The recent surge in violence in the eastern Democratic Republic of the Congo has led to significant loss of life, trauma, displacement, and the destruction of critical health infrastructure, exacerbating an already dire situation for millions of people.
The situation remains tense and volatile, and the health needs are immense. WHO remains on the ground, and has continued to respond to the health needs by providing lifesaving medical supplies, supporting health workers, and coordinating the emergency response.
Hospitals and morgues are overwhelmed. Since 26 January, 3082 injured and 843 dead have been reported from 31 health facilities in and around Goma, North Kivu.
With the alarming expansion of violence further south, 65 injuries were reported from 3 hospitals in South Kivu.
These numbers are expected to rise further as more injured people are able to reach health facilities and more dead bodies are gathered off the streets. Wound infections are a risk for those who have not been able to reach health care facilities quickly, and as health facilities are running out of supplies they need to clean and disinfect.
The sight of bodies lying uncared for is distressing. Though the bodies of people who have died from injury do not generally carry or spread disease, it is the right of the dead to be identified and receive proper burial, and important for the living to know their loved ones have received this care.
Over 70 (or 6%) of the health facilities in North Kivu have been affected, with some completely destroyed and others struggling to restart operations. Some ambulances have also been damaged. A WHO-supported health clinic in North Kivu was temporarily occupied by armed groups. Health workers have had to flee in places, while in others, they have been working round the clock for days, with limited resources and overwhelming demand, and sometimes at risk to their own lives.
Cancer, diabetes, hypertension, mental health and other routine services are also affected as medicines have run out and health workers are either absent or overburdened.
The risk of death during pregnancy and childbirth has increased from already high levels. Given the insecurity, pregnant women cannot reach health facilities for safe delivery. Experience with conflict in the region has shown the drastic effect it has, with the rate of births attended to by skilled health workers dropping to near zero during periods of intense violence.
The threat of infectious diseases has multiplied. Cholera, malaria, measles, meningitis, mpox and tuberculosis are among the infectious threats in the area. The water supply in Goma was disrupted and has only partially resumed, leading people to use water from the lake, and heightening the risk of cholera spread. Close to 600 suspected cases of cholera and 14 deaths were reported from North Kivu between 1 and 27 January.
Eastern Democratic Republic of the Congo, especially South Kivu province, is the epicentre of the mpox outbreak that prompted the WHO Director-General to declare a public health emergency of international concern last August. The mpox response is heavily impacted. Ninety percent of the mpox patients (128 of 143) in isolation units in Goma had fled for safety, making it nearly impossible to provide them with care, and increasing the risk of spread.
One in four people in the region was already facing emergency levels of hunger, with the recent violence expected to worsen the situation. Malnutrition and disease go hand-in-hand: malnourished people are less able to fight disease, while disease leads to further malnutrition. This vicious circle is especially concerning when it comes to children, and pregnant and breastfeeding women.
Goma was home to over 2 million people, including 700 000 people displaced by this crisis. These people have had to flee yet again, in search of safety. They are in temporary settlements, with their health and safety at risk.
A rapid assessment of 10 healthcare facilities in and around Goma showed a concerning rise in rape and other gender-based violence: there were 45 cases reported among the displaced, and 21 survivors of gang-rape admitted to two hospitals. These numbers are only the tip of the iceberg. These patients require medical care, psychological support, and support with maintaining their livelihood, especially when they are the sole providers for their families.
WHO has deployed emergency medical supplies, hygiene and water treatment supplies, and tents to increase hospital capacity by 1000 beds. Supplies are being depleted rapidly, and more resources are urgently needed.
WHO is preparing further deliveries as part a European Civil Protection and Humanitarian Aid Operations (ECHO)-led effort to fly in critical supplies. For this, the Goma airport, a critical lifeline, must be urgently reopened. WHO is also exploring options to deliver critical supplies through other routes.
WHO and partners were able to resume mpox vaccination in Goma on Wednesday, 5 February after a 10 day pause.
The United States’ recent decision to freeze foreign aid is significantly impacting relief efforts in the Democratic Republic of the Congo. Last year, the US contributed to as much as 70% of the country’s humanitarian response. Additionally, the US is a major funder of the mpox response, and has pledged a million vaccine doses of its own stock to global efforts. While WHO’s humanitarian response in the region relies on funding from other donors—including the European Union, United Kingdom and the WHO’s Contingency Fund for Emergencies—reductions in overall aid will have repercussions on people’s health.
To meet immediate health needs in eastern Democratic Republic of the Congo, including for safe and dignified burials, WHO has spent US$ 600 000. The overall response requires US$ 50 million.
WHO calls for humanitarian access, the protection of health workers and facilities, and an end to attacks on health care. Health facilities, supplies, workers and patients should be protected. Ultimately, we call for peace, and an end to the unimaginable and long suffering of the people in this region.
