Men, women, and children cross a river as a they flee violence in the Democratic Republic of Congo's Katanga province. Photo © Per-Anders Pettersson/Getty Images

Ngombe Kangula is chief of Kitondwa, a village in the northeast of the Democratic Republic of Congo's vast and mineral rich Katanga province. Today, he is slumped under a tree in the corner of Camp II, one of the three displacement camps that Doctors Without Borders/Médecins Sans Frontières (MSF) has constructed around the small town of Dubie, situated in the north east of the province.

He is not alone. Dubie alone has seen an influx of more than 18,000 others forced to flee their homes, including all of those from his village, which is now no more than a few charred remains. It is estimated by MSF that in the areas where the organization is active more than 90,000 people have been displaced in the last few months.

"They arrived in huge numbers with nothing, sometimes without even any clothes. We also noticed that there were very few children under one year of age. These are the most vulnerable and most had simply not survived their ordeal." – Goedele Van Bavel, MSF project coordinator in Dubie

Ngombe Kagula's flight is the result of a November clash between the Congolese national army, the FARDC, against militia groups known as the 'Mai-Mai,' which occupy large swathes of northern Katanga. Such clashes have forced villagers to seek refuge in makeshift shelters in the bush, deserting their homes at risk to their lives and health in the process.

Ngombe Kangula did just that in June 2005. "We lived in the bush for six months because we were too scared to go back to our village," he says above the steady hammering of a villager working nearby on the construction of a shelter. "I lost my wife because there was no medicine. I have only one child left, the other four are all dead."

His story is not unusual among the displaced in Dubie. The November offensive by the FARDC forced the MaiMai into retreat, ending months in which the population had essentially been held hostage; too frightened to return to their homes, but also unable to reach the relative sanctuary of Dubie.

Living in the bush has taken its toll. Without adequate shelter and no healthcare, many people have succumbed to diseases such as malaria and gastroenteritis. Trekking for up to 90 miles through the bush to reach Dubie also cost numerous lives.

"The state of health of many of the displaced is appalling," says Goedele Van Bavel, MSF project coordinator in the area. "They arrived in huge numbers with nothing, sometimes without even any clothes. When the first groups came in a massive wave in November, we immediately started doing medical triage and many people were in such an awful condition that they had to go straight to hospital. We also noticed that there were very few children under one year of age. These are the most vulnerable and most had simply not survived their ordeal."

"We lived in the bush for six months because we were too scared to go back to our village. I lost my wife because there was no medicine. I have only one child left, the other four are all dead." – Ngombe Kangula, chief of Kitondwa, a village in the northeast of Katanga province

The displaced are housed in three sprawling camps set up hurriedly by MSF on the outskirts of Dubie. Provided with essentials such as plastic sheeting, they have gone about building makeshift shelters with remarkable speed. A food shortage has further compounded the misery in the camps.

For weeks, with promised food supplies unforthcoming, people were reduced to chewing the virtually inedible left over skins of the cassava- a root vegetable that is a staple food in the region. Large wild mushrooms, which came into season in mid-January, have provided temporary respite but the lack of a large-scale food distribution is a genuine concern.

Although numbers have not reached alarming rates yet, the steady stream of severely malnourished children under five years of age into the MSF therapeutic feeding centers in the region is a testament to the worrying food situation. In Dubie a large tent has been erected to deal with an overflowing inpatient department.

An MSF physician checks on a sick patient in Dubie, a village in the Democratic Republic of Congo's Katanga province. Photo © Per-Anders Pettersson/Getty Images

The influx of displaced has almost tripled the population of Dubie in the space of three months putting a huge strain on resources. But new arrivals have slowed to a trickle and the MSF teams are beginning to be able to consolidate. "One of our greatest fears now is an outbreak of cholera," says Van Bavel. "We have completed a measles vaccination campaign in the camps but when there is such a concentration of people, the threat of cholera is always there."

In other parts of Katanga, cholera has struck with devastating effect. In the area of Kikondja near Upemba Park, MSF has taken care of 770 cases in the past three weeks. The epicenter was the village of Mangui, which saw 473 cases in 19 days. Without assistance, cholera kills up to 50 percent of those infected and if left untreated. It is especially fatal among the young, the old and those in poor health.

While the situation in Dubie seems to be calming, MSF teams in other parts of Katanga are facing the full effect of the fighting. MSF is providing basic health care and essential items in a number of the worst affected areas in central Katanga including Mitwaba, Nyonga, and Mukubu.

"As the combat moves southwest, we are starting to see more and more displacement. Where we are working around the Upemba Park, the insecurity has reached such a pitch that we can't even distribute essential items to people for fear that this will attract looters," says MSF head of mission Jean-Guy Vataux. "Getting supplies in is also a nightmare. The roads are appalling and many freight companies won't come to the area. Virtually the entire population for dozens of kilometers to the east of Lake Upemba has been displaced. The situation is terrible and is likely to get worse as the fighting increases."