A humanitarian catastrophe is unfolding in North Kivu, in the east of the Democratic Republic of Congo (DRC), where an estimated 1 million people have been forced to flee their homes in the past 12 months to escape fighting related to the re-emergence of the armed group M23. This severe crisis is exacerbating an already critical humanitarian situation. Not only displaced people, but entire communities isolated by the fighting are facing serious health risks.
The current humanitarian response is largely inadequate, denounces Médecins Sans Frontières (MSF), which is present in the area and is calling on the international community and authorities to urgently increase efforts to meet the needs of the population.
“The situation is alarming,” says Raphaël Piret, MSF coordinator in the DRC. “One only has to look at the appalling conditions in which people live on the outskirts of Goma to realize that the response is not up to the needs, despite the fact that there are many humanitarian organizations active in the area.”
Precarious living conditions
In recent months alone, hundreds of thousands of people have fled their homes and villages to live with host families or in informal places. Around Goma, makeshift shelters made of plastic sheeting or mosquito nets stretch as far as the eye can see, while others have found shelter 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 Celestine, 65. “For the past eight months, our daily life has been a succession of difficulties in sleeping, eating and dressing. There has been only one food distribution since the beginning of the year, and because my name was not on the list, I received nothing. We make do as we can with what we find in the surrounding fields.”
About 3,000 shelters have been built on the outskirts of Goma in the past year, currently housing about 15,000 people, but these numbers are small compared to the scale of people’s needs. “This is a drop in the bucket compared to the hundreds of thousands of displaced people currently camped on the outskirts of the city,” says Abdou Musengetsi, MSF’s project coordinator in Goma. “Families have been at the mercy of rains, epidemics and violence for months, as evidenced by the alarming number of victims of sexual violence we treat every day in our medical facilities.”
Since May 2022, MSF teams have been working in informal IDP (internally displaced persons) sites around Goma, providing free medical care, transporting drinking water supplies and building latrines and showers.
However, there is still much to be done. In Bulengo, an informal settlement 10 km west of Goma, there is only one latrine for nearly 500 people, less than one-tenth of what is required to meet basic humanitarian emergency standards. In the nearby settlement of Lushagala, displaced people survive on little more than a liter of clean water a day, well below the recommended 15 liters of water.
Inadequate and overcrowded shelters and the lack of clean water and latrines create ideal conditions for the spread of disease. In recent months, cases of measles and cholera have broken out north of Goma in Nyiragongo territory. The health situation has also become critical in Bulengo and Lushagala, with suspected cases of measles and cholera multiplying in recent weeks.
“In Bulengo alone, in March, we treated nearly 2,500 patients with cholera symptoms and more than 130 children with measles,” continues MSF’s Musengetsi.
“It is a shocking situation,” declares Piret, MSF coordinator. “Our teams are working around the clock to fight cholera and deal with the growing cases of measles, but they are completely overwhelmed. In the face of the humanitarian and health disaster before our eyes, there is an urgent need to intensify assistance to the displaced, both in Goma and elsewhere.”
According to the United Nations, about 2.5 million people are displaced in the North Kivu province today. As fighting continues, even more people may be forced to leave their homes and require aid to survive. “Actors involved in the humanitarian response need to be more responsive and more flexible to respond quickly to people’s needs and adapt to changing population movements,” continues Raphaël Piret, of MSF.
Limited access to health care
North of Goma, MSF teams are also observing the consequences of the crisis in Masisi, Rutshuru and Lubero territories. As the fighting fronts have shifted, most of the main access routes to the region have been disrupted. Links to this agricultural region, known as “the granaries of the province,” are essential for trade in North Kivu. Cut off from the rest of the province, residents have been unable to sell their crops or buy essentials, except for a few, whose price has doubled.
Many medical facilities have run out of medicines due to supply problems; in Rutshuru territory, for example, some health centers have not received medicines for months. Access to health care in these territories was already difficult, but now it is even more so because of the lack of functioning health facilities and the cost of medical care; medical care is unaffordable for many in the current economic crisis.
“Due to lack of financial means, most of the population no longer has access to health care,” says Monique Doux, MSF project coordinator in Rutshuru. “They have to choose between eating or receiving medical care. Even those who can afford to pay for treatment still have to find a functioning health facility, which can take several hours of walking.”
With rising prices and deteriorating access to health care, food insecurity is worsening in the province. According to the United Nations, more than a third of North Kivu’s population-three million people-are currently at risk of food insecurity. “In the health centers we support in Rutshuru territory, we treated more than 8,500 malnourished children in 2022, which is almost 70 percent more than in 2021,” explains MSF’s Doux.
In the Rutshuru territory, as in Lubero and Masisi, there is a glaring lack of organizations to provide much-needed aid. “It’s as if the people here have been abandoned. For months, MSF has been the only humanitarian organization working in Rutshuru territory, but the needs of the inhabitants far exceed our capacity to respond,” concludes Monique Doux, MSF project coordinator in Rutshuru.
“There is no time to waste,” declares MSF’s Piret. “The aid community and authorities must redouble their efforts to ensure that humanitarian aid reaches the people who need it, wherever they are, while all parties to the conflict must commit to facilitating access for humanitarian organizations.”
MSF’s emergency response
MSF launched an emergency response to provide medical assistance to displaced people in the Rutshuru territory in April 2022. After the first influx of IDPs arrived in Goma in May last year, MSF emergency teams provided medical care, set up water supplies, and improved sanitation conditions in informal IDP sites, first in Munigi and Kanyaruchinya, and more recently in Bulengo and Lushagala. In February 2023, MSF teams provided medical assistance and humanitarian aid to about 30,000 temporarily displaced people in the town of Mweso. MSF staff are currently strengthening the response to displaced people in Kayna, Lubero territory, and Minova (South Kivu). Meanwhile, MSF medical teams maintain their regular activities in Goma, Rutshuru, Kibirizi, Bambo, Binza, Mweso, Masisi and Walikale, providing basic medical care to thousands of people in the province of North Kivu.