More than 10 months after tens of thousands of people who fled violence in Democratic Republic of Congo (DRC) arrived at Busuma camp in eastern Burundi, living conditions remain extremely precarious, while cuts to humanitarian funding threaten water, shelter, food, and medical care.
Doctors Without Borders/Médecins Sans Frontières (MSF) continues to support the Ministry of Health in providing essential medical, water, and mental health services in the camp. But broader humanitarian funding shortages have led to a critical lack of latrines and showers, rapidly deteriorating shelters, and repeated cuts to food and cash assistance. Many refugees say they would rather return to DRC — despite ongoing conflict — than remain in the camp.
MSF is concerned that conditions may deteriorate further, as several humanitarian organizations operating in Busuma are only funded until the end of 2026, while some have not secured funding beyond the end of this month.
The UN Refugee Agency and the World Food Program are facing global funding reductions after steep cuts from the US and other donor countries, and both agencies have warned of potential impacts on refugees in Burundi and elsewhere.
People are facing the rainy season with unreliable shelter
“Due to insufficient funding, food and cash distributions have been repeatedly scaled back and shelter needs remain enormous,” says Ouo-ouo Sakouvogui, MSF emergency response coordinator at the camp.
A rainstorm hit the camp on October 20, with muddy streams flowing through walkways and seeping into people’s tents.
“The shelters built at the beginning of the crisis have a lifespan of just six months and are deteriorating as the rainy season starts,” adds Sakouvogui. “If nothing changes, the situation could once again become extremely critical.”
“It feels as though we are goats tied to a stake and left there to graze,” says Ibonge Alinoti, who arrived in Busuma in December 2025 after fleeing clashes near Uvira, DRC. “I thought I would be able to go home in April, but we are still in this camp where everything is in short supply. We are suffering so much.”
Since April, more than 20,000 refugees have returned to DRC under a United Nations-run voluntary return program to areas considered safe. However, around 35,000 people still live in Busuma, where the lack of available humanitarian funds is exacerbating an already critical situation.
Living conditions put refugees’ health at risk
Although emergency interventions in early 2026 helped improve sanitary conditions and bring cholera and measles outbreaks under control, refugees’ living conditions remain extremely precarious. In September, there was just one latrine for every 119 people and one shower for every 242 people in the camp.
“Cases of waterborne diseases declined during the dry season, but the rainy season — against a backdrop of El Niño-related forecasts — could change that,” says Sakouvogui.
Medical needs also remain extremely high. Between July and September, MSF teams conducted more than 12,000 outpatient consultations in the camp and the surrounding host community, mainly for respiratory and intestinal infections. More than 300 people also received more specialized medical care.
Psychological distress is particularly concerning. MSF teams are seeing a high demand for mental health support, driven by the violence people experienced in DRC, their flight from home, their losses, and the deteriorating living conditions in Busuma.
“Many people are deeply desperate,” explains Vanessa Niyonizigiye, an MSF clinical psychologist working in the camp. “Aid is dwindling, while some people do not even have a tarpaulin or a blanket to protect themselves. We are seeing depression, anxiety, psychosis, and post-traumatic stress disorder (PTSD). The needs are truly enormous.”
“We fled, leaving everything behind, only to arrive here and face cholera, infections, and people dying around us,” says Asiya Bipemaju, who shares a shelter with 14 other refugees after fleeing violence in DRC. “Now we are struggling to sleep and feed our children. All these problems are weighing heavily on me. Honestly, I am overwhelmed. I want to go home.”
Returning to DR Congo despite the risks
Like Bipemaju, many refugees say they want to return to DRC, despite the volatile security situation. For some, conditions in Busuma have become so difficult that returning home seems preferable to remaining in the camp indefinitely.
“We simply do not want to stay here,” says Alinoti. “There is too much suffering and not enough aid. We do not want money; we just want to leave. I have already fled violence three or four times in [DRC]. If it happens again, we will flee again.”
“The people of Busuma cannot go on living in such conditions,” stresses Ouabo. “It is unacceptable that refugees should feel they would rather risk their lives than remain in a camp that is supposed to protect and support them. This situation is a wake-up call that demands urgent action.”
