More than 80,000 people have arrived in South Kivu’s Minova health zone in eastern Democratic Republic of Congo (DRC) after fleeing conflict in neighboring North Kivu province. Doctors Without Borders/Médecins Sans Frontières (MSF) has launched an emergency response focusing on reaching people in areas humanitarian assistance has been nonexistent.
When day breaks, Rehema mobilizes her children. There is no time to lose. It will take five hours to walk to Kalungu, where she sells various goods—today, it’s coal—for $1.50 per day. The town lies at the crossroads of Lake Kivu’s low-lying shores and the mountainous Hauts Plateaux region, where she and her family are taking refuge in the small, isolated village of Numbi.
Rehema is among the tens of thousands of people who have fled escalating violence in neighboring North Kivu province this year. The rapid influx of displaced people has overwhelmed services in the area, and a recent measles outbreak has put additional stress on health care providers. MSF has launched an emergency response to address the dire situation.
May 10 04:30 PM
A state of constant emergency in North Kivu's Masisi hospital
In DR Congo, MSF is responding to the health consequences of years of conflict and displacement.
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Back on the road, Rehema and her two teenagers carry sacks of coal on their backs while another child carries the baby, named Innocent. Their journey will take them across hills left muddy after recent heavy rains, green pastures with grazing cattle and groups of women carrying heavy boxes on their backs, supported by ropes looped around their foreheads.
The family must endure this journey to get to the MSF-supported hospital that provides free-of-charge health care. “By the time I get back [to Kulungu], my feet are in paint,” said Rehema. The $1.50 she makes each day covers rent for a small room in a building made of clay, where her whole family lives under a roof of plastic sheeting held up by branches, which leaks when it rains. “With the money that is left over, I buy corn,” said Rehema. “I worry that my children might go all night without having eaten.”
View of the town of Kalungu. DRC 2023 © Igor Barbero/MSF
An MSF team works to pull a motorbike out of the mud to continue the journey through the Hauts Plateaux of the Minova health zone, in South Kivu. DRC 2023 © Igor Barbero/MSF
View of the Hauts Plateaux of Minova’s health zone, in South Kivu. DRC 2023 © Igor Barbero/MSF
Precarious conditions of displacement
The conflict in North Kivu has forced about one million people from their homes according to local authorities. Around one-third live in the Hauts Plateaux area, like Rehema and her family.
“We had heard there were clashes, but we didn’t think they would reach [our hometown of] Rubaya,” said Rehema. “One day in February, I saw soldiers descending from the hill and [heard] gunshots. I didn’t want to wait for the violence to arrive [at my door]. Hundreds of us left. I couldn’t take anything with me, only my four children.”
The displaced people sheltering in Numbi are largely invisible to outsiders due to the lack of attention given to this crisis and because most live with host families or rent small rooms, rather than camps or informal sites. Their needs are significant, but humanitarian assistance has been negligible.
“The displaced people are living in extremely precarious conditions, compounded by a lack of space, inadequate hygiene and insufficient access to food,” said Ulrich Crépin Namfeibona, MSF’s emergency coordinator in South Kivu. “These factors combined make them very vulnerable to disease.”
Three to four children per hospital bed
The hospital in Numbi, which now receives support from MSF, is overwhelmed with patients after an explosion of measles cases across the Minova health zone a few weeks ago. Beds are shared by Three or four children at a time, many with co-infections and malnutrition.
MSF staff and Ministry of Health staff examine patients at the Numbi hospital center, in South Kivu. DRC 2023 © Charly Kasereka/MSF
MSF nurse Francine measures the height of a child at Numbi hospital, in South Kivu. DRC 2023 © Charly Kasereka/MSF
“My youngest child is sick with measles and was admitted to Numbi hospital three days ago,” said Maniriho, was referred there by the health center in Lumbishi, a village a few kilometers away. “I looked for a motorbike, but it was impossible to find a rider as the route is in very bad state due to the heavy rains. It took me the whole day to reach the hospital. I came because the service is free.”
Maniriho comes from Masisi in North Kivu and came to Hauts Plateaux in March, soon after her parents were killed. She is now staying in a small room in the town, along with her husband and four children. “We have no assistance, only what the church provides,” she said. “With the conflict, I think it will be very complicated to return home anytime soon.”
Close by sits Josephine, a widow with seven children from Walikale in North Kivu. Her youngest son, Valentin, was diagnosed with malaria and measles and spent six days at the hospital. Now his condition is improving and he has started to eat again. “At first I thought it was simple malaria and I gave him some medicines myself,” she said, “but he didn’t improve and that’s why I came to the hospital.”
It took Josephine and her children about a month to reach Numbi on foot after they fled the violence in North Kivu. “The children suffered a lot, their legs were swollen,” she said. “On the way an armed group took everything from us. Now all I have is what I am wearing. Here, MSF provides us with food and soap, but after we are discharged, we will have no support,” she said.
A constant cycle of violence and displacement
In the eastern fringes of DRC, a constant cycle of violence and displacement has lasted for three decades. Dozens of armed groups with different interests and political affiliations are fighting each other, against or alongside Congolese armed forces, with alliances changing over time.
Rehema, 35, is from Rubaya, Masisi, in North Kivu province. She lives with her four children, including baby Innocent, in Numbi, a town in the Hauts Plateaux of South Kivu. DRC 2023 © Igor Barbero/MSF
Josephine, 32, is a single mother from Walikale with seven children, including Valentin, who is one and a half years old, displaced in South Kivu. DRC 2023 © Igor Barbero/MSF
DRC 2023 © Charly Kasereka/MSF
Birandala and Riziki, a couple in their fifties, know this all too well. Over the past 25 years, they have had to flee their hometown five times, each time starting again from scratch somewhere new.
“Every time we flee, we have always had to start again from zero,” said Birandala. “When you leave everything behind, the most important thing is to have good health, food and a place to sleep. At times we have gone several days without food or water, to the point where I thought I’d go mad. What gives us strength is the love that we have for each other and for our children. If I was able to send a message to the world, it would be that we need peace.”
About MSF in Minova
MSF teams started working in Minova in December 2022 to support health authorities by responding to a cholera epidemic. Due to the arrival of displaced people from North Kivu, MSF launched an emergency response in Minova health zone in late March 2023, covering both the Littoral and Hauts Plateaux areas.
Between late March and late May, MSF medical teams treated 2,019 patients, mostly children with measles, severe acute malnutrition and cholera, at the hospitals in Minova and Numbi. MSF water and sanitation teams have chlorinated water supplies to make it safe for drinking and constructed latrines and showers, mostly in sites hosting displaced people in the Littoral.
Over the past year, MSF teams have responded in various locations to the medical and humanitarian needs of displaced people fleeing the escalating conflict in North Kivu.
