Thousands of Congolese refugees who fled violence in the Democratic Republic of Congo (DRC) are now living in extremely precarious conditions in the designated Musenyi site in Burundi. Médecins Sans Frontières (MSF) has launched an emergency response to reduce the risk of measles and malaria, but more support is needed as people’s humanitarian needs remain largely unmet.

Since the beginning of the year, thousands of people have fled fighting and insecurity in the provinces of North and South Kivu in the DRC. Crossing the Rusizi river into Burundi, they have hastily set up camp in schools, sheds, churches and stadiums in the province of Cibitoke on the border with South Kivu.

In March, the Burundian authorities and the Office of the High Commissioner for Refugees (UNHCR) relocated the refugees to the Musenyi site, an official site inaugurated in 2024 in the south-east to provide basic facilities and services for up to 10,000 refugees.

Unfortunately, the site's capacity was quickly exceeded: according to UNHCR, by the end of April, some 18,000 refugees were living at the Musenyi site. Unsurprisingly, their living conditions quickly became unbearable and created health risks for adults and children alike.

“I’ve been living in a shed since I arrived because there aren't enough shelters for everyone,” says Nathalie*, a refugee who arrived in February. “Tarpaulins are given to large families to make shelters. But I live here, and we sleep in this shed, without mattresses, with toads, and moisture everywhere. We feel abandoned.”

Built on poorly drained clay soil, the Musenyi site is particularly prone to flooding during the rainy season. Now, since the end of April, the rainy season has begun and, although drainage channels have been dug, water is stagnating in many parts of the site. People are trying to protect their shelters and the communal latrines as best they can to prevent the dirty water from spilling into the alleyways.

“There is an urgent need to improve the living conditions on this site, as all the elements for serious health problems are present,” says Barbara Turchet, MSF's emergency coordinator in Burundi. “Given the hygiene conditions, we have started to set up isolation units as a preventive measure in case of a cholera outbreak. And to reduce the risk of malaria, which is exacerbated by the amount of stagnant water everywhere, we have distributed more than 8,000 mosquito nets and are planning long-term mosquito spraying at the site.”

Given the concentration of children at the site, MSF has also helped the health authorities organise a measles vaccination campaign, as several cases of this highly infectious but preventable disease have already been confirmed among the refugees.

“We set up four vaccination points,” says Turchet. “We were able to vaccinate 8,500 children against measles and treat those who were infected. That's something, but we have to do more to improve the refugees' situation and protect their health.”

Essential services overwhelmed as aid funding contracts

A few organisations other than MSF are also present to offer healthcare to the refugees, but many people are unhappy with the insufficient access to care.

“Here, refugees living with HIV have no access to treatment,” says Henri*, a refugee from South Kivu who was moved to Musenyi site from another in Burundi. “When we were in Rugombo, [also] in the province of Cibitoke, there was medical follow-up and treatment. But here, the health facilities don't offer this kind of care.”

In Musenyi, as in many other places today, humanitarian organisations are struggling to provide sufficient support because funding has decreased. Several humanitarian agencies are unable to provide sufficient medical follow-up for patients in the clinics they support. Food distributions are also clearly inadequate, further increasing the vulnerability of families. The UN estimates that US$76 million are required to meet the humanitarian needs of Congolese refugees in Burundi.¹

“The gravity of the situation is real and calls for more attention and support," warns Turchet. “At our level, we are doing our utmost and have extended our support to provide medical care for victims of sexual violence and psychosocial support for refugees suffering from mental health problems. But there are needs everywhere...”