Accompany award winning photographer Phil Moore as he sets out with the medical charity Médecins Sans Frontières on an expedition to vaccinate people in the remote war torn mountainous region of Eastern Congo.

1. THE LAND OF A THOUSAND HILLSVACCINATION IN REMOTE, MOUNTAINOUS, WAR-TORN, EASTERN CONGO
PHIL MOORE FOR MEDECINS SANS FRONTIERES

2. Mist rises out of the forest at dawn over the village of
Ngomashi in Masisi territory in the east of the Democratic
Republic of the Congo. Ngomashi is a four hours trek over
mountains and through bush from the end of the nearest
road. The village hosts the main health centre providing
health care to many more remote villages in the area.

3. A convoy of MSF Landcruisers drive the road from Nyabiondo
towards the village of Kazinga in Masisi territory, in the east of
the Democratic Republic of the Congo.
The drive from the base in Masisi to Kazinga should have taken
three hours, but due to poor road conditions, it took six.

4. Danny, an MSF driver, tries to extricate a vehicle from thick
mud on the road between Kazinga and Nyabiondo in Masisi
territory in the east of the Democratic Republic of the Congo.
The road is almost inpassable during rains, thick with mud
and with several precarious log bridges to cross.

5. http://youtu.be/opUQXyx1CWs
Photographer Phil Moore’s diary.

6. Doctor Adolph Batundi Bindu speaks on a satellite
telephone from a vaccination site in the village of
Kishee during an MSF vaccination campaign in
remote areas of Masisi territory in the east of the
Democratic Republic of the Congo.
It took two days to reach Kishee from the MSF base in
Masisi, first driving five and a half hours to the village of
Kazinga, which lies at the end of a dirt-road. From
Kazinga, the team walked for three hours over hills and
through bush to Nyabiondo where they spent the night,
followed by another two hours trek to Kishee.

7. Nothing ever goes to plan in eastern Congo. It was supposed to take three hours to drive from
the MSF base in Masisi-Centre to the village of Kazinga. Six hours after packing into the Toyota
Landcruisers, we finally arrived, having got stuck in the mud, stuck behind logging lorries, and
and stuck rebuilding precarious log bridges over streams and rivers, which subsided with the
passing of each of the five vehicles in our convoy.
I had no real idea where we were going. Kazinga was just a small dot in the middle of a great
expanse of nothingness on the most detailed map I could find lying around the base. "You can't
really trust the positions on it, anyway,” one of the team told me. The other villages that we
expected to visit, and in which we would spend the night, did not even feature. My only notion
was a roughly scribbled sketch map, giving approximate walking time between the sites. On
the "official" map, these areas were simply great voids.
In Kazinga, MSF assembled a team of 55 porters to carry all the equipment necessary to
perform the mammoth task of vaccinating communities so far removed from any kind of
infrastructure. We left the last road we would see for four days. Rain-clouds loomed overhead,
and the narrow mud trails were already getting churned up by our boots. The rain that poured
down ten minutes into our journey would not be the first. The thick vegetation of these verdant
hills needs a lot of water to thrive.
If neighbouring Rwanda is dubbed "The Land of a Thousand Hills", then eastern Congo must
surely be the land of ten thousand, and we immediately began sliding down one of them,
surrounded by deep forest and rising, rounded peaks. At times, coarse blades of elephant
grass arched over the path, brushing against our faces.
I have rarely felt isolation in Congo, but this first day's trek crossed between the territory of two
different armed groups, their territories eerily demarcated by emptiness, where the sound
THE LAND OF A THOUSAND HILLS
VACCINATION IN REMOTE, MOUNTAINOUS, WAR-TORN, EASTERN CONGO
Photography and story by Phil Moore
The Land of a Thousand Hills,
all photographs by Phil Moore.
To enquire about this story
or to view other MSF Photo
stories from our projects
around the world, contact:
jon.levy@london.msf.org
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8. The jungle had taken over pathways and ultimately houses. In the village of Luho, the only
giveaway that it was once occupied was the occasional glimpse of bamboo marking a
doorway. Other than that, every structure had become just another mound of vegetation,
reclaimed by the greedy weeds.
Along the trail, we would occasionally pass reminders of why so much is deserted: groups
of men perched on hilltops, dressed in civilian clothes but with AK-47 rifles slung over their
shoulders, and Walkie-Talkies dangling. Since we left Masisi, there has been no cell
reception, and the only means of communication is by radio or satellite phone.
The terrain was tough, the mud making rubber boots a necessity. Within two hours of
starting, I had a huge blister on the heel of my foot which stung with every descent as my
feet slid inside the boots. My legs warmed to the pace, but every time I stopped to
photograph it was difficult to get going again, coaxing the lactic acid from my muscles. But
whatever my complaints, I was only carrying 20kg on my back; the more laden porters
have huge cool-boxes slung between them on bamboo poles, the only way to keep live
vaccines cold enough to survive the week. If they got too hot, the whole endeavour will be
pointless.
Dusk was fast setting when we reached Ngomashi, the first stop and where we would
spend the night. Thunder had been rumbling over the hills, and lightning forked across the
sky, heralding much more mud for the following morning.
The group split into small teams and parted ways in order to cover the maximum ground.
As we passed through small villages to our vaccination site, Papa Pascal, an MSF health
promotor, was calling out to all the mothers in the village, telling them to bring their children
to Kishee for vaccination. These are places seemingly forgotten by the state, so maximising
the number of people this campaign would reach was imperative.
When we arrived in the village of Kishee, a man was constructing a new house from thin
sticks covered with fresh, green palm leaves. Next to this small dwelling lay the crumbling

9. Children sit on the remains of a church
building ahead of a vaccination session in
the village of Kishee.
Kishee lies a six hour trek through bush and
over mountains from the end of the nearest
road, in Kazinga.

