North Kivu Is In a Constant State of Emergency

Civilians are getting pushed out of their homes, being raped and catching diseases.

The real losers in any war are the civilians. Look at the recent conflict in Gaza: over two thirds of the 165 Gazans killed by Israeli missiles were civilians, and the same goes for Israelis killed by Hamas' rockets. The ongoing fighting in the eastern Democratic Republic Of Congo (DRC) tells a similar story. The conflict recently stepped up a gear when, on the 20th November, the M23 rebel group – led by the worryingly-named General Bosco “The Terminator” Ntaganda – took the largest city in the region, Goma, from government forces with little resistance. 

The eastern Congo has been a hotbed of violence and suffering for civilians for decades, with numerous rebel groups vying for control of the resource-rich region. As well as war, the civilians in the region have had to deal with near constant epidemics of cholera, malaria and measles, lack of clean access to water, government corruption and a rape crisis, which are just some of the reasons why the international medical humanitarian organisation Medicins Sans Frontieres (Doctors Without Borders) has a permenant operation in eastern Congo.

I spoke to Thierry Goffeau, Chief of Mission for MSF's operation in North Kivu, about the humanitarian situation in the region and how MSF is dealing with the fallout from the recent fighting.

VICE: Hi Thierry. Can you briefly explain the situation in eastern DRC prior to the offensive by M23? 
Thierry Goffeau: It was unstable. The first M23 offensive in July 2012 got a lot of people moving and many have settled down in the outskirts of Goma – around 70,000 internally displaced people (IDPs) in the Mugunga camps west of Goma, and 55,000 in the Kanyarucinia camp north of Goma. Some areas in those camps weren't properly taken care of by the local authorities or the international community and there's poor food distribution, insufficient access to water, bad sanitation, poor access to healthcare, etc.   

Why do MSF have a presence in eastern DRC?
The health system doesn't have the capacity to provide free of charge, quality healthcare to the population, who are recurrent victims of conflict and malnutrition. The region has been unstable for more than 15 years, deeply damaging the health services, public health and infrastructure, and the constant displacement of the population has exposed them to all kinds of epidemics, sexual violence and lootings. We're in a constant emergency in North Kivu.

What's the size of MSF's operation in eastern DRC and what services are they providing?
MSF works in all the key places in North Kivu: Walikale, Masisi, Goma, Rutshuru, but also Ituri and South Kivu. All our projects are staffed with around 70 skilled expatriates and hundreds of local national staff. We support four hospitals, 12 health centres, four health posts, provide mobile clinics, repond to epidemics and provide health care and nutrition in IDP camps in all those areas. And all of it is free of charge.

Wow, that's good of you. What have MSF been doing to help the humanitarian situation since M23 started their offensive?
We set up mobile clinics and health posts in camps, and we collect the wounded on the frontline and transfer them into hospitals where we provide surgery. Our mobile clinics allow us to follow the movements. On Thursday 22nd, around 100 wounded civilians were counted in Goma's hospitals; MSF is now taking care of 54 of them.

How was M23 able to take Goma with such little resistance from government and UN forces?
M23 are mobile, well equipped and motivated. It's never easy to secure a city like Goma. The Monusco mandate is restricted to the protection of civilians. The population was shocked to see how fast the invasion occured.

What have the UN been doing? Are they doing enough?
On the humanitarian front, they do what they can, but they're suffering shortage of supplies and funding.

That sucks. Do you think M23 will make a push for Kinshasa, like they've threatened to?
It's unlikely. That would mean we'd shift to a regional war. Let's see what happens with the ongoing negotiations in Kampala.

Are the DRC military preparing to fight M23?
Definitely. This conflict is far from over, unless an agreement is reached between M23 and President Kabila in Kampala. Therefore, we're prepared to stay on the frontlines and continue our job.

Have MSF facilities and staff been threatened or attacked by the rebels?
We've managed to negotiate our humanitarian space. However, one of our trucks got looted on the road to Rutshuru a week ago. No one got harmed too much, fortunately.

Have you seen anything to suggest that M23 are using child soldiers?
Honestly, in Rutshuru and Goma, no. But an individual is considered a child up to his 15th brthday, and many look older than that physically, so it's hard to tell.

Do rape cases increase when rebel groups start offensives in eastern DRC?
In our Rutshuru hopsital, the number of rapes are the same as this time last year. But the number was already very high before, so I'd say the horror remains at exactly the same level. Raping is a major issue in this part of DRC. I'd never seen such high numbers or heard such terrible testimonies before I came here.

What's the situation like in Goma now that it's in the hands of M23?
People remain fearful and traumatised, but life goes on and many shops are open. There's no electricity or running water yet, and that could cause some major health issues if it continues. Cholera is endemic here and we have sick patients in the camps – a threat that needs to be followed up closely.


Since I spoke to Thierry, the peace talks between M23 and the Congolese government in the Ugandan capital of Kampala seem to have been a success, with M23 promising to withdraw from Goma. Although they didn't necessarily leave empty-handed. Yesterday, witnesses spotted M23 troops raiding the central bank of all its cash. Even if M23 completely withdraw, it's unlikely they'll be gone for long, and the suffering of local civilians is likely to continue as services remain cut off and the equally feared Congolese army return. 

Photos by Aurelie Baumel/MSF.

Follow Henry on Twitter: @Henry_Langston

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