Conflict in DR Congo: What’s happening & how to help

Since January 2025, fighting between M23/AFC (Alliance Fleuve Congo), the Congolese army, and their respective allies has escalated. M23 has been progressively taking over territory in eastern DRC since 2022, and the fighting intensified in January 2024, causing mass casualties and displacement. The conflict has impacted people’s access to health care, food, and other basic needs, triggering mass waves of displacement and raising the risk of disease outbreaks. 

2025 escalation

M23/AFC is now in control of parts of North Kivu, including Goma, and has quickly continued its advance into South Kivu, capturing the strategic towns of Kalehe and Kavumu. As a result of the fighting, many people—including those who were already displaced—are now on the move again.  

Despite the hostilities, MSF teams continue to provide medical assistance to affected communities through regular and emergency projects in North and South Kivu.  

Armed clashes with the M23/AFC are also taking place in other parts of North Kivu, such as Masisi and Mweso, where we are carrying out medical activities, as well as in South Kivu, where M23/AFC have also made progress in recent weeks, taking over the town of Kalehe and moving the front line to just a few kilometers away from Kavumu. Fighting in the region is ongoing and continues to trigger population movements further south.

MSF response in Goma

In the first days of the escalation in Goma, the fighting forced MSF to partially reduce activities in some displacement camps and temporarily withdraw some staff from several medical facilities and offices in Goma, however we continued to care for the wounded at Kyeshero Hospital. After several days of violence and looting in Goma, the situation de-escalated somewhat, allowing MSF teams to resume activities in and around Goma. These activities include: 

• supporting Kyeshero and Virunga hospitals in treating wounded people;
• collecting and distributing blood bags for overwhelmed hospitals; 
• returning to several displacement sites to support local health centers; expand or re-establish cholera treatment units and special clinics for survivors of sexual violence; provide food, water, and fuel for water pumping stations; and empty latrines and install hand-washing facilities.  

Priorities at this stage remain caring for 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 of Goma, as the impact on the population is enormous. The next few days will allow us to assess the next steps. 

Over 8 million people are internally displaced across DRC, including 500,000 who have been displaced by the current fighting since January 2025.  The situation for displaced people was already dire before the current escalation, particularly in the camps around Goma. Over the years they have grown more crowded and living conditions have deteriorated further, with severely limited access to basic needs such as proper shelter, food, water, sanitation facilities, and health care. Displaced people living in these conditions face high risk of falling ill.

For people leaving the camps, MSF is particularly concerned about the level of access to health services when they arrive in their new location. After several years of war, many health facilities have been looted or abandoned and will be unable to provide adequate medical care to those who need it, either now or in the longer term. The situation in the places people have fled is likely to be equally disastrous if NGOs, UN agencies, and authorities fail to provide the minimum level of essential services.

To ensure a minimum level of health care for displaced people in areas of return, MSF has set up mobile clinics on roads leading out of Goma to the east and the north. MSF teams are also carrying out assessments in the areas to which people are returning.

Many of the already-displaced people living in these camps are fleeing yet again, as the fighting has taken place in and around Goma. While many are returning to their places of origin—where they originally fled from—others are fleeing across the border to other countries, such as Burundi. That’s why, in addition to our response within DRC, MSF has sent a team to Burundi’s Citiboke province to assess needs and provide emergency assistance for arriving refugees. 

The humanitarian situation in eastern DRC was already dire before the current escalation. The international humanitarian response has been inadequate and far too slow to meet the severity of the situation and fast-growing needs, with underfunding, ineffective coordination, and lack of emergency preparedness in areas close to the front lines. In some areas, MSF has been alone in addressing medical and humanitarian needs, which far outweigh our capacity to respond.  

Since January 2025, humanitarian needs have been skyrocketing even more. MSF teams have witnessed some people dismantling humanitarian facilities and taking with them anything that could potentially be of use: chairs, metal sheeting, tarpaulins, ropes and so on.  

Humanitarian organizations must be guaranteed access to all places of return, and returnees must be able to access essential health services, including support for survivors of sexual violence. Failure to provide these services risks exacerbating people’s health needs. 

Cholera is endemic to eastern DRC, with recurrent outbreaks across all three provinces. The risk is especially high in camps where displaced people live without access to drinking water and nonfunctional or nonexistent latrines, and following floods. MSF has responded to several cholera outbreaks in the region, including in Minova, Rutshuru territory, and in and around Goma, by setting up cholera treatment centers, oral rehydration points, and isolation units, and distributing clean drinking water.

Despite being rich with fertile agricultural land, DRC is one of the most food-insecure countries in the world, with more than 23 million people experiencing food insecurity across the country, including an estimated 2.7 million in the eastern provinces of Ituri, North Kivu, and South Kivu alone. Food shortages have led to a significant increase in prices, while checkpoints on roads impede access to farmland, leaving crops abandoned. These factors contribute to rising malnutrition rates in DRC.

MSF teams have seen worrying levels of malnutrition among children in many of our projects in eastern DRC. In 2023, monthly admissions of children for malnutrition doubled, with an average of 800 per month. 

Measles cases surged in DRC in 2024. DRC has faced persistent epidemics for years and high fatality rates due to inadequate routine vaccinations and supplementary immunization. In 2023, over 300,000 measles cases were recorded, resulting in nearly 6,000 deaths. Children are particularly vulnerable; from 2018 to 2020, 8,000 children died from measles during the largest outbreak ever documented in DRC. Despite the persistent threat of measles, vaccine coverage remains insufficient in the country.

The first case of mpox, formerly known as monkeypox, in a human was identified in DRC in 1970, and the disease continues to affect communities there. The risk is particularly high in areas where the natural environment is conducive to its spread, such as dense woodlands where people rely on hunting and fishing for food.  