10. A team of MSF staff prepare
coolboxes for an intensive
vaccination campaign,
leaving the village of Kazinga
in Masisi territory, in the east
of the Democratic Republic
of the Congo.

11. A porter carries cool-boxes for
safely storing live vaccines, out of
the village of Kazinga in Masisi
territory, in the east of the
Democratic Republic of the Congo.
Three teams of six people set-off
from Kazinga to trek to remote
villages in the bush, along with 55
porters. Kazinga marks the end of
the road leading into the area,
which is controlled by two different
armed groups.

12. Porters carry sacks containing vaccination
equipment over a bridge of bamboo and
vines between the villages of Kitobo and
Katanga. Just before reaching the bridge,
one must cross a checkpoint manned by
rebels who control the surrounding area.

13. The brick walls are disintegrating and lined with moss. Its roof is gone. Over the benches
made from bamboo logs, dried palm fronds provide shade from the occasional glimpse of
sun, although would offer little shelter against the rain clouds that loomed overhead.
Crowds of mothers quickly assembled outside as the team unpacked syringes, rubber
gloves, vaccination cards and began preparing the vaccines. Within a short space of time,
the sound of children's scream pierced the air, their first encounter with a hypodermic
needle. A few brave children stood obediently waiting for the alien jab, their faces stoic
with the needle-prick.
As dusk fell, I spoke with Amin Bandu, a seventeen year-old girl who lives in the
neighbouring village of Katanga. There is no health centre in Kishee nor Katanga; people
are obliged to go to the health centre in Ngomashi, the trek we had made that morning.
She described the difficulties of living in the area. "To reach Ngomashi when there is
insecurity is impossible, it's terrifying. … We are often attacked by armed groups," she
explains, "I have seen people being killed". It turned out the group we had passed as we
left Kazinga the previous day was feared for these attacks.
That night, whilst asleep on the floor of the mud-hut where Amin and I had spoken, I was
awoken at 1am by a very different kind of army: ants had invaded my sleeping bag and
were biting me all over. I lay awake until my alarm rang out four hours later. My eyes were
as dreary as the morning that greeted us; the village was shrouded in mist, the dull light
just about showing the outlines of the hills across which we would trek on our way to the
next village.
From Kishee, we passed through Amin’s village, having crossed a very rickety bridge
spanning the river. The bridge is made from creaking bamboo and weathered vines. It
flexed and stretched with every step, and I looked for vines to grab in case it finally gave
way under my weight.
Just prior to this bridge was a "check-point", manned by militia men from one of the
armed groups. Whilst their presence was not threatening when we passed with our band

14. porters (they had received instruction from their commanders to allow us free passage) the
real negotiations were to ensure the porters had free passage on their return journey after
the vaccinations were over.
The village of Kalungu marked the furthest point of our expedition, and it is seemingly
completely removed from the body politic. But globalisation has trickled in to this remote
place, with plastic flip-flops and basic cooking pots, their price still scribbled on in black
pen: "$8". Brightly coloured umbrellas covered figures running between the wattle and
daub huts, under the huge storm that erupted in the afternoon. And then there are the
guns of the militia men that pass through the village.
The people here cultivate very little; fields have been abandoned due to the conflict. This
meant that food was scarce, despite the rich vegetation that surrounded us. "Fou fou", a
mixture of water and flour, was the ubiquitous meal, often made by pounding dried
bananas in a huge mortar and pestle. We would sometimes eat in the mid-afternoon, but
on some days, the first meal came once the day's work was over, as night set in. The
weekly market in Kazinga was abundant, but aside from the day's travel to get there,
villagers must negotiate the armed groups, and issues of ethnicity can quickly deteriorate.
Five days after we began this journey, we finally got back to Kazinga. The market stalls
were empty, and armed men were prolific. As hail beat down on a small tin-roofed hut, I
sheltered with three of them. An AK-47 stood propped in one corner, a rocket-propelled
grenade launcher in the other. Symbols, in part, of the factors contributing to the lack of
development that has reached this land.
It was not until six hours later, having repeatedly got stuck in thick mud, that the first signs
of government authority appeared. As we approached the main road, government soldiers
stood by the roadside. As roads disappear, so does the government’s influence, and off the
major axes, one enters the fiefdom of Congo's myriad armed groups.
Phil Moore, August 2014

15. Porters carry sacks containing vaccination equipment
over a bridge of bamboo and vines between the villages
of Kishee and Katanga during the intense vaccination
campaign in Masisi territory.

