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”.

President Trump’s executive order a week ago called for all foreign aid to be re-evaluated to ensure that it complies which his new foreign policy priorities.

The immediate scope of the order was not clear but on Friday, according to news reports, the US Secretary of State Marco Rubio issued an order putting any new funding on hold, pending review.

The State Department directive reportedly clarifies that funding for existing programmes is also suspended until it has been reviewed.

The only exceptions were reportedly for military assistance to Israel and Egypt and emergency food aid.

Concern over aid freeze

“The Secretary-General notes with concern the announcement of a pause in US foreign assistance,” said the statement issued on behalf of António Guterres by his Spokesperson.

“The Secretary-General calls for additional exemptions to be considered to ensure the continued delivery of critical development and humanitarian activities for the most vulnerable communities around the world, whose lives and livelihoods depend on this support.

The statement added the Mr. Guterres was looking forward to engaging with the Trump administration on how “much needed development support” can be provided to citizens in the developing world who face the severest challenges.

“The United States is one of the largest aid providers and it is vital that we work constructively to jointly shape a strategic path forward,” the statement continued.

The US Government is the largest single donor of aid in the world, disbursing around $72 billion in assistance during 2023. It also reportedly provided more than 40 per cent of all humanitarian aid accounted for by the UN during 2024.