Democratic Republic of the Congo
What to know about the armed conflict in North and South Kivu
The armed conflict between the M23/AFC armed group and the Congolese army, backed by their allies, has spread from North Kivu to the neighbouring province of South Kivu.
3 questions on the intensification of the armed conflict in North and South Kivu
The northeast of the Democratic Republic of Congo (DRC) has endured decades of insecurity since the fallout of the 1994 genocide in neighbouring Rwanda. Driven by ethnic tensions and a fight for resources, the protracted violence involves over 100 armed groups (such as the M23), as well as Congolese government forces and UN peacekeepers. Millions of people have been displaced, infectious disease outbreaks are frequent and access to essential healthcare is a critical need.
The conflict has spilled over into South Kivu province and recently brought the front line even closer to the civilian population, and has reached Goma, the capital of North Kivu province, where 650,000 people have already been displaced into makeshift camps alongside an estimate of 2 million people living in the city.
After heavy fighting, the M23/AFC took control of most of Goma at the end of January 2025 and announced on February 6 the establishment of a new parallel administration (mayors, administrators) in Goma – not recognized by DRC’s official government.
Despite the hostilities, MSF teams continued to provide medical assistance to affected communities through its regular and emergency projects in North and South Kivu.
MSF's response
On February 6, 2025
A week after M23/AFC managed to seize most of the city, MSF teams were already:
- supporting 2 hospitals for the treatment of wounded (Kyeshero and Virunga hospitals);
- collected and distributed blood bags for overwhelmed hospitals;
and were able to return to several displacement sites to support local health centres; expand and/or re-establish cholera treatment units and special clinics for survivors of sexual violence (Tumaini clinics); provide food and water and fuel for water pumping stations; empty latrines and install hand-washing facilities.
Priorities at this stage remain the care of the wounded and reducing the risk of cholera outbreaks, which is a concern due to unsafe water sources, inadequate sanitation and displacement.
MSF teams continue to assess humanitarian needs every day, both in the camps and in the city, as the impact on the population is enormous. The next few days will allow us to assess the next steps.
Our activities in 2024 —
million outpatient consultation
vaccinations against measles in response to an outbreak
people treated for sexual violence
children admitted to inpatient feeding programmes
surgical interventions
people receiving HIV antiretroviral treatment
The Democratic Republic of Congo (DRC) was Médecins Sans Frontières’ (MSF’s) largest country of operation in 2024. Our teams responded to people’s immense humanitarian needs, which have been exacerbated by years of conflict.
In 2024, MSF increased activities to respond to the devastating impacts of the brutal conflict raging across North Kivu, South Kivu, and Ituri provinces in eastern DRC, which had displaced four million people by the end of the year. We also responded to numerous other emergencies, including disease outbreaks and floods, and continued to run our regular and specialist projects throughout the country.
Response to conflict in eastern DRC
The conflict in North and South Kivu, which began in 2021, escalated in 2024 between the M23, the Congolese armed forces (AFC), their respective allies, and other armed groups, causing new waves of displacement.
In February alone, 250,000 people arrived in the already overcrowded camps on the outskirts of Goma, the capital of North Kivu. In 2024, the living conditions in the camps continued to deteriorate, due to a lack of national and international action, and the frontlines moved closer to the city, making them more vulnerable to armed violence.
Many civilians were caught in the crossfire, with numerous killed or wounded by heavy artillery shelling, while others were subjected to sexual violence.
To address this critical humanitarian crisis, we scaled up our emergency response efforts, strengthening general, maternal, and paediatric care, delivering lifesaving vaccinations, and providing treatment for victims and survivors of sexual violence, many of whom were women and children. In 2024, our teams treated an unprecedented number of people for sexual violence in North Kivu. We remained the primary water provider in the camps around Goma, making significant investments in sanitation infrastructure, including a solar-powered water supply system, a water-pumping station, and a faecal sludge treatment plant. These efforts were critical, as we also treated thousands of patients for cholera in the displacement sites.
Escalating fighting on multiple fronts and repeated forced displacement in both North and South Kivu further limited people’s access to healthcare, including vaccinations. As a result, there was a rise in cases of malnutrition, measles, and cholera in the hospitals and health centres where our teams work.
Medical facilities where MSF teams are working have seen a significant influx of war-wounded patients and civilians seeking safety from ongoing fighting, particularly in the towns of Mweso and Masisi in North Kivu. To assist people on the move, our teams set up mobile clinics in displacement areas, although high insecurity repeatedly restricted our movements, particularly in Masisi territory. In early 2024, in South Kivu, tens of thousands of people fled to Littoral and Hauts-Plateaux in the Minova health zone. This was followed by other massive movements later in the year, which brought the number of displaced people in the area to over 200,000. We launched emergency activities, delivering medical care to the sick and injured, and improving hygiene conditions in displacement camps, following an increase in cholera and measles cases.
The ongoing crisis in Ituri province has been largely overlooked by the DRC government, and has seen a limited international response, despite continued and widespread attacks on civilians throughout 2024. Neither hospitals nor sites for displaced people were spared. On 6 March, Drodro General Referral hospital was attacked and looted by armed individuals, who killed a patient in her bed. This, and other violations of international humanitarian law, had a significant impact on people’s access to healthcare in Ituri.
We continued to support Salama clinic in Bunia, providing surgery and post-surgical care, including physiotherapy, orthopaedic services, and mental health support for patients suffering from trauma or violence-related injuries. We also helped 13 health zones in the province to prepare for mass-casualty events by conducting training and strengthening the referral system.
MSF maintained support for the two general hospitals in Angumu and Drodro, as well as the surrounding displacement sites, focusing on treatment for malaria and respiratory infections, and maternal and paediatric care.
Response to disease outbreaks and other emergencies
During the year, we ran emergency interventions to support people displaced by conflict or natural disasters in other regions of the country, including Mai-Ndombe and Kisangani.
While responding to measles epidemics remained a primary focus for MSF’s emergency mobile teams throughout 2024, we also addressed a surge in outbreaks of mpox, formerly known as monkeypox. The rise in cases was driven by a mutation that enhanced human-to-human transmission of the virus. This was compounded by extremely high population density in displacement sites around Goma, North Kivu, and Minova, South Kivu.
In Équateur, South Kivu, South-Ubangi, NorthUbangi, Tshopo, Haut-Uélé, Bas-Uélé, Ituri, and North Kivu provinces, we conducted epidemiological surveillance, awareness-raising, and research activities, and supported the Ministry of Health with patient care. In Tshopo, we also responded with surveillance and supported the Ministry of Health in setting up and running two treatment centres. In Uvira, a hotspot for mpox in South Kivu, MSF assisted with case management, infection prevention and control measures, and community awareness-raising.
In January, when torrential rains caused flooding in the capital, Kinshasa, our logistics teams worked to construct latrines and showers, and distribute drinking water and tents, while our medical teams provided medical and mental health care.
General and specialist care activities
Alongside our emergency activities, we continued to run our regular projects across DRC. These include supporting health facilities and training networks of community health workers to detect high-prevalence conditions such as malaria and malnutrition, particularly in hard-to-reach areas.
Care for victims and survivors of sexual violence is another major component of many of our projects. Our teams provide not only medical treatment, but also psychological support, and engage communities with awareness-raising activities to ensure that people know where to seek treatment.
In Kinshasa, we offer HIV care in Kabinda hospital and five health centres. In addition, we are working to improve access to healthcare for people with disabilities, such as by supporting health facilities in becoming wheelchair-accessible and sending mobile clinics with sign language interpreters to communities.