For Congolese Women in Goma, Nowhere is Safe

Every week, hundreds of survivors of sexual violence seek care at health centres supported by Médecins Sans Frontières/Doctors Without Borders (MSF) in Goma, eastern Democratic Republic of Congo (DRC). In 2024 alone, nearly 40,000 women were treated by MSF teams in North Kivu province — a record high. Since January 2025, when M23/Alliance Fleuve Congo (AFC) forces took control of Goma, the prevalence of sexual violence has shown no signs of decreasing.

In January 2025, after years of fighting against the Congolese army and allied armed groups in North Kivu, eastern DRC, the M23/Congo River Alliance (AFC) — backed by Rwanda — seized control of Goma, the provincial capital and home to over a million people.

During the first week of the offensive, hospitals rapidly became overwhelmed by a surge in casualties, both military and civilian. Morgues filled quickly as the Congolese army and its allies retreated, allowing M23/AFC to take over as the new authorities in the city. Heightened insecurity, increased crime and rampant violence became the new normal.

MSF teams continue to record alarming levels of sexual violence cases. Between January and April, more than 7,400 survivors of sexual violence received treatment at Ministry of Health facilities supported by MSF in Goma. West of the city, in Saké, an additional 2,400 survivors were treated during the same period.

Sexual violence remains prevalent under the new order

Throughout the week, female survivors of sexual violence, of all ages, can be found gathering from early in the morning at health centres where MSF works in Goma. They need healing, support and to be heard. Nasha*, 35, was among many patients to visit in May. Like many of the women, her life has been turned upside down by persistent conflict in North Kivu.

Originally from Masisi, a territory to the West of Goma, she fled ahead of clashes in the province between 2021-2024. They moved to a displaced persons camp alongside some 650,000 others on the edge of Goma. But in February 2025, the M23/AFC armed group ordered the dismantling of camps, effectively forcing their residents to leave. Large numbers are unable to return to their area of origin because they lack the resources to do so or because their lands have been seized. This has led many to seek refuge with host families or low-cost housing in Goma and the surrounding suburbs.

I lived in the Rusayo displaced persons camp,” said the young woman. “After it was destroyed, we moved to the courtyard of a school where we built a shelter. Armed men broke in one evening at 22:30. They attacked me. When my husband tried to protect me, they shot him dead.”

Nasha’s story is far from isolated in Goma and its outskirts. Every day, before nightfall, women travel to the city from the neighbouring territory of Nyiragongo in a bid to stay safe – too often in vain. Attacks on shelters, whether on small plots of land, rooms rented out by Goma residents themselves or public places, are frequent.

In recent years, most rapes happened during daily activities – particularly when women left the displaced persons’ camps to search for firewood or to engage in small-scale trading activities,” explained Armelle Gbagbo, who runs women’s health activities for MSF. “Today, many attacks happen at sites where women are living – whether in a house or in a refuge – and particularly during the night when insecurity increases. They are attacked wherever: in their homes, with their families, alone, in the streets of Goma or during outings on the edge of town.”

Nowhere is safe. Denisa*, 15, is originally from Rutshuru. She fled with her family to Goma amid the M23/AFC advance deeper into North Kivu a few months ago. In April, armed men broke into their home. “They were wearing military uniforms and came to steal from us. I was with my dad, my brothers and my little sisters. The men ordered my family to leave and raped me,” she said.

Not all sexual violence is committed by armed men, in military uniform or otherwise. Many cases are also committed by those closest to the victims themselves.

We shouldn’t discount the very significant proportion of sexual violence committed by family members, other members of the survivors’ entourage, or within host families” said Armelle Gbagbo.

Exploiting vulnerabilities

“The population of Goma has been gripped by fear since the city was taken,” said Frédéric Germain, MSF’s project coordinator. “There is significant insecurity in the city. Many criminals commit attacks, rapes and murders by night. A high availability of weapons mean that bandits and armed groups pose a constant threat. The economy is slowing down and the population is facing a system of violent predation.”

Sarah*, 25, also recently visited one of the health centres in Goma. Her husband was recently kidnapped by men armed with rifles and machetes who stormed into the small house where she and her family were staying after the camps were dismantled. “It was a few weeks ago and I haven’t had news since,” she said. Others around her recounted stories of killings, looting, kidnapping and similar forced disappearances of fathers and brothers.

A recent study by Épicentre, MSF’s epidemiological research centre, highlights a surge in violence in Goma, with the number of violent incidents reported in the first six months of this year being more than five times higher than in 2024.(1)

“The proportion of violent deaths recorded in this study is very high, representing one in four deaths. Incidents of physical violence and verbal threats are also occurring in large number, as testified by the number of people witnessing such events,” explained Dr Brahima Touré, an epidemiologist working with Épicentre. “The results show high levels of sexual violence which are likely to be significantly underestimated given that in this kind of study on violence, survivors find it difficult to speak out.”

(1) Study conducted by Épicentre on the monitoring of the oral cholera vaccination strategy and its impacts through repeated multi-indicator surveys in the city of Goma and the rural area of Bukama, including a retrospective mortality survey for the period from 31 March 2024 to 11 June 2025.

Targeted support, immense needs

The offensive on Goma led many civil society figures to flee, with several humanitarian organisations working to support sexual violence survivors also leaving, in part due to the impact of American budget cuts.

In Goma, we are practically the only association providing health services to these women. But the needs are immense,” said Frédéric Germain.

After being attacked in May, 75-year-old Angélica*, didn’t confide in friends or family. “I was ashamed,” she said. “I didn’t know where to find help so I stayed at home. After five days, I went to look for medicinal leaves to heal myself. I felt very bad and had pain in my stomach. I met a community health officer who directed me to the CCLK health centre where MSF offers free care.”

Among the survivors seen by MSF, close to 20% are unable to seek medical attention within 72 hours of being attacked – a critical window during which the administration of post-exposure-prophylaxis medication can significantly reduce the likelihood of contracting sexually transmitted diseases (STDs).

There is a high percentage of women suffering from STDs,” said Armelle Gbagbo. “This is also linked to the phenomenon of gang rapes or the practice of trading sex to survive. Many women say they are sexually exploited by the people housing them in exchange for food or a roof over their head.”

Congolese women are also suffering the consequences of the dismantling of the US Agency for International Development (USAID) under the administration of Donald Trump. An order of 100,000 post-rape kits – which include medication for preventing infection from HIV and other STDs – that were set to be distributed to multiple organisations treating sexual violence survivors in the eastern DRC was cancelled this year, with catastrophic consequences.

In May, the United Nations Population Fund (UNFPA) in North Kivu, which helped sexual violence survivors with support from USAID only had 2,500 emergency kits for the entire province, while thousands of women are attacked every month,” said Armelle Gbagbo.

Sexual violence is not limited to Goma or its suburbs. Survivors travel tens of kilometres to seek treatment in the city.

“It is essential that other international partners step up to support these women. Thousands are in need of urgent medical assistance,” concluded Frédéric Germain.

*Names have been changed to protect the identity of patients.