MSF staff member in DRC

When you arrive in Goma, you might think everything is fine. There's a resilience within the population despite the hardships. As you move around, you can see that life has gradually resumed in Goma. You go out in the evening, the bars are open.



But what you don't see is the deep fear that still lingers among Goma's population. You have to remember there are still cases of score-settling. Assassinations, arbitrary arrests — these things keep happening, though quietly and out of sight.

North Kivu: Beneath the Surface

MSF staff member in DRC

Goma fell in January 2025. When the city fell, we spent an entire week locked inside our homes. They were carrying out sweep operations throughout the city of Goma.



After years of advances across North Kivu,

the armed group AFC/M23 launched an offensive on Goma in January 2025.



Several thousand people were killed

during the fighting and in the days that followed.



They started suspecting everyone. There were many sweep operations in the working-class and outlying neighbourhoods of the city. That's where we recorded numerous cases of arbitrary arrests, forced recruitment of young people, mass detentions… It was truly terrifying for the population. And at the same time, the FARDC soldiers [Armed Forces of the Democratic Republic of Congo] and rival armed groups were themselves behind much of the crime and insecurity in the city.



The M23 ran multiple awareness campaigns trying to convince people they were fighting for their benefit, that trust needed to be built. But that trust crisis gave rise to this fear. And even if things have improved, to this day, the mistrust remains.



Today in Goma, civil society does not exist. It has no right to speak out. Civil society members are in exile — either in Burundi or in other cities in the DRC. And even their relatives in Goma are being hunted down.



They have set up what we call propaganda bodies to get people to join their movement.



Wherever they go, they install a parallel administration. The existing order, the existing structures — all of that is gone. They put in place new structures, new institutions.



In its offensive across North Kivu, the armed group AFC/M23, whose Rwandan backing has been documented by the United Nations, faced numerous armed groups, in addition to the Armed Forces of the Democratic Republic of Congo [FARDC].



Among them, the Democratic Forces for the Liberation of Rwanda (FDLR), an armed group made up of Rwandan Hutus who fled Rwanda after taking part in the genocide of the Tutsis in 1994.



Others chose to side with the Congolese government, uniting under the banner of the Volunteers for the Defense of the Homeland (VDP).



You have to understand that Goma is the M23's headquarters. They try to reinforce security and reassure everyone. Goma is like a showcase for them. But once you leave Goma, you start to sense a breakdown: more and more robberies, more and more areas becoming inaccessible. There are zones where the M23 has never even set foot, run entirely by rival armed groups or militias.



Testimony from Éléonore, a patient at Rutshuru Hospital supported by MSF: Before, the FDLR used to farm their fields, but now they've fled into the forest and prey on civilian populations. They've come through my village twice. It's not just my home — they commit abuses throughout other villages. They take everything: money, food, and clothes. They leave nothing.



The real large-scale operations began around 2022. The population felt abandoned by the government army. I remember when the M23 arrived at Rutshuru. People didn't know what to do — some fled to Uganda, others to the far north, others to the Bwisha chiefdom.



Testimony from Masika: During the conflict, I lost my father-in-law. We never even saw his body. Many people died without their families being able to recover their bodies. We fled on foot to Kasaï, then to Kazaroho. From there, we took a motorbike to the Rwasa displacement camp. We fled alone. Every person left on their own.



From 2022 onwards, people kept moving, believing the situation would change. But the further things went, the more it created a back-and-forth movement — a perpetual displacement. Even today, those who haven't returned think that if they come back and the fighting resumes, they'll be forced to flee again.



Before Goma was taken by the M23 authorities, there were several displacement camps housing nearly 700,000 people. After the takeover, the camps were forcibly dismantled. Some displaced people chose to stay in the city for personal safety reasons, and also because they told us their villages had been destroyed. This group is increasingly vulnerable, with no work.



In May 2025, they launched large-scale operations against all these resistance groups. This created a very difficult situation for the population, now caught between these resistance groups and the M23.



The Rutshuru territory is the scene of near-daily abuses by armed groups: sexual violence, assassinations, arrests, massacres.



Patients treated by MSF gave accounts of massacres in July 2025. All identified armