTA), have made recommendation for tsetse
fly control in various African areas, and the Belgian veterinary authorities, prior
to 1960, carried out a considerable program to recover tsetse infested areas
through the use of insecticides, game control and bush clearing.
The most widespread and pathogenio trypanosome to cattle is T. congolense, and the
most important tsetse vectors are Glossina morsitans, G. pallidipes and G. brevipalis.
Nagana is the common collective term expressing trypanosome infection in domestic
animals. No immunity as such exists for the disease, but certain strains of indigenous
livestock are reported to tolerate infection better than others. Non-indigenous
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livestock types are extremely susceptible. Chemotherapy, using various phenanthridium,
and more recently prothidium and metamidium, compounds are used as curatives, and
the latter may offer a degree of protection for 4 to 6 months.
? The trypanosomes causing sleeping sickness in man are not pathogenic to
I/ 3/ 14/ 15/ 22/ 23/ 24/
animals.
(2) East Coast fever -- East Coast fever is a virulent and highly fatal
protozoal disease of cattle, periodically taking a high toll in the eastern Congo
provinces. Theileria parva, the infective agent, is transmitted by the tick
Rhipicephalus appendiculatus. All species of domestic cattle are susceptible but the
African buffalo is quite resistant, showing only a mild febrile reaction. Although
recovery from the disease produces a natural effective immunity, no practical
preventive immunization has yet been discovered. Control is dependent on control of
3/ 7/ 8/ 15/ 23/ 214/ 31_11/)
the vector.
(3) Babesiosis (Piroplasmosis) -- This is probably the most widespread
of the protozoal infections in the Congo. Babesia bovis is transmitted by a limited
number of Ixodidae ticks, the chief offender being Boophilus decoloratus. Indigenous
cattle are constantly exposed from birth and develop a degree of acquired immunity.
However, the destructive effect of the parasite on red blood cells leads to considerable
3/7/8/15/22/
debility. Loss can be considerably reduced by effective tick control measures.
(4) Lumpy skin disease -- This disease, confined for many years to East
Africa, was first noted in the Congo in 1955. The virus, immunogenically closely related
to that of sheep pox, may produce a highly virulent or a quite mild form of the disease.
Because of resulting morbidity, infertility and serious hide damage, the disease is of
great economic importance. Intradermal inoculation of culture propagated sheep pox
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virus is reported to protect against the disease in East Africa. Recently, a
3/ 15/24h/
successful vaccine has been announced by South African workers.
(5) Rinderpest Rinderpest, an acute virus disease, has long been the
most serious epizootic among cattle in Africa. In recent years, most countries,
including the Congo under Belgian authority, prevented wholesale ravages by wide use
of an effective vaccine. The Congo and Ruanda-Urundi, under current unsettled condi-
tions and the almost complete breakdown of veterinary services, are vulnerable to .
huge losses from this disease unless steps are taken to contain outbreaks that in-
evitably occur periodically in Africa, as a result of stock association with disease
resistant wildlife reservoirs of the infective agent.
3/ 15/ 22/ 314a/
(6) Rabies -- There has been a recrudescence of animal rabies in the
Congo and Ruanda-Urundi in recent years. Unless steps are taken to control stray
animals and re-instate regulated canine immunization this disease will continue to be
3 / 15/ 23/ 34a/
a serious public health threat.? ?
(7) Cysticercosis Cysticercosis incidence in animals in the area is
almost unbelievably high. Surveys in slaughter establishments have shown an incidence
as high as 90 percent in cattle carcasses and 16 percent in swine carcasses. While
the beef cysticercus does not pose as serious a threat to human health as that in pork,
the degree of animal infection is a definite public health problem. It also vividly
demonstrates the lack of any concept of personal hygiene on the part of the native
3/ 15/ 23/
population.
(8) Tuberculosis Tuberculosis in cattle may be more widespread than
heretofore expected. Redent surveys in abattoirs show one percent infection in cattle
and percent in swine. Tuberculin tests on several large ranches show a progressively
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increasing incidence.
(9) Anthrax -- Anthrax is a continuously severe problem. Although
European ranches have regularly vaccinated against anthrax, native cattle raisers
seldom bother to apply preventive measures. Proper disposal of anthrax carcasses is
seldom carried out and natives may even attempt to market the meat and almost
certainly the hides of dead animals.
3/ 15/ 34a/ 34b/
b. Other important diseases of animals -- Other important diseases of animals
in the Congo and Ruanda-Urundi are foot-and-mouth disease, Newcastle disease, blackleg,
3/7/8/15/34a/34b/
cutaneous streptothricosia, anaplasmosis, brucellosis and leptospirosis.