16. A mother with her child stands holding a vaccination
card outside her home in the village of Kishee during
an MSF vaccination campaign in remote areas of
Masisi territory.
From Kazinga, the team walked for three
hours over hills and through bush to
Nyabiondo where they spent the night,
followed by another two hours trek to Kishee.

17. Porters carry an 'accumulator', a cool-box for
safely storing live vaccines, through the bush
between the villages of Kazinga and Ngomashi.
MSF conducted the campaign across territory
controlled by armed groups, in villages
accessible only by foot.

18. Alpha Atafazali Bahunga speaks to mothers to
raise awareness of vaccination ahead of a
vaccination session in a church - school in the
village of Kalungu II in Masisi territory.
Over the course of a week, MSF teams trekked
into remote parts of Masisi territory to vaccinate
pregnant women and children under five years old.

19. Mothers listen to Alpha Atafazali Bahunga
telling them that they require three rounds of
vaccination during a session in a church-
school in the village of Kalungu II

20. Cool boxes for live vaccines are pictured in a
church used as a vaccination site in the village
of Kishee during an MSF vaccination campaign
in remote areas of Masisi territory in the east of
the Democratic Republic of the Congo.

21. Porters carry accumulators filled with ice to keep live
vaccines cold, out of the village of Kazinga.
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22. A nurse prepares vaccines in a church used as
a vaccination site in the village of Kishee

23. A child stands atop a tree stump outside a church-school
used as a vaccination centre in the village of Kalungu II.

24. Mothers and their children queue for vaccinations in
the village of Kishee.

25. A child is given a measles vaccination in a church used
as a vaccination site in the village of Kishee
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26. A house stands empty as it is reclaimed by the jungle
in the abandonned village of Luho in Masisi territory in
the east of the Democratic Republic of the Congo.
Luho is one of several villages in the area which have
been abandonned due to the conflict, in an area held
by the rebel group.

27. A lady cooks food over a fire in her home in the village of
Kishee in Masisi territory in the east of the Democratic
Republic of the Congo.
Kishee lies in an area controlled by armed people, and took
six hours of trekking across mountains and through bush to
reach from the end of the nearest road, in Kazinga.
People here say that there is often conflict linked to the
armed groups operating in the area, with difficulties in
accessing quality health care.

28. A porter carries a bag containing vaccination
equipment, arriving in the village of Kishee.

29. A child receives a polio vaccine from a day-labourer
in the village of Kishee.
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30. A phial of diluted live
measles vaccine sits on top
of ice-packs on a table in the
church-school in the village
of Kalungu II during an
intense vaccination
campaign in remote parts of
Masisi territory in the east of
the Democratic Republic of
the Congo.

31. Polio (top left), and live
measles (top right) and
yellow-fever (bottom left)
vaccines, along with
hyperdermic needles, sit on
top of ice-packs on a table
in the church-primary school
in the village of Kalungu II.
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32. Porters carry an 'accumulator', a cool-box for
safely storing live vaccines, through the village
of Kalungu II to resupply an intense vaccination
campaign in Masisi territory.
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33. A girl carries a basin through the village of Kalungu II in
Masisi territory in the east of the Democratic Republic
of the Congo. The village is in the heart of territory
controlled by an armed group.

34. Sheltering from the rain in the doorway of a
church-school in the village of Kalungu II.

35. A militia man carries a rocket-propelled grenade
under the rain in the village of Kazinga.

36. A militia man of an armed group carries an
AK-47 in the village of Kalungu II.

37. Children shelter from the rain in the doorway of
the church-school in the village of Kalungu II.

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Issa Chirihahira Nyamirenge followed by Justin Ndagijimana Ntimba,
MSF nurses, walk through the abandonned village of Mukatato at the
end of an intense vaccination campaign in Masisi territory in the east
of the Democratic Republic of the Congo.

39. Elke Stoppie, an MSF nurse working in the Health Promotion team,
walks through the rain after returning to Kalungu II after visiting a
nearby village as part of the MSF vaccination campaign in remote
parts of Masisi territory.
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40. Alpha Atafazali Bahunga raises awareness of vaccination ahead of
a vaccination session in the village of Kitobo II..
The session in Kitobo was extra to the planned Intense Vaccination
Campaign organised by MSF over the period of a week, due to
conflict between Kitobo and Kalungu which prevented residents
from crossing between the two villages.

41. Mothers and their children have vaccination cards filled out after
receiving vaccines as part of an Intense Vaccination Campaign in
the village of Kitobo II.

42. A pregnant woman is vaccinated in the village of Kitobo II.

43. Filling out vaccination cards in the village of Kitobo II.

44. A child receives a polio vaccine in the village of Kitobo II.

45. A child looks into a church being used as a vaccination
centre in the village of Kitobo II.

46. Mud is splattered over the door of an MSF Landcruiser
on the road between Kazinga and Nyabiondo in Masisi
territory in the east of the Democratic Republic.