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This profile refers to the Democratic Republic of Congo (DRC), sometimes called Congo (Kinshasa), once known as Zaire. It should not be confused with its smaller neighbour, the Republic of Congo, often called Congo (Brazzaville). These two countries are separated by the vast expanse and power of the Congo river.
With a population of over 62 million Congo is home to more than 200 ethnic groups, each with its own language, dialect and customs. The most common languages include French (official language spoken by 80% on Congolese), Lingala (90%), Kingwana (a dialect of Swahili or Kiswahili), and Tshiluba.
Until 1960 Congo was under the colonial rule of Belgium during which time it was heavily exploited for its rich resources. Throughout the colonial period and since independence it has suffered from human rights abuses, frequent wars, political unrest, and economic hardships. Corruption is endemic and human rights abuses continue. Although rich in natural resources and mineral wealth Congo is one of the poorest countries in the world. The wealth of Congo lies predominantly in the hands of the ruling elite together with foreign interests. 75% of Congo is rain forest. Only 10% is agricultural or pasture.
Distrust between the various ethnic groups in Congo is extremely common. The uniting force of each community often relies on belonging to a particular church. The church thus plays a dominant role in the life of the Congolese by giving community support, health provision and education. 50% of Congolese are Roman Catholic and 20% are Protestant. A further 10% belong to syncretic sects that mix Christianity with traditional beliefs. 10% of Congolese adhere to traditional religions, the most popular of which is called Kimbanguism. Traditional religions include concepts such as monotheism, animism, vitalism, spirit and ancestor worship, witchcraft, and sorcery. These systems of belief vary widely among the ethnic groups. The Muslim faith is followed by 10% of the population. Many Congolese in Ireland have joined Evangelican churches rather than Catholic or Protestant ones. As in the Congo specific churches in Ireland have become the focal point for their congregation and they give the Congolese community a feeling of security and spiritual well being.
Contraception, although available and known about, is not widely practiced in Congolese communities due to religious beliefs that stress that children are a gift from God. Children are highly valued in Congo. When family planning is used natural methods are usually preferred over modern methods. The infant mortality rate in Congo is high (94.69/1,000 live births).
Abortion is illegal and is also forbidden by cultural laws. However, premarital sex is common and abortions do frequently take place as families consider it shameful for unmarried daughters to have sex or to be pregnant. Abortions will usually be carried out by taking herbal medication or by attending an illegal abortionist. Having an abortion is punishable by prison sentence. In some cases the families will instead bring the daughter to the baby's father's home, demand a fine and leave her with his family to take responsibility for.
Despite having inadequate health facilities Congolese women will usually opt to give birth in hospital. Caesarean births, however, are frequently viewed by the community as a failure on the part of the mother and this level of medical intervention will be avoided.
After birth in Congo the new mother is given extensive support from her own family for up to 3 months and she is expected to take lots of rest. Congolese mothers in Ireland find this period very difficult because these traditional supports are usually absent. At three months of age Congolese children are usually brought to church to undergo a celebration.
All male Congolese babies are circumcised, usually at 0-3 weeks of age. The requests for circumcisions at this age can cause much upset for Congolese mothers in Ireland as hospitals usually operate a waiting list of several months. This leads many mothers to seek to have circumcisions done by traditional doctors. Only 5% of females in Congo are circumcised but those that are usually have Type II which involves the removal of prepuce and clitoris together with the partial or complete excision of the labia minora.
Naming for babies is extremely important for Congolese and in one ethnic group (Kongo) a baby will not be considered to be truly a person until they are named. During Mobutu's rule Congolese were ordered to abandon Christian or foreign names and change to Congolese names. Many Congolese have reverted back to using Christian names while many retain the use of Congolese names. The present structure of naming involves having a first name - often Christian - followed by two traditional names. Names will often be chosen to reflect an event surrounding the birth or to evoke a family story. A child's name will usually be chosen by a maternal uncle (male) or by the mother or mother's sister (female). The person can choose which of these names they will ordinarily use so it is important to ask Congolese how they would like to be addressed.
Babies are usually breastfed in Congo. They will grow up to have a staple diet that includes cassava, plantains, maize, groundnuts, fish and rice.
Community solidarity is important throughout Congo and instilling respect for elders is practiced within all ethnic groups. Children will learn not to make direct eye contact with elders or to initiate handshakes. Instead they will learn to bow or kneel down to greet elders and they will often prostrate themselves. Children will usually be seen as the responsibility of the whole community and all adults in the community are expected to discipline children. Discipline is usually strict and corporal punishment in the form of slapping is the norm, as is the use of a raised voice. However, communication through eye contact is also used frequently as disciplinary tool. Non-verbal communication can also convey many other messages throughout Congo and what seem like simple gestures can easily be mis-understood between the Irish and Congolese.
If a Congo child need to go into care it is important that they be placed with a person that the family trusts. It is more likely that they will distrust a member of the African community - unless they have been vetted through their church - as they have no assurance that the person is not a witch. White families are free from such suspicion.