D. Medical organization and administration (veterinary)
1. Civilian
a. Administration
(1) National -- Until independence, in June 1960, the Belgians maintained
a national veterinary service designed to support and supply the provincial services,
the private veterinary employees of large ranches and the INEAC (Institut National pour
11 Etude Agronomique du Congo Beige) veterinary phase of the ten-year plan. The
national organization was composed of an administrative unit employing three
veterinarians. It maintained two veterinary research and production laboratories,
one at Ieopoldville (4-183 - 15-18E) and the other at Elisabethville (11-40S - 27-28E).
The laboratories were well staffed with competent veterinarians and technicians, and
were able to produce or compound nearly all of the biologicals and pharmaceuticals
required by the various field service veterinary personnel. In additions these units,
in collaboration with INEAC laboratories at Yangambi (0-46N - 24-28E) were able to
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train native veterinary technicians and attendants for laboratory and field services
in the Congo and Rtanda-Urundi.
After the creation of the Republic of the Congo, most of the Belgian veterinarians
left the country and a Congolese non-veterinarian was appointed as Director of
Veterinary Services. One Belgian veterinarian was retained as an advisor. The few
veterinarians who remained in the Congo were left pretty much without material, equip-
ment or finads to operate. The laboratories have been virtually non-functional and
1/4/15/22/23/25127/
vaccine and medical stocks are either nearly exhausted or deteriorated. 34/34E7
(2) Provincial -- Each of the six:provinces of the Belgian Congo had a
director of provincial services responsible for organizing and supplying the disease
control programs in the field. They were also responsible for training field
technicians. Most of the field veterinarians were private employees of large cattle
ranches, but the provincial services had some personnel to organize disease control
programs for native livestock owners. Both private and provincial veterinarians
carried out state requirements in quarantine and food inspection at district and
municipal level.
When the Belgian government withdrew- from control, virtually all of the European
veterinarians left the country. A few stayed on in an attempt to care for established
herds. No Congolese veterinarians were available as replacements and a large share
of the livestock population is now without veterinary attention. Three European
veterinarians remained in Ruanda-Urundi and the Food and Agriculture Organization (FAO)
of the United Nations sent in a few veterinarians to assist in critical disease
3/ 4/ 15/ 25/ 34a/ 34b/
conditions.
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(3) Municipal -- Disease investigation and food control at district and
municipal level were carried out by provincial or privately employed veterinarians
paid from state or provincial funds. INEAC veterinarians provided service to
4/ 15/ 25/ 34a/ 34b/
several regional stations in the various provinces.
(4) Port and airport -- Ports and airports receiving livestock or
livestock products were serviced by the national office in respect to animal inspection,
'quarantine and health certification. This function is now performed through the
4/ 15/ 25/ 34a/
office of the advisor to the Director of Veterinary Services.
(5) International -- Under Belgian authority veterinarians had actively
participated in African regional programs for research and disease control. Currently,
the Congo is dependent, and will for a long time be dependent, on international
organizations for advice and operation of animal health and veterinary public health
programs. Laboratories, not currently functioning, will require staff from inter-
national organizations or the employment of foreign national veterinary personnel.
In mid-1960, there were 108 veterinarians, mostly Belgians, working in the
? Congo, and 19 in Ruanda-Urundi. After independence, this number had dwindled to less
3/ 4/ 15/ 34a/
than a dozen.
b. legal controls
(1) Licensire -- Under Belgian control a veterinarian was required to be
on the government approved list. Veterinarians of other nationalities were approved
on examination of credentials. Since independence, no uniform system for veterinary
22/
accreditation has been established.
(2) Quarantine -- Imported livestock "Products are regulated under Belgian
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authority by the Director of Veterinary Services. Theoretically, this directorate is
still responsible for this function. Because of the serious rabies problem, the
importation of dogs was discouraged by Belgian authorities, and until July 1960 at
least, a long quarantine period for incoming dogs was an effective deterrent.
Attempts to control movement of livestock from surrounding countries to prevent
15/ 22/ 23/ 27/ 34a/
epizootics were never very successful.
(3) Inspection -- The Office of the Director-General of Medical Services
under Belgian rule imposed regulations for inspection of food of animal origin, and
the directorate of veterinary services carried out inspection within the areasof
European habitation. Designated food of animal origin for certain markets was required
to carry a stamp of official inspection. It is likely that, in recent times, the re-
quirements related to food sanitation are, at best, superficial.
