A humanitarian disaster is unfolding in North Kivu, eastern Democratic Republic of Congo, where around one million people have fled their homes in the past 12 months to escape fighting linked to the resurgence of the M23 armed group. This crisis deepens an already critical humanitarian situation in the province, exposing displaced people and those in remote, conflict‑cut‑off communities to numerous health risks. Médecins Sans Frontières (MSF) denounces the current humanitarian response as vastly inadequate and calls on the international community and authorities to urgently scale up efforts to meet people’s needs.
“The situation in North Kivu is alarming,” says Raphaël Piret, MSF country representative in DRC. “You only have to look at the appalling conditions on the outskirts of the provincial capital, Goma, to realise that the response is insufficient, despite the many humanitarian organisations working in eastern DRC.” Over the past few months, hundreds of thousands of people have fled their homes and villages, seeking shelter with host families or in informal sites. Around Goma, makeshift shelters of plastic sheets or mosquito nets stretch as far as the eye can see, while others have taken refuge in churches and schools. “We arrived here in June last year and settled in a disused church in Kanyaruchinya with about 150 other families,” says 65‑year‑old Celestine. “For the past eight months our daily life has been a series of difficulties—sleeping, eating and clothing ourselves. Only one food distribution has taken place since the beginning of the year and, because my name was not on the list, I didn’t receive anything. We make do as best we can with what we find in the surrounding fields.”
About 3 000 shelters, currently accommodating some 15 000 people, have been built on the outskirts of Goma in the past year, but these numbers are tiny compared to the scale of need. “This is a drop in the ocean compared with the hundreds of thousands of displaced people camping around the city’s gates,” says Abdou Musengetsi, MSF project coordinator in Goma. “Families have been at the mercy of rains, epidemics and violence for months, as shown by the worrying number of sexual‑violence victims we treat daily in our medical facilities.” Since May 2022, MSF teams have been working in informal displacement sites around Goma, providing free medical care, trucking in drinking‑water supplies, and constructing latrines and showers. Yet much remains undone. In Bulengo, an informal settlement 10 km west of Goma, there is only one latrine for almost 500 people—less than one‑tenth of the minimum required by humanitarian standards. In the neighbouring settlement of Lushagala, displaced people survive on just over one litre of clean water per day, far below the recommended 15 litres.
Inadequate, overcrowded shelters and a lack of clean water and sanitation create ideal conditions for disease spread. Recent months have seen measles and cholera outbreaks in sites north of Goma, in Nyiragongo territory, while the health situation has become critical in Bulengo and Lushagala, with suspected measles and cholera cases multiplying. “In March, in Bulengo alone, we treated almost 2 500 patients with cholera symptoms and over 130 children with measles,” says Musengetsi. “It’s a shocking situation,” adds Piret. “Our teams are working around the clock to fight cholera and the growing measles cases, but they are completely overwhelmed. Stepping up assistance to the displaced—both in Goma and elsewhere—is a matter of urgency.”
North of Goma, MSF teams are also witnessing the crisis’s impact in Masisi, Rutshuru and Lubero territories. As frontlines have shifted, most major routes into the region have been cut off, severing essential transport links for trade. Cut off from the rest of the province, inhabitants cannot sell their crops or purchase essential goods, which have doubled in price. Many medical facilities have run out of drugs due to supply problems; in Rutshuru, some health centres have received no medicines for months. Access to healthcare, already difficult, is now even more challenging because functional facilities are scarce and the cost of care is unaffordable for many. “Due to a lack of financial means, the majority of people simply no longer have access to healthcare,” says Monique Doux, MSF project coordinator in Rutshuru. “They have to choose between eating or getting medical treatment. Even those who can pay must walk several hours to find a functional health facility.”
With prices rising and healthcare access deteriorating, food insecurity is worsening. More than one‑third of North Kivu’s 3 million residents are at risk of food insecurity, according to the UN. “In the health centres we support in Rutshuru, we treated more than 8 500 malnourished children in 2022, almost 70 % more than in 2021,” says Doux. In Rutshuru, Lubero and Masisi, there is a glaring lack of organisations providing aid. “It feels as if people here have been abandoned,” Doux adds. “For months, MSF has been the only humanitarian organisation working in Rutshuru, but the needs far exceed our capacity.”
“There is no time to lose,” says Piret. “The aid community and the authorities must redouble their efforts to ensure humanitarian aid reaches those who need it, wherever they are, while all parties to the conflict must commit to facilitating access for humanitarian organisations.”
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