Following fighting and evacuation orders from the group M23 (March 23 Movement)/AFC (Alliance Fleuve Congo), hundreds of thousands of people have fled displacement camps around Goma, Democratic Republic of Congo (DRC).
In response, Doctors Without Borders/Médecins Sans Frontières (MSF) has adapted operations, deploying mobile teams to support people who are, once again, on the move. The many people returning to hometowns they had previously fled face uncertain and perilous conditions.
The landscape of Goma, the capital city of North Kivu province, has dramatically changed in just a few weeks. Before M23/AFC seized the city at the end of January, Goma hosted around 650,000 displaced people—most living in makeshift camps on the city’s outskirts—and was home to 2 million residents.
Some camps started to empty as fighting escalated in late January, and virtually all were abandoned after the de facto new authorities ordered people to return to their places of origin. While some displaced people chose to stay near Goma, the majority went north or west toward neighboring territories, unsure of what awaited them.
Within days, endless lines of men, women, and children poured on to the roads, carrying what little they could by foot, motorcycle, or minibus. Some patients told MSF teams that they had walked for days without food or water.
“Given these massive movements, we deployed teams along the routes to assess health facilities that would be overwhelmed by this sudden influx of patients,” said Anthony Kergosien, head of MSF mobile activities around Goma.
“Everywhere, we found the same reality: health facilities that were already barely functional before the crisis were either abandoned or, at worst, destroyed or looted," said Kergosien. "These facilities are now expected to cope, and there is a risk that diseases such as cholera, mpox, or measles, which were present in the camps, could spread.”
Emergency response in DR Congo: "Everything is destroyed."
Adapting to meet the urgent needs of returnees
Based on early assessments, MSF teams began providing equipment, medicines, and staff to more health centers in the territories of Nyiragongo and Masisi. Teams also set up mobile clinics in hard-to-reach areas to provide free medical care to people returning home and passing through.
One of the facilities supported by MSF during this emergency response is the referral health center in Sake, a small town located about 15 miles west of Goma. Sake has seen its share of intense fighting in recent years given its strategic location. The city serves as a critical crossroads for people traveling to the town of Masisi to the west, Kitchanga to the north, and further south to Minova and South Kivu.
“Residents are coming back to Sake, and the city is the only junction point for those returning to Masisi territory or South Kivu after leaving the camps in Goma,” said Kergosien. “That’s why we decided to carry out emergency repairs to the health center, which had been severely damaged during the recent fighting."
Kergosien added, "We also rebuilt the cholera treatment unit, which is currently treating around 20 patients daily. Now, nearly 200 consultations are carried out in the health center every day, mainly for respiratory infections and diarrheal diseases. But we’re also seeing cases of mpox and patients seeking care after experiencing sexual violence.”
MSF dispatches mobile medical teams
From Sake, MSF teams have launched mobile medical services and have supported other health facilities along the mountainous roads. Access to free health care is crucial for people returning from the camps, who are now in an extremely vulnerable state, often without money, crops, and in some cases, without even tools to grow them.
“I’ve been back in Kabati for a week now,” said Bigirimana, who spent two years in Bulengo camp before returning home. “It’s peaceful, but hunger is a real problem. We need medicine. Most of us are ill—there’s a lot of diarrhea, especially among the children.”
“The risks linked to food insecurity are serious,” warned Kergosien. “That’s why we’ve re-established several therapeutic nutrition units. On top of that, we face the threat of epidemics that have been concentrated around Goma. There’s an urgent need to improve living conditions and access to essential services in areas of return, and to ramp up humanitarian support. Sadly, very few organizations are currently operating in these areas.”
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MSF response in North Kivu
MSF’s emergency mobile teams are currently supporting health facilities in the remote areas of Buhumba, Kilolirwe, Sake, Kingi, Luhonga, and Makombo. Alongside these activities, MSF continues to provide care in several health centers and hospitals across North Kivu, as well as for the wounded at Kyeshero and Virunga hospitals. We are also supporting several facilities in Goma providing basic health care, malnutrition and cholera treatment, and care for victims of sexual violence.
