Escalating violence intensifies population displacement

Clashes between the Armed Forces of the Democratic Republic of Congo (FARDC) and the Alliance Fleuve Congo (AFC)/M23, alongside their respective allies in the Hauts plateaux de Fizi, are exacerbating long-standing inter-community tensions. This surge in violence has triggered new, massive waves of population displacement. The number of internally displaced persons in the broader region has now reached nearly five million, with 1.9 million of these concentrated in South Kivu and Maniema, according to data from the Office for the Coordination of Humanitarian Affairs (OCHA).

Lacking adequate reception facilities, almost all displaced individuals have sought refuge with host families or within crowded IDP camps, such as Monge Monge. Access to basic necessities like water, food, and essential healthcare remains severely constrained for both local residents and the displaced.

Long distances and prohibitive costs hinder healthcare access

With ongoing conflicts plaguing the region, numerous displaced families have lost their primary sources of income. In response to this dire situation, MSF is adapting its strategy, strengthening the provision of healthcare to communities impacted by these hostilities.

Ikupe Roger, 60, recounts fleeing his village a year and a half ago to escape the fighting. “When the clashes erupted, I left with my wife and our eight children to save our lives,” he shared. “My main concern today is simply being able to remain in Baraka, despite the pervasive violence and insecurity. Before MSF arrived, there was almost no access to medical care. Paying over 100,000 Congolese francs for treatment is simply beyond our means.” To support his children, he relies on farming, fishing, and a small poultry operation. Despite these relentless efforts, living conditions remain exceptionally precarious.

“Stripped of resources, many can no longer afford transportation or access basic healthcare,” explained Gianpietro Campedelli, MSF’s project coordinator in Baraka. Consequently, many patients arrive at health facilities in a critical state, often too late to benefit from life-saving treatment.

Civilians fleeing violence targeted

Beyond injuries directly sustained in clashes, numerous individuals also endure trauma and physical harm resulting from assaults experienced en route, particularly during their perilous journeys through highly unstable zones.

Fatou, a 40-year-old woman now residing with a host family in Mwandiga, fled her village of Makobola in great haste. “During our escape, I was struck by armed men. We were also robbed of everything we possessed. When we left, the village was deserted, and everything we had left behind was looted,” she recounted.

MSF bolsters health system against epidemics and influx of wounded

In Baraka, medical facilities are simultaneously grappling with the arrival of conflict-related casualties, recurring cholera outbreaks, and a significant rise in malaria cases. Overwhelmed by this confluence of emergencies, local health structures struggle to cope.

In response to these urgent needs, between January and April 2026, MSF has:

• Provided support to the Baraka General Referral Hospital through medical and logistical supplies, as well as training sessions for healthcare personnel, to better manage the influx of injured patients;
• Covered the treatment costs for patients transferred due to severe conditions, including severe forms of malaria, acute respiratory infections, and diarrheal diseases;
• Supported seven community health posts for the rapid detection of malaria, pneumonia, and diarrhea cases.

In total, 26,234 patients received care, including 426 war-wounded individuals, 16,574 for malaria, 2,953 for diarrheal diseases, and 3,832 for pneumonia.

Our teams have also been actively involved in responding to epidemics:

• 1,002 cholera patients have been treated at the Baraka Cholera Treatment Centre (CTC), supported by MSF, since January;
• Distribution of essential hygiene kits;
• Installation of chlorination points and repair of manual water pumps in Baraka, Mwangaza, and Mushimbakye;
• Distribution of 488 kits containing essential items (soap, blankets, plates, and mosquito nets) within the Monge Monge displaced persons camp, alongside 870 feminine hygiene kits distributed to women in the same camp.

Broader mobilization from other actors is indispensable

Currently, our teams are focusing their efforts on reproductive health and providing care for survivors of sexual violence at the Baraka health center, while simultaneously continuing their water, hygiene, and sanitation initiatives within the Monge Monge displaced persons camp.

Nevertheless, the situation remains deeply worrying. Despite ongoing interventions, the needs far outstrip the available response. “MSF’s presence, though critical, is insufficient to cover the entirety of needs. A broader mobilization of other humanitarian actors is more than necessary to assist populations who remain highly exposed to health and social vulnerabilities,” concluded Gianpietro Campedelli.