By the end of the year, 5.6 million people were displaced across North Kivu, South Kivu and Ituri provinces. MSF also responded to numerous other emergencies throughout the country, including disease outbreaks, floods and landslides.

Response to conflict in eastern DRC
In North Kivu, the ongoing conflict between the armed group M23 and the Congolese armed forces and their allies, which erupted in late 2021, intensified towards the end of the year, causing new waves of displacement. By December, 2.5 million people were displaced in the province, half of them due to the ‘M23 crisis’.

Throughout the year, repeated influxes of people fleeing Rutshuru, Masisi and Nyiragongo exacerbated the disastrous situation in the overcrowded displacement sites around Goma city, which continues to deteriorate, due to a lack of national and international action.

In response, we expanded our emergency activities, strengthening the provision of general, maternal and paediatric care in the sites. We also worked to address the increase in waterborne diseases, in particular an explosion of cholera cases in February, as well as malnutrition, measles and war-related injuries. Treatment for sexual violence was another key activity; we saw a worrying surge in cases in 2023.  

This humanitarian crisis affected not only the Goma area but communities across the entire province, as flare-ups in fighting on different fronts repeatedly forced people to flee. This, in turn, reduced their access to healthcare, including vaccinations, resulting in an increase in admissions for malnutrition, measles, cholera and war-related injuries in the many hospitals and health centres supported by MSF.

To assist people on the move, our teams set up mobile clinics in displacement areas, although increasing insecurity repeatedly hindered our mobility, particularly in Masisi territory.

Neighbouring South Kivu was also affected by the violence. In the early months of the year, tens of thousands of people fled to Littoral and Hauts-Plateaux in Minova health zone, where our teams launched an emergency intervention, providing medical care to the sick and injured, and improving hygiene facilities following an increase in cholera and measles cases.

The underreported crisis in Ituri
Less visible in the media were the widespread, relentless attacks on civilians in Ituri, which showed no respite in 2023. In Drodro region, an intensification in violence between January and March forced people, including health workers and patients, to flee, leaving most health centres in the area deserted. During this period, we maintained our services in Rho camp, where many people had gathered, while also increasing our support in displacement sites, by supplying clean water, installing sanitation facilities, distributing hygiene kits, and increasing general, specialised and community medical services.

In Angumu, our teams continued to support the general hospital and 13 displacement sites, focusing on tackling malaria, treating respiratory infections, and providing maternal and paediatric care. In Bunia, we supported the general hospital through training and donations, and launched a project at Salama hospital focusing on surgery and post-surgical services, including physiotherapy, orthopaedic care and mental health support, for patients with accidental trauma and violence-related injuries.

Violence, natural disasters and epidemics
MSF’s response to situations of violence was not limited to North Kivu, South Kivu and Ituri. Further west, in Tshopo and Mai-Ndombe provinces, we launched emergency interventions to assist people caught up in land or intercommunal conflicts by providing general healthcare, running mobile clinics and referring wounded patients. We also installed sanitation facilities and distributed relief items, including mattresses and hygiene items.

In addition, our teams responded to disasters in 2023. In May, in Kalehe, South Kivu, floods and landslides devastated entire villages, causing several hundred deaths and numerous injuries. MSF teams quickly arrived on site to treat the wounded, refer the most serious cases by boat to hospitals in Bukavu, and provide donations of medicines and body bags.

Measles, a major killer in the country, once again spread rapidly in 2023, with nearly 300,000 cases and 6,000 deaths registered during the year. This was partly due to deteriorating security in the east and the worst vaccination setback recorded in DRC in years.

As well as treating many thousands of patients, our mobile teams launched emergency vaccination campaigns across the country, regularly administering other multi-antigen vaccines to curb the spread of diseases such as diphtheria, whooping cough, hepatitis, pneumonia and polio.

Our teams also responded to a typhoid fever outbreak in Panzi, in Kwango province, as well as an outbreak of mpox in Bolomba, in Équateur province. In both cases, our teams provided healthcare to patients and supported the health authorities with community epidemic surveillance and staff training.

Regular general and specialist care activities
Alongside our emergency interventions, we continued to run our regular activities across DRC. In addition to supporting health facilities, we train networks of community health workers to detect high-prevalence diseases such as malaria and malnutrition, particularly in hard-to-reach areas.

Care for victims and survivors of sexual violence is another major component of many of our projects. Our teams provide not only medical treatment, but also psychological care, and engage communities with awareness-raising activities to ensure they know where they can seek relevant medical treatment.

In the capital, Kinshasa, we launched a new project in early 2023 to strengthen access to general and specialised care for people with disabilities. The project focuses on improving access to healthcare facilities, boosting hygiene in accommodation sites, and working with the community to cater to the needs of people with disabilities. Meanwhile, we handed over our HIV care activities in Goma and our sexual violence project in Kananga to the health authorities.