Before independence the primary school system was well developed by religious groups but the secondary school system is limited, and higher education remains under-developed. Literacy rates in Congo are currently between 65.5% and 77% and it is estimated that 40% of Congolese have no formal schooling at all and the vast majority of this group are female. Only 15.4% of adults have received secondary school education and only 0.7% attended university (est in 2000). Males noticeably outnumber females in schools.
The elderly are cared for by the extended family
Death rites in Congo can be very elaborate and long and surrounded by numerous cultural beliefs. For example, suicide is an unacceptable death and is greeted with enormous shame. In all deaths it is also inappropriate for the deceased to undergo a post-mortem or cremation as this is seen as interfering with the deceased person's after-life. It is also considered important for ancestors to welcome the deceased and for this reason many Congolese abroad will request that their bodies be repatriated so that they can undergo proper burial.
In normal burials the body is usually brought to the hospital but it is then returned to the family home where it will lie exposed for one to two days.
The community will gather to mourn with the family of the deceased for at least a week. It is usual to stay overnight, to sing and talk and give comfort and support. Financial contributions are also expected.
Burial takes place after a special ceremony in a cemetery where other deceased family members are also buried.
A week or so after burial the family will hold a party to thank all those who supported them. This also helps the family to have the strength to move on with their lives. Congolese in Ireland whose family members die abroad will mirror this celebration with their new community here in Ireland.
It is not uncommon for wives to be chosen for sons in Congo as marriage is usually seen as a union between the two families. As such it is important for marriages to be approved by both parents and couples that do not follow these rules are often left without family and community support. Cousin marriage is also practiced in some ethnic groups in Congo.
Marriage is an important ceremony for Congolese and celebrations may go on for some days and involve many rituals. The man usually pays a bride price to the bride's family. The money can be demanded back if the couple divorce.
Depending on the ethnic group, lineage in Congo will go through the paternal or maternal line. However, while all women are responsible in the domestic sphere the authority for children will rest with a male - either with the father (if lineage is paternal) or with the maternal uncle (if lineage is maternal). In some ethnic groups women are the head.
Most women in Congo receive unequal treatment and married women have to ask their husbands for permission to do such things as take a job, get a passport, open a bank account, rent or sell property.
Appearances matter in Congo in relation to health so if a person looks healthy they will be perceived to be healthy. Being well fed is synonymous with good health and illnesses that do not show as immediate sickness will often be given little importance, for example HIV infection will not easily be associated with AIDS so diagnosis and treatment will rarely be sought.
AIDS/HIV is particularly prevalent in Congo. Some estimates put the figure at approximately 33% of the population with adult females having a 1 in 2 chance of having AIDS/HIV (www.globalhealth.org). However, malaria remains the primary cause of mortality in Congo and the life expectancy at birth is 49 years.
Some tribes in Congo believe that to speak about something in the abstract will bring that something about in reality. So some Congolese will shy away completely from discussing any issues relating to health prevention such as health screening. Care should be taken not to create undue fears for Congolese patients by talking about specific diseases.
Adolescent pregnancy is common in Congo and the mortality rate for mothers in childbirth is three times higher than the average in Africa. Because preventative medicine is not practiced effectively in Congo pre-natal care equally may not be readily availed of. WHO have been working in Congo since 2000 to introduce preventative medical care and to encourage mothers to avail of prenatal services. However, it is possible that some Congolese in Ireland will be slow to avail of preventative health care services due to their unfamiliarity with the concept and the practices entailed. Many Congolese will also not have received vaccinations prior to their arrival in Ireland.
Psychiatric problems are seen very negatively in Congo so it is very difficult for Congolese in Ireland to accept and avail of mental health services.
Congolese will usually go to a hospital or private clinic in Congo when they are sick where they will see a consultant and get treatment. In Ireland, the Congolese will usually follow the same practice and even when they know of the GP system they might be reluctant to use it as they feel it is not specialist enough or the GPs surgeries are not treatment based. Payment for treatment and medication is expected and in Congo the fee will be paid prior to treatment. When a Congolese person uses a health clinic in Ireland they will usually be surprised to find that it has other services not directly related to health such as CWO services etc. Congolese do think of health as more than just absence of sickness, it is also about having enough food and satisfactory living conditions.
It is usual for fees to be paid to health care workers in Congo. It is therefore to be expected that Congolese in Ireland need to be told clearly when services are free so that they fully avail of them. There is strong evidence that Congolese do avail of services if costs are not an issue. Most health care services in Congo are run through the various churches. Churches are therefore usually seen as the primary centre for care and community service. The churches in Ireland are similarly seen as a focal point for social support.
Medication - including anti-biotics - are readily available without prescription in Congo and can be bought at pharmacies - many of which are not regulated - and even in the markets. Usually, Congolese will self-diagnose and will buy the medication they feel is necessary for their ailment. It is only when the sickness perseveres or is unusual that they will consult a doctor. When a doctor is consulted medication will be expected. This will often be given as an injection or intravenously by the doctor rather than in tablet form. Many Congolese will find the strict regime in Ireland, whereby drugs are only available by prescription, difficult initially.
