Escalating Violence in Eastern DRC Devastates Health Systems and Communities

The sight of unattended bodies on the streets underscores the urgent need for proper identification and dignified burials, which are essential for both public health and the psychological well-being of surviving families.

The eastern Democratic Republic of the Congo (DRC) is witnessing a surge in violence that has resulted in a devastating toll on human life, widespread trauma, mass displacement, and the collapse of critical health infrastructure. This escalation has severely compounded the already precarious living conditions for millions of people in the region.

Since January 26, 2024, 3,082 injuries and 843 deaths have been reported across 31 health facilities in and around Goma, North Kivu. The violence has expanded southward, with 65 additional injuries reported in three hospitals in South Kivu. These figures are expected to rise as more victims reach medical facilities and more bodies are recovered from the streets. The inability to promptly access healthcare has led to an increased risk of wound infections, while hospitals struggle with dwindling medical supplies.

The sight of unattended bodies on the streets underscores the urgent need for proper identification and dignified burials, which are essential for both public health and the psychological well-being of surviving families.

Impact on Health Infrastructure

Over 70 health facilities—6% of those in North Kivu—have been affected, with some completely destroyed and others barely operational. Ambulances and a WHO-supported health clinic were damaged or temporarily occupied by armed groups. Health workers, facing threats to their own lives, are either fleeing or working under extreme conditions with limited resources. Routine medical services for chronic conditions like cancer, diabetes, hypertension, and mental health issues have been severely disrupted, leaving many without essential care.

Maternal and Child Health at Risk

The risk of maternal and neonatal deaths has surged as insecurity prevents pregnant women from accessing healthcare facilities for safe deliveries. Historically, conflict in this region has led to a near-total drop in births attended by skilled health professionals during periods of intense violence.

Rising Threat of Infectious Diseases

The health crisis is exacerbated by outbreaks of infectious diseases, including cholera, malaria, measles, meningitis, mpox, and tuberculosis. The disruption of Goma’s water supply has forced residents to rely on unsafe sources, contributing to nearly 600 suspected cholera cases and 14 deaths reported in North Kivu between January 1 and 27. The mpox outbreak remains critical, with 90% of patients fleeing isolation units in Goma, further complicating containment efforts.

Food Insecurity and Malnutrition

One in four people in the region was already experiencing emergency levels of hunger. The ongoing violence has intensified this crisis, creating a vicious cycle where malnutrition weakens immunity, increasing susceptibility to disease, which in turn exacerbates malnutrition. This is particularly dire for children and pregnant or breastfeeding women.

Displacement and Gender-Based Violence

Goma, home to over 2 million people, including 700,000 already displaced by conflict, faces a renewed exodus as residents flee to seek safety. Temporary settlements are overcrowded, and the health and safety of these displaced populations are at grave risk. A rapid assessment of 10 healthcare facilities revealed a sharp rise in gender-based violence, with 45 cases of rape reported among the displaced and 21 gang-rape survivors admitted to two hospitals. These figures likely represent just a fraction of the actual cases.

WHO’s Response and Funding Challenges

WHO has deployed emergency medical supplies, hygiene kits, water treatment resources, and tents to expand hospital capacity by 1,000 beds. However, these supplies are rapidly depleting, and urgent additional resources are required. WHO’s efforts are part of a broader initiative led by the European Civil Protection and Humanitarian Aid Operations (ECHO) to deliver critical supplies, contingent on the reopening of Goma airport. Alternative delivery routes are being explored.

Mpox vaccinations in Goma resumed on February 5, after a 10-day suspension due to the violence.

Impact of US Aid Freeze

The recent decision by the United States to freeze foreign aid has severely impacted relief efforts in the DRC. The US previously accounted for up to 70% of the country’s humanitarian response and was a key funder of the mpox response, pledging one million vaccine doses to global efforts. Although WHO relies on funding from other donors such as the European Union, the United Kingdom, and its own Contingency Fund for Emergencies, the reduction in overall aid will significantly affect health outcomes in the region.

Call to Action

To address the immediate health needs in eastern DRC, including dignified burials, WHO has already spent US$600,000. However, the overall response requires US$50 million. WHO urgently calls for:

• Immediate humanitarian access to affected areas
• Protection of health workers and facilities
• An end to attacks on healthcare infrastructure
• Reopening of critical supply routes, including Goma airport

Ultimately, WHO calls for peace and an end to the prolonged suffering of the people in eastern DRC.