DR Congo: New surge of attacks on civilians in Ituri

Critical injuries arrive daily at MSF’s clinic

At the MSF-supported Salama Clinic in Bunia, the corridors are crowded. Stretchers are carried in, one after another, by staff or from the few ambulances available. Open fractures, gunshot wounds, and shrapnel injuries on patients tell the story of the brutal conflict.

Since January, 250 patients have been treated for severe conflict-related injuries—105 of them between July and August alone. Teams have already performed 934 surgeries for gunshot and blade-related trauma, with many patients requiring multiple operations to survive.

“In the past three months, admissions have nearly doubled,” said Asiyat Magomedova. “We’ve had to switch to emergency mode and set up tents for extra beds. But the reality is, most of the wounded never reach us.”

How the attacks started

The latest escalation began on June 27 in Djangui, Djugu territory, where nine people—including women and children—were killed during an attack on a displacement camp. On July 31, the village of Katsu was targeted, leaving more people wounded and displaced. After that, over 40 people were massacred inside a church in Komanda, and Bunia, the provincial capital, was also attacked.

In these areas, access to health care is already extremely limited, so most victims are not able to get the medical care they need despite serious physical and psychological consequences.

“We woke to the sound of gunfire,” said Adèle,* a mother of seven, who was shot in the arm as she tried to take cover during the July 31 attack on Katsu. “Everyone was running for their lives. That’s when the attackers started shooting at people. There were no fighters—this was a senseless attack.”

Civilians are trapped in recurring cycles of violence

Caught between recurring clashes, intercommunal tensions, and the proliferation of armed groups, civilians in Ituri continue to pay the heaviest price. In our March 2025 report Risking their lives to survive, MSF highlighted that women and children accounted for nearly one third of victims of violence treated in its facilities.

“What is happening in Ituri is unacceptable,” said Asiyat Magomedova, MSF head of mission in the region. “Civilians are victims of atrocities committed by armed groups daily. MSF calls on all state and non-state actors to spare civilians. Protecting the population from these atrocities is critically urgent.” 

“I heard gunfire from across the river before running into armed men,” said Jean-Bosco,* who is from the village of Tsotso and fled an armed attack on August 2. “They accused me of hiding a weapon in my home. I told them I was just a civilian. Some wanted to spare me, others insisted I should be killed. I raised my arm to shield my head, and that’s when they struck me twice with a machete on my wrist and fingers,” he added.

Behind wounds are invisible scars

Patients at Salama Hospital come from areas such as Drodro, Nizi, Lopa, Fataki, and Komanda, where treatment for severe injuries is almost nonexistent. MSF supports 15 health zones with ambulance referrals and mobile kits to stabilize patients.

Beyond their physical wounds, survivors carry invisible scars: the fear of tomorrow, anxiety, trauma, silent tears, vacant stares. Each outbreak of violence deepens psychological wounds.

The renewed violence is also driving mass displacement and compounding already immense humanitarian needs. More than 1.56 million people are currently displaced in Ituri, according to provincial authorities, nearly half of them in Djugu territory, with high concentrations in Drodro and Angumu health zones.

Between mid-July and mid-August alone, over 82,800 people fled fresh attacks in Djugu and Irumu, according to OCHA.

“Every day, the humanitarian space is shrinking: with roads closed, activities suspended, insecurity everywhere,” said Magomedova. “Behind these barriers, the needs for medical care, nutrition, clean water, protection, and psychosocial support continue to grow for thousands of displaced families. Protecting civilians and ensuring access to health care are legal obligations in times of conflict. Authorities and armed groups must urgently act to end abuses and guarantee safe, unhindered humanitarian access.”

*Names have been changed