Congolese may use herbal medications to deal with illness, especially specific illnesses like `flu, diabetes, prostrate problems, back problems, asthma, and malaria which all have a particular herbal treatment attached to them. Specialist practitioners in herbal treatments may be consulted. These treatments are considered to come from their ancestors and Congolese in Ireland will not use any other herbal medicine available in Ireland as an alternative. Occasionally it is possible for Congolese to get dried herbal remedies from Congo but traditionally healing herbs were used fresh so the practice of herbal treatment is dying out here. However, spiritual beliefs concerning illness still prevail in Ireland.
In Congo, if no cause for an illness can be found then the Congolese - from all walks of life - will usually turn to a traditional spiritual healer (Feticheur) who will help them identify the cause of the illness. The cause will always be supernatural and usually a member of the extended family will be accused of causing the illness, sometimes because of a perceived misdemeanour on the part of the patient towards this person. In Congolese terms this person is a witch and they must be appeased or placated in order to stop them harming the patient. Appropriate rituals will be recommended by the traditional spiritual healer. These practices are decreasing with the growth of religious beliefs that consider these practices to be sinful.
In Ireland, however, Congolese will not always feel themselves to be free from spiritual causes for illness. They usually carry with them the same fears and mistrust that are endemic in Congo although in Ireland they will often attribute the blame for illness to the devil but witchcraft from as far away as Congo may not be ruled out. Rather than attending a traditional healer, they will usually turn to prayer or will visit church elders as an important part of their health seeking strategy.
Because of this holistic attitude toward health and the need to know the cause for any ill health it is important for health care providers to be proactive in explaining the cause for each illness. It is also important for the patient to have family and friends around them during an illness and visits to the patient in hospital should be accommodated and encouraged.
There are over 200 ethnic groups in Congo. The Luba, Mongo, Kongo, and Mangebetu-Azande are some of the larger groupings of tribes making up 45% of the population. Other tribes include the Anamongo and Lunda.
One of the significant ethnic groups in Congo is the Bakongo. Bakongo people trace their lineage through their mothers (matriarchy). Kimbanguism, officially "the church of Christ on Earth by the prophet Simon Kimbangu," claims about 3 million members, primarily among the Bakongo tribe of Bas-Congo and Kinshasa. Kimbanguism, was seen as a threat to the colonial regime and was banned by the Belgians. However, in 1969, it was the first independent African church admitted to the World Council of Churches. 10% of Congolese practice Kimbanguism.
This very readable Canadian site gives a short account of the county's geography, history, sports, arts, work, family and health. It is socially orientated rather than health focussed, as it is designed to initiate communication and integration between habitual Canadian residents and newly arrived immigrants. It will therefore not explain aspects of culture to a depth that some health care providers would need. However, it does offer avenues and ideas that could be used to open up a productive communication process between health care providers and clients that would lead to relevant information being exchanged. ۞ ۞ ۞
This reliable UNICEF site gives background information and health related statistics that could prove especially useful for health care providers who need to determine the health and social history of their clients. Some cultural information can also be deduced relatively easily from the statistical detail. There is an emphasis on children's and women's health due to UNICEF's focus on children. ۞ ۞
This site from the US Library of Congress presents an extensive volume on the country, but it is no longer up to date especially where statistical data is sought. However, it is easy to find sections on health and social topics which are very comprehensive. It gives the major diseases that affect the people and it outlines the classical medical services that are available. Although the volume is easy to navigate the writing is not very approachable. It is heavy on fact but gives no information on traditional medicine and cultural issues that could affect access to health. Use as a last resort and be aware that major changes will have taken place in the last decade. ۞
This BBC site will give you a brief overview of the current political situation in each country. This may help you to know what political situation your client may have left behind and what their relations are currently living with. It also gives a brief overview of statistics - population, religions, languages, life expectancy and exports. ۞
This site gives you basic facts and a map of each country. It gives basic demographic details that include religion, ethnicities, health risks, mortality rates etc. which may be useful, especially if comparative material is required. A short synopsis of the political situation in the country is included. ۞
In 2002 Access Ireland produced a directory aimed at assisting those who are working with refugees and asylum seekers. The directory opens with a comprehensive and valuable account aimed at improving cultural competency, especially in relation to health. Topics include: Intercultural communication; Developing inclusive, intercultural policies and service provision: Refugees health and well being. Also included are 5 cultural profiles relating to refugee communities in Ireland (Angola, DRC, Nigeria, Roma, and Romania) Unfortunately they are not available on their website but the directory can be obtained from the above address. ۞ ۞۞ ۞
SPIRASI does not necessarily agree with the facts and opinions presented in this guide or any linked websites.
This Cultural Profiles web-site was designed to be fully compliant with modern standards for web publication (as specified by the W3C). The pages will be accessible and readable on any display using any web browser, old or new.