Vivian van de Perre, Deputy Head of the UN Stabilization Mission in the DRC (MONUSCO), provided a detailed briefing from Goma, highlighting the dire humanitarian situation and the need for “urgent and coordinated international action” to stop the fighting between Rwanda-backed M23 rebels and Congolese forces – as they battle for control of the city.

She reported that the recent clashes have led to massive displacement, with over 178,000 people fleeing Kalehe territory after the M23 took control of Minova.

More than 34,000 of those on the run have sought refuge in already overcrowded IDP sites in and around Goma, exacerbating the humanitarian crisis and overwhelming the city’s infrastructure.

Rebels and Rwandan troops joint attack

“Despite the appeals from Member States during the Security Council meeting on 26 January, the M23/RDF [Rwanda Defence Force] launched an attack on Goma, using heavy direct and indirect fire,” Ms. van de Perre stated.

“These attacks have resulted in numerous civilian casualties, further displacement, and significant trauma among the population.”

She emphasised the critical role of MONUSCO in providing refuge and protection, noting that the mission has received a large number of people seeking safety, including officials and armed elements who have surrendered.

“MONUSCO’s bases are not able to accommodate the large number of surrendering elements and civilians seeking refuge,” she said. “The Uruguayan Battalion (URUBATT) alone has taken in approximately 1,200 Congolese soldiers and over a thousand civilians, placing immense pressure on resources.”

UN bases ‘not safe’

The situation is further complicated by damage to water tanks, compromising the security of UN personnel and property.

“Our bases are not safe: two mortars have hit MONUSCO bases and compounds in the last three days, as well as numerous bullets,” Ms. van de Perre reported.

“Installations of [formed police unit] staff in Jambar camp have been destroyed and burnt.”

Casualty evacuation efforts remain a significant challenge, with peacekeepers injured during the fighting in Sake.

Despite the closure of Goma airport, MONUSCO continues to facilitate medical evacuations with the help of SAMIDRC – the Southern African Development Community mission in DRC.

Evacuation of injured ‘blue helmets’

“We continue to do our utmost to ensure timely evacuation of injured peacekeepers and other casualties to our level 3 hospital in Goma despite continued challenges,” Ms. van de Perre said.

The M23 and Rwandan forces’ capture of Goma’s international airport and their advance from multiple directions have heightened the risk of weapons proliferation, as combatants blend into the civilian population, the Deputy UN Special Representative continued.

The mass influx of IDPs, separation of families, and escape of prisoners from Goma prison have increased the vulnerability of women and children to sexual and gender-based violence.

Ms. van de Perre called on all parties to guarantee the protection of life and access to basic services, and to prevent sexual violence.

“The degree of suffering that the population here in Goma and its environs is enduring is truly unimaginable,” she said.

“Let us please draw on our humanity and do our utmost to bring an immediate end to such levels of violence and suffering.”

In light of the ongoing conflict, Ms. van de Perre urged the establishment of humanitarian corridors between Goma, Minova and Bukavu, and the reopening of critical airports and border points.

Political solution must be found

She emphasised that military action cannot resolve the conflict and called for a resumption of the Luanda Process under the auspices of the Angolan Government to ensure de-escalation and “avert the looming threat of a third Congo war.”

The briefing concluded with a call for urgent and coordinated international action to address the crisis in Goma. Despite the challenges, MONUSCO remains a vital lifeline for vulnerable groups, but its effectiveness is being severely tested by the ongoing violence and logistical difficulties.

“The protection of civilians and the pursuit of a peaceful resolution must be prioritised to end the suffering in Goma,” MONUSCO’s deputy head stressed.

The internet also remains down in the provincial capital and only mobile phone networks are functioning, with M23 fighters apparently in control of “a significant portion of the city” after intense clashes with the Congolese army, UN agencies reported on Wednesday.

Aid teams from the UN World Health Organization (WHO) “cannot move freely to support the hospitals, even ambulances cannot run. It’s a situation that in public health is a nightmare,” said Dr Boureima Hama Sambo, WHO Representive in DRC.

‘Vulnerable people need us’

Speaking to UN News, Dr Sambo added: “We just hope that the situation will return to normal for the Government … vulnerable people really need us.”

Conditions in provincial capital Goma remain “dire”, he added, with no running water, electricity cut and civilians trapped – including health professionals.

Echoing those concerns, a senior UN peacekeeping official warned that the level of suffering among those caught up in the violence was “unimaginable”.

Vivian van de Perre, Deputy Special Representative for Protection and Operations in the UN Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) told the Security Council late Tuesday that there was a need for “urgent and coordinated international action” to stop the fighting between Rwanda-backed M23 rebels and Congolese forces as they battled for control of Goma.