DRC experienced an mpox outbreak in 2024 affecting all provinces in the country, with a genetic mutation first identified in South Kivu causing uninterrupted human-to-human transmission of the virus. On August 14, the World Health Organization (WHO) director-general declared that the surge of mpox cases in DRC and a growing number of countries in Africa constitutes a public health emergency of international concern. On September 13, WHO announced that the MVA-BN vaccine is the first vaccine against mpox to be added to its prequalification list. The MVA-BN vaccine can be administered to people over 18 years old as a two-dose injection given 4 weeks apart.

In response to the 2024 mpox outbreak, MSF mobilized emergency teams across the country to support local health authorities.

MSF teams in DRC have seen alarming rates of sexual violence as reported by our patients, especially in camps around Goma. Most assaults are perpetrated against women searching for food or wood outside the camps, driven to venture out due to lack of access to basic supplies. Our teams treated more than 22,000 survivors of sexual violence in North and South Kivu’s Minova health zonein 2023, and continue to see high numbers of cases at the facilities where we work throughout the region. This represents only the survivors who sought care from MSF; the true number of survivors is likely far higher due to stigma and barriers to accessing care.  

As the fighting intensifies near cities, civilians are in increasing jeopardy. MSF teams are treating patients with gunshot wounds and injuries from explosions, including children. At MSF's center specializing in trauma surgery and post-surgical care at Salama Hospital in Bunia, one-third of the 863 patients treated by the end of 2023 were direct victims of the violence. 

Vaccination coverage among children under 5 years old in DRC is currently the lowest in about 30 years, according to the World Health Organization (WHO). Low coverage, along with a shortage of medicines and medical supplies and poorly functioning health structures, has increased the risk of disease outbreaks in DRC for years, but the current escalation has worsened the threat by forcing more people into crowded, unsanitary camps as they flee the violence.  

Even before the recent escalation of violence, DRC’s health care infrastructure was fragile with insufficient funding and a lack of resources. The conflict has made health care even more difficult to access, forcing staff and patients to abandon facilities near the fighting and restricting people’s ability to reach care through checkpoints and impassable roads. The facilities that remain functional are overwhelmed and undersupplied, with several patients sharing beds. Some have been attacked.

Pregnant women, particularly those with high-risk pregnancies or complications, are at particular risk, often delaying or foregoing seeking care due to difficulty getting to health facilities. DRC has some of the highest rates of maternal and neonatal deaths in the world.

To strengthen local health care infrastructure and improve the quality of medical care throughout DRC, MSF teams are training local medical staff, improving the quality of biomedical equipment, supporting the referral system, donating medical equipment, and constructing health infrastructure.

People living in remote areas of DRC often have to travel dozens of miles through the bush to reach health facilities, delaying care. These remote areas are also difficult for health workers to access during vaccination campaigns. Further, it’s sometimes not possible to transport medical supplies like vaccines by foot, because they require refrigeration. 

MSF teams use motorcycles and canoes to reach remote communities, but the gaps in care remain.

Extreme weather events linked with climate change and longer rainy seasons increase the risk of diseases in DRC by causing floods and damaging water infrastructure. Cholera and skin infections thrive in settings with a contaminated water supply, while mosquitoes that spread diseases like malaria and dengue, which breed in standing water, proliferate.

To curb the spread of disease in camps, MSF provides clean drinking water and constructs and improves water and sanitation infrastructure, including latrines and showers. MSF built a water pumping and chlorination station on the shores of Lake Kivu that processes up to 2 million liters (more than 500,000 gallons) of water each day and distributed hundreds of thousands of gallons of potable water each day to camps around Goma in 2023. We also built a 2-mile pipeline to connect Lushagala camp to a water treatment plant in Bulengo, and installed a platform to distribute up to 200,000 liters (more than 50,000 gallons) of water per day in Rusayo. In response to the Congo River floods in early 2024, MSF teams installed latrines, showers, and lighting; and distributed tents and drinking water to people affected. 

• In the city of Goma, we support two health facilities providing medical care and psychosocial support for children in street situations, and sex workers.  
• In Walikale territory, MSF supports pediatrics and maternal care at the general referral hospital, provides partial support for seven health centers, and offers care for survivors of sexual violence at a dedicated clinic.
• In Rutshuru territory, MSF supports the general referral hospital and six health centers providing pediatric care, family planning, and treatment for malnutrition and victims of sexual violence.
• In the Sake area, MSF provides vaccinations, cholera response, and constructs latrines in camps.
• In Kibirizi, Binza, Masisi, and Mweso health zones, we support hospitals and health centers in emergency room care, pediatrics, family planning, nutrition, and care for victims of sexual violence. We provide malnutrition care at therapeutic feeding centers in Masisi and Mweso.

• In Bunia, MSF set up a center specializing in trauma surgery and post-surgical care at Salama Hospital and supports Kishinji Health Center, which provides care for both local and displaced people and referrals of severe cases to Minova General Referral Hospital.
• In Drodro and Angumu, Ituri province, MSF supports two Ministry of Health hospitals, 12 health centers, three advanced health posts, and 20 community care sites.
• MSF teams are rehabilitating the health center at Blukwa'Mbi to transform it into a referral center that can provide specialist medical care. It includes a solar-powered operatic theater.
• In Bambo health zone, MSF supports the emergency room, pediatrics, intensive therapeutic nutritional unit, and treatment for victims of sexual violence at the general referral hospital.  

In Minova health zone, MSF supports Kishinji Health Center, which provides care for both local and displaced people and referrals of severe cases to Minova General Referral Hospital. We also support three health centers where we treat children for malnutrition and survivors of sexual violence.