Goma, DRC - For years, Médecins Sans Frontières (MSF) teams have repeatedly warned of the alarming level of sexual violence in eastern DRC. The number of victims and survivors treated by MSF has surged in the past three years, since fighting between the Congolese army, the M23/AFC (Alliance Fleuve Congo) armed group, and their respective allies, resumed. The crisis is particularly acute in North Kivu province, where MSF teams treated an unprecedented number of victims and survivors - nearly 40,000 - in 2024.

This worrying trend has continued so far in 2025. Since January, MSF teams have treated an alarmingly high number of victims and survivors in the facilities they support in North and South Kivu provinces.

“The context in this region has changed, but the problem of sexual violence—which disproportionately affects women—has not,” says François Calas, head of MSF's programme in North Kivu. “Sexual violence remains a medical emergency that requires immediate action.”

In North Kivu province, Goma’s camps, housing more than 650,000 displaced people, were dismantled in February 2025 following the capture of the city by M23/AFC. However, MSF teams continue to treat new victims and survivors of sexual violence every day in facilities in and around the city, totalling nearly 7,400 patients between January and April 2025. Twenty kilometres west of Goma, in the small town of Saké, more than 2,400 victims and survivors were treated over the same period. 

Since the camps were dismantled, many displaced women have been unable or unwilling to return home to their villages and are often left alone with their children where they are sheltering. 

“We receive many women who have been abused in or near the host families’ homes or community centres where they are staying,” says Calas. “Very often, they are coerced into sexual acts in exchange for accommodation. Wherever they are, they don't seem to be safe anywhere.”

As has been the case for years, most assaults reported by victims so far in 2025 have been committed under the threat or use of a weapon by individuals who could not be identified. This is due to the large number of people carrying weapons - both civilian and military - the proliferation of weapons, and persistent insecurity.

“In Goma, many patients report that they are raped at night during periods of high insecurity; during burglaries that are often accompanied by the kidnapping or even murder of their husbands,” says Calas. “But in some neighbourhoods, these attacks are even committed during the day.”

“Armed men came into our home at around 10.30 p.m.,” says Nasha*, a woman who built a shelter in the courtyard of a school after she was displaced. “Some men were killed and some women, including me, were raped. 

“Three men wanted to rape me in front of my husband and eight children,” says Nasha. “My husband resisted . . . they killed him.”

On the outskirts of Goma and Saké, many victims say they were attacked on the roads or in the fields. 

“They asked me to choose between handing over my body or being killed,” says Rika*, a resident of a village about 40 kilometres west of Goma. “They raped me, one after the other.”

In South Kivu province, the situation is also worrying. In Kalehe and Uvira territories, MSF teams have treated nearly 700 victims and survivors of sexual violence since the beginning of 2025. Most of the accounts gathered describe acts committed at gunpoint. 

“We suffered in the fields where we took refuge,” says a woman from a village in the hills around Kamanyola in South Kivu. “The armed men did not allow us to cross the villages. Some women were even raped when they tried to cross to reach health facilities.”

“The figures are underestimated because there are many obstacles to accessing care,” says Luders Leriche, head of MSF medical activities in South Kivu. “Fear of reprisal, stigma, geographical remoteness, and lack of treatment capacity in the facilities.”

The higher or lower number of cases in certain areas reflects available treatment capacity, rather than the scale of the problem in that region.

Essential services under threat

The impact of sexual violence - which mainly affects women, and even children - has long been known and documented. The number of men who are victims, although much lower, is also a cause for concern. Beyond the health and psychological impact, the social consequences are devastating: family and social rejection, stigma, divorce, suicidal thoughts, and immense difficulty for survivors to continue living in the locations where they were assaulted.

The situation is even more worrying because access to treatment services is becoming increasingly difficult. Several health facilities in North and South Kivu provinces have already run out of medicines and kits they need to treat victims and survivors of sexual violence. 

“In addition to the disruption of supply chains and the delivery of medicines due to the ongoing conflict, global cuts in humanitarian funding are raising serious concerns about the future,” says Calas. “Despite the current challenges, we must not abandon these women and children. Their care must be an absolute priority.” 

In addition to supporting care for victims and survivors, MSF calls on all stakeholders to do their utmost to further guarantee the protection of civilians and their access to healthcare.