Massive displacement and fear

Before M23 fighters closed in on Goma, more than 700,000 internally displaced people lived around the provincial capital. But hundreds of thousands fled in anticipation of clashes between the Rwanda-backed rebels and DRC troops, prompting renewed alarm about the further spread of deadly disease.

“When you have as many as 700,000 people living in camps, you can imagine the human suffering,” the WHO official told UN News, pointing to “a lot of ongoing [disease] outbreaks” in North and South Kivu – two mineral-rich regions close to the Rwanda border, where dozens of armed groups have held sway for decades.

Disease ever-present

Repeated mass displacement in DRC has created ideal conditions for the spread of many endemic diseases in camps and surrounding communities in the Kivus, including cholera (more than 22,000 cases and 60 deaths in 2024), measles (close to 12,000 cases and 115 deaths) and malaria, as well as chronic child malnutrition. 

In August last year, WHO Director General Tedros Adhanom Ghebreyesus also declared the mpox outbreak a public health emergency of international concern.

Despite a “robust” initial response to the mpox threat by WHO and national partners that has been coordinated from Kinshasa and field offices in Goma and South Kivu, Dr Sambo warned that mpox patients had fled at least one camp’s treatment centre and were now living now in host communities and with families.

“So, we are there’s a fear for the disease to be spreading widely in communities, but at this point we cannot say because we have not been able to get there and assess what’s happening right now.”

Child separations on the rise: UNICEF

Children’s agency UNICEF‘s Representative in DRC, Jean Francois Basse, described the situation in Goma as “extremely grave,” further complicating an already dire humanitarian crisis. 

He highlighted the severe hardships faced by the displaced population, including exposure to traumatic events, hunger, thirst, and exhaustion. 

Beyond the health risks, he said there has been a surge in the number of children separated from their parents, making them vulnerable to kidnapping, recruitment by armed groups, and sexual violence.

The agency is urgently calling for $22 million to continue providing life-saving support, including clean water, proper sanitation, medical supplies, treatment for severely malnourished children, and protection services.

Mr. Basse emphasised the need for parties to the conflict to halt the military escalation, which is exacerbating the suffering of children and worsening the already appalling humanitarian conditions.

The move from the UN agency dedicated to ending the disease came in response to an immediate 90-day funding pause for all foreign assistance laid out in an executive order by President Trump, including the US President’s Emergency Plan for AIDS Relief (PEPFAR).

PEPFAR is the world’s leading HIV initiative which directly supports more than 20 million people living with HIV, representing two-thirds of all people receiving HIV treatment globally.

The waiver approves the continuation or resumption of “life-saving humanitarian assistance,” which applies to core life-saving medicine and medical services, including HIV treatment, as well as supplies necessary to deliver such aid.

‘Critical role’

“UNAIDS welcomes this waiver from the US Government which ensures that millions of people living with HIV can continue to receive life-saving HIV medication during the assessment of US foreign development assistance,” said UNAIDS Executive Director, Winnie Byanyima.

“This urgent decision recognises PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV.”

The funding pause of development assistance for “assessment of programmatic efficiencies and consistency with United States foreign policy,” was one of the first major foreign policy decisions of the new administration.

UNAIDS will continue efforts to ensure that all people living with or affected by HIV are served and that other key components of PEPFAR’s life-saving efforts, including service delivery and services for HIV prevention, care, and support for orphans and vulnerable children, are continued.

Immediate impact

Earlier, the UN World Health Organization (WHO) expressed deep concern about the implications of the funding pause for HIV programmes in low and middle-income countries.

These programmes provide access to life-saving HIV therapy to more than 30 million people worldwide. Globally, 39.9 million people were living with HIV at the end of 2023.

“Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the US,” said WHO in a statement issued before the Secretary of State’s emergency waiver was announced.

More than 26 million lives saved

PEPFAR has been a flagship initiative of the global HIV response since its establishment over 20 years ago, WHO stressed.

Any funding pause for PEPFAR would have a direct impact on millions of lives that depend on the predictable supply of safe and effective antiretroviral treatment.

PEPFAR works in over 50 countries around the world and has saved more than 26 million lives over the past two decades. Currently, PEPFAR is providing HIV treatment for more than 20 million people living with HIV globally, including 566,000 children under 15 years of age.

Growing self-reliance

WHO said that over the past year, PEPFAR and partners – including WHO – “have been working on sustainability plans with countries for greater country ownership and reduced donor support up to and beyond 2030.”

A sudden and prolonged stop to programmes would hamper a managed transition and puts the lives of millions at risk.

The agency said it would remain committed to supporting PEPFAR and other partners, as well as national governments, in managing change processes effectively to minimise the impact on people living with HIV.

Intensifying hostilities in eastern Democratic Republic of the Congo involving the non-state armed group M23 have caused further mass displacement in the mineral-rich region, with fears that the regional capital Goma could come under attack, UN agencies warned on Friday.