15/ 22/23/ 25/ 27/
c. Professional veterinary organizations -- The Belgian veterinarians in
the Congo are all members of the Belgian Order of Veterinary Surgeons. No
22/
professional organization exists in the Congo.
d. Veterinary research -- During the decade 1950-1960, veterinary research
became a rapidly growing activity. Belgian veterinarians, cooperating with and
supported by such organizations as the Inter-African Bureau of Animal Health (IBAH),
the Permanent Interafrican Tsetse and Trypanosomiasis Bureau (BPITT), have participated
in a considerable part of the basic research related to studies of the tsetse fly and
trypanosomiasis. The FAO and other organizations have aided the veterinary service
in the Congo in development of applied research related to the important animal
3/ 15/ 17/ 22/ 23/ 24/ 25/ 27/ 34b/
disease in the Congo and Ruanda-Urundie
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f. Emergency veterinary services -- Under present conditions, any require-
ment for emergency veterinary services will be dependent on provisions made by the
34a/
United Nations.
2. Military ?-- NO military veterinary medical services exist in the Congo or,
Raanda-Urundi. Before July 1960, military police were quite normally employed in
assisting veterinary authorities in carrying out routine immunization procedured or
22/ 25/ 341)/
restricted livestock movement orders.
E. Medical manpower -- A general trend towards increased medical personnel,
beginning in 1948, was sharply reversed with the advent of independence. In 1948,
the overall public health personnel working in the Congo numbered 3,865. This was
increased until in January 1959, 8,493 were reported. Figure
shows the medical and paramedical personnel over a 3-year period.
Government physicians numbered 380 and those employed otherwise (missions,
private companies, etc.) 323, for a total of 703 in 1959. Of the total 8,493 medical
and paramedical personnel, 5,663 were African. The remainder, 2830, mostly Belgians,
with missions, private companies and philanthropic organizations, making up the
rest of the component.
After July 1960, a general exodus of Belgian and other foreign nationals occurred,
which included medical missionaries. Subsequent reports from various sources show
wide discrepancies in estimating the number of medical and paramedical personnel
remaining in the country. It is safe to,concludel that the number of doctors, including
116 WHO physicians listed at the end of 1961 does not exceed 300. The numbers of
paramedical perAonnel are similarly reduced. There are no Congolese doctors and the
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number of active medical assistants is almost certainly reduced to a figure below
that enumerated in 1959. The veterinary manpower is decimated and relatively impotent
because of lack of funds and continuing political turmoil. About 70 physicians were
engaged in Ruanda-Urundi in 1957-1958, but that number has been sharply reduced since
1960. Of 19 veterinarians in 1960, only two or three remain.
Information on the distribution of medical personnel is not currently available,
but it is doUbtful if many personnel. are permanent in areas outside the major cities.
The number of missionary people in outlying areas has fluctuated with the occurrences
of unrest over the past two years, and mbstYauthorities believe the native personnel
who may be left at hospitals dispensaries or treatment centers, are severely handi-
capped by lack of supplies and experience.
The optimum physician-to-population ratio occurred in 1959, when it reached
approximately 1:19,000, which compared favorably with that of other West African
countries. The current situation places the Congo in a much less favorable medical
care position and, since the current presence of physicians is extremely fluid and
many of the WHO medical personnel are on relatively short-term assignment, a ratio
calculation is not significant.
A progressive training program for medical personnel at all levels was an
important feature of the Belgian ten-year plan. However, advances in the less
sophisticated phases, where it was not necessary to send people abroad, was much more
rapid. Nearly every qualified observer of the medical situation in the Congo has made
the point clear that, the general low level of basic education has produced few
indigenous personnel capable of undertaking medical education in the near future.
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Medical and paramedical training was provided in the Belgian Congo by the govern-
ment and by missions or philanthropic organizations. The scope of training had
increased gradually from 1950 to 1960 as increased numbers of Congolese became
qualified. The Iovanium Congo University Center in Leopoldville added a medical
school in 1954. Special schools of tropical medicine were establishedtto provide
post-graduate training in tropical medicine for Belgian qualified nurses and midwives.
In 1956, the University of the Belgian Congo and Ruanda-Unundi at Elisabethville
established a medical school. By 1959, there had been established 134 other schools
for training African public health personnel. Figure
gives some detail concerning these schools.
A number of fellowships abroad for various types of medical and paramedical
science have been granted to Congolese personnel. The INEAC in Yangambi and the
veterinary laboratories in Leopoldville and Elisabethville have trained a number of
veterinary assistants and laboratory technicians. The INEAC program was geared
particularly to providing field personnel to carry out animal disease preventive work.