Dead bodies lie in the streets, hospitals are overwhelmed and there has been an uptick in reports of sexual violence, rape and looting.

“Roads are blocked, ports are closed and those crossing Lake Kivu risk their lives in makeshift boats,” said Shelley Thakral, spokesperson for the UN World Food Programme (WFP) – one of many UN agencies on the ground striving to provide assistance and protection wherever possible. “I spoke just moments ago to an activist In Goma and he told me, ‘We’re here, we’re hiding. We don’t know who will come to help us.’”

The UN aid coordination office, OCHA, echoed the humanitarian community’s deep concerns about the spiralling violence across the resource-rich region that has uprooted some 300,000 people from camps around Goma in a matter of days.

Aid targeted

“Our colleagues in the DRC report heavy, small arms fire and mortar fire across the city and the presence of many dead bodies in the streets,” said OCHA spokesperson Jens Laerke. “We have reports of rapes committed by fighters, looting of property, including of a humanitarian warehouse and humanitarian and health facilities being hit.”

The emergency has left hospitals in Goma reportedly overwhelmed by the influx of wounded people, electricity and water supplies “compromised” and internet services cut off on Monday. “Goma is still offline this morning,” Mr. Laerke told journalists in Geneva.

The development came amid urgent calls from the international community including the Security Council in New York, where ambassadors on Monday demanded an immediate halt to the M23 rebel offensive and called for the group to withdraw from territories it has seized.

The ambassadors reiterated their support for the UN peacekeeping force in the DR Congo, MONUSCO, and paid tribute to blue helmets who have lost their lives from South Africa, Malawi and Uruguay in recent days.

The Council also condemned the presence of “external forces” in eastern DRC – amid reports Rwandan troops are heavily involved in the offensive – and called for all parties to adhere to the ceasefire and return to diplomatic talks.

Years of crisis

Before the latest escalation in violence in eastern DRC’s Kivus, some 5.1 million people had already been displaced by years of insecurity in the mineral-rich region and forced to live in overcrowded camps with little food and no security.

UN agencies and partners continue to monitor the highly unstable situation which has forced WFP to temporarily pause food assistance activities in around Goma. “The airport and major access roads within the region have been cut off…Depending on the duration of violence, the supply of food into the city could be severely hampered,” said WFP’s Ms. Thakral.

“This is a huge test for Congolese trapped by fighting in Goma and surrounding areas…the next 24 hours will be critical as people start to run low on supplies and will need to see what they can find to survive.”

Disease fears

The highly mobile nature of the emergency has prompted additional fears that existing diseases may spread quickly among uprooted populations, although preventive measures were taken before the latest escalation, the UN World Health Organization (WHO) said. 

For the moment the immediate concern is to help victims of the violence.

“There are currently hundreds of people in hospital, most admitted with gunshot and shrapnel wounds, with secondary infections becoming a health risk,” said Dr Adelheid Marschang, Emergency Response Coordinator for the DRC.

She noted that before Goma airport closed on Saturday, WHO had sent critical medical supplies for trauma and emergency care, infection prevention, cholera and more.

The UN agency’s response to the crisis has also included providing tents for hospitals to cope with the increasing number of injured. It has medical hubs in North and South Kivu, in the cities of Goma and Bukavu to support health care needs in eastern DRC.

Last year the provinces of North and South Kivu reported high numbers of cholera, measles and malaria cases and deaths, Dr. Marschang said, warning of a “heightened risk for spillover of cholera” into neighbouring countries and provinces.

The area was also the epicentre of an outbreak of a new strain of mpox, declared a public health emergency of international concern in August 2024. Dr. Marschang warned that the new wave of displacement will make it increasingly hard to track and treat the disease.

Amid the lethal violence, hospitals and health workers themselves are in danger, the WHO official said, with “reports of health workers being shot at and patients including babies being caught in crossfire”.

“Attacks on healthcare violate the rules of war. Healthcare must be protected at all times,” she insisted.

Sexual violence alert

WHO and other UN agencies and partners said that they are especially worried about the increasing risk to women and girls from violence, including rape.

“Pregnant women are at risk, with very high maternal death rates, even before the violence escalated,” WHO said.

“Sadly, hospitals and health workers are in danger.  We are hearing reports of health workers being shot at, and patients, including babies, being caught in the crossfire.  WHO reminds everyone that attacks on healthcare violate the rules of war.  Health care must be protected at all times.”

Echoing those concerns, WFP’s Ms. Thakral reported that mobile teams and mobile clinics are at work amid reports that women had been raped multiple times while searching for firewood or after leaving the perimeter of their camp.

Other reports indicated “an increase in rape along the pathways that some of the conflict partners are now taking into South Kivu,” she said, underscoring the agency’s efforts “to have some solutions to follow the populations as they move”.