The Directorate of Veterinary Services in Rnanda-Unundi was responsible for
developing veterinary services from a virtual non-extant state in 1953 to a point
where 19 veterinary officers, participating in a disease control and training program,
1/4/13/15/22/25A7/30/34a/
trained over 100 livestock and laboratory technical assistants. 341:7417g67--
F. Veterinary facilities -- Three major veterinary laboratory centers have been
established in the Congo and one in Ruanda-Urundi for nesearch. The Elisabethville
Veterinary Laboratory (Laboratoire Veterinaire d, Elisabethville), the Laboratory for
Veterinary Instruction in the Belgian Congo (Iaboratoires et de 1,Enseignement
CONFIDENTIAL
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CONFIDENTIAL
Veterinaires du Congo Beige), now the Leopoldville Veterinary Laboratory, and the
laboratories of the Zootechnical Division of the National Institute for Agronomic
Studies in the Belgian Congo (INEAC) at Yangambi, are the primary units in the Congo.
These laboratories have produced practically all of the biologicals used in the Congo
and carried out most of the necessary investigations for field work. Each has been
responsible for a number of sub-stations in various parts of the country. In
Rilanda-Urundi the main veterinary laboratory is the Veterinary Research Laboratory at
Astride, (2-365 - 29-hh1,). The work of sub-stations is directed from this installation.
ILEAC also set up a Zootechnical Center at Rubona (I-58S - 29-38E).
The larger foreign private livestock ranches had set up animal care facilities
1/ 11/ 15/ 23/ 27/ 34a/ Nib/
on their awn properties prior to independence.
G. Veterinary supplies and materials -- At the time of independence the government
laboratories in Leopoldville and Elisabethville and the INEAC. laboratories at Yangambi
were producing nearly all of the biologicals and compounding most of the veterinary
medicaments used in the Congo. A few specially required products were obtained
elsewhere, chiefly from Belgium. In 'June 1960, theIeopoldville and Elisabethville
Laboratories had stockpiled biological' requirementsfor normal application to last
through the period-covering an expiration date for their viability. According to
reports of veterinary authorities visiting or communicating with veterinary advisors to
the Government of the Congo, many of the products were neither effectively used nor
properly handled. Furthermore, production of further supplies remained at a standstill
and it is unlikely that Congolese technicians will be capable of carrying on production
operations without outside guidance and financial support.
CONFIDENTTAL
-30-
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H. Reference data -- A number of charts and tables to be submitted with the
contribution.
I. Comments on principal sources -- For the Belgian Congo and Ruanda-Urundi, prior to
independence, June 1960, there are a number of comprehensive studies of the health
problems and resources. Although statistical figures on diseases, treatments, etc.,
for humans or animals do not represent a major share of the population, they are
sufficient to provide a reasonably good evaluation of disease studies and medical
activity over the ten-year period prior to independence. Medical and veterinary
reports subsequent to independence are numerous, often sketchy and more often contra-
dictory. However, they do enable investigators to conclude that deterioration of the
medical and veterinary activity in the past two years has been rapid and serious.
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Figure 1: Medical and paramedical personnel95 in the Belgian Congo, January-1, 1957, 1958 and 1959.
1958 :
Types of personnel : Govt. : Other : Total : Govt.: Other : Total : Govt. : Other :Total.
EUROPEAN PERSONNEL:
Physicians
Parmacists
Dentists
Veterinarians
Biologists
Auxiliary medical mid
sanitary inspectors
Nurses (religious and
non-religious)
Total
AFRICAN PERSONNEL:
Medical assistants
Male nurses (certified)
Sanitary inspectors
Nurse-midwives (trained)
Assistant male nurses
(certified)
Asst. midwives (trained)
Total
Combined total
:
:
?
.
?
.
?
?
:
?
.
?
:
?
?
:
:
:.
:.
:.
:.
:
:.
:.
:.
:
31711) :
9 :
43 :
13 :
:
4142: i
992 :
:
. . .:
. . .:
. . .:
. . .:
:
. ? ..:
. ? .:
? ? .::
303
46
28
59
268
960
1,664
104
869
88
15
3,256
268
4,600
:
:
:
:
:
?
:
:
:
:
:
:
:
:
:
:
:
:
:
?
?
643 :
62 :
37 :
102 :
13 :
:
715 :
1,084 :
2,656 :
t
104 :.
1
869 ?
_.
88 :
15 :.
:
3,256 :.
268 :.
4,600 :.
:
374:
16:
10:
49:
11:
:
472:
139:
1,071:
:
. . :
? ? :
? ? :
. ? :
:
.
? ? ?
. . :
. . :
312
57
30
59
148
1,011
1,617
113
892
93
15
3,744
375
5,232
.
.,
:
:
:
!
:
:
:
:
:
:
:
:
:
:
:
:
686
73
40
11;..11
620
1,150
2,688
113
892
93
15
3,744
375
5,232
:
:
:
:
:
:
:
:
:
:
:
:
:
:.
:?
:.
:.
:
:.
:.
:.
.
?
380:
19:
8:
49:
110
483:
155;
1,105:
t
. . .:
? ? ?:
. . .:
? ? .:
:
?. 4.:
.? .:
? ? ?:
:
:
323 :
63 :
35 :
59
:
?
:
:
:
1,::: :
:
1,725 :
:-
:
128 :
990 :
118 :
16 :
S
3,927 :
484 :
5,663 :
703
82
43
108
11
644
1,239
2,830
128
990
118
16
3,927
484
5,663
:
992 :
6,264
:
7,256;
1,071:
6,849
:
7,920
:
1,105;
7,388 :
8,493
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Declassified in Part - Sanitized Copy Approved for Release 2013/09/25: CIA-RDP80R01426R009800120014-0
Figure, --Training facilities for African public health Personnei in tne beigian uongo, Jank.uaky i,L.,
,
Category and location
Number
of
schools
Educational
requirements
for admission
Duration
of
course
Language
of
instruction
Number of students
Enrolled
Cont.
study
Grad.
Failed
Physicians
.
Faculte de Medicine
Universite Lovanium
Leopoldville
2
Congolese second-
ary school diplo-
ma and 1 year
7 years
French
22
22
y Faculte de Medecine
pre-university.
112
Universite Officielle du
1
.
Congo Beige et Ruanda-Urundi
Elisabethville
Nurses and midwives-graduate
training in tropical medicine
L'Institute de Medecine
3
Legal Belgian di-
15 months
French
Tropical, section inferieure
ploMa for nurse
7
Government: Leopoldville
or midwife or
5
Stanleyville
Elisabethville
Congolese equiva-
lent
8
Hospital nurses
, Ecole d'Infirmieres
hospitalieres
1
9 years and su-
perior grades
3 years
French
A.1
Leopoldville
Medical assistants
Ecoles d'Assistants Medicaux
3
9 years
6 years
French
145
111
10
24
Indigenes
4 theory
Government: Leopoldville
2 clin.
70
42
9
19
Affiliated: Kisantu
65
61
1
3
Kalenda
10
8
2
Male nurses
Ecolcs d'Infirmicres Indigenes
10
8 years
5 years
French
573
341
87
145
Government: Leopoldville
3 theory
74
45
. 9
20
Coquilhatville
2 pract.
44
21
10
13
Stanleyville
129
75
17
37
Elisabethville
64
41
8
- 15
Affiliated: Yasa -
57
26
6
25
Kimpese
76
60
8
8
Yakusu
54
35
12
7
Katana
29
18
4
7
Kalenda
Luboudaie
Ilealth inspectors
Ecoles de Gardes Sanitaires
Government: Leopoldville -
Bukavu
Elisabethville
Nurse-midwives
Ecoles d'Infirmieres-
accOucheuses
Government:
Affiliated:
Leopoldville
Elisabethville
Yasa
Mikalaie
Katana
Assistant midwives
Ecoles d'Aides-Accoucheuses
Leopoldville
Equateur
Orientale
Kivu
Katanga
Kasai
Assistant male nurses (orderlies)
Ecoles d'Aides-Infirmieres
Leopoldville
Equateur
Orientale
Kivu
Katanga
Kasai
Dentists
Ecole.de dentisterie
Lubondaie
A:tsistnnts in pharmacy
d'Assistants en Pharmacie
3
5
42
14
6
6
6
4
6
69
18
15
7
3
13
13
1
1
6-8 years
6-8 years
Literate in the
vernacular, some
knowledge of
French
Literate in ver-
nacular, some
knowledge of
French
NA
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33
4
16
4
9
5
8
5 years
French
65
28
11
26
2 pract.
25
8
5
12.
3 theory
24
10
3
11
16
10
3
3
3 years
theory &
practice
French
212
4
38
2
12
20
2
12
6
6
13
10
3
38
20
8
10
3
1
2
2 years
Vernacular
405
174
93
107
theory &
109
61
28
20
practice
35
20
11
4
83
23
18
21
70
17
10
33
20
7
7
6
88
46
19
23
1 year
Vernacular
1,104
413
318
283
3 months
and French
150
82
44
24
theory
144
24
59
61
9 months
232
94
44
35
pract.
112
34
19
28
111
43
32
36
355
136
120
99
NA
NA
20
12
8
5 years
NA
4
4
'theory &
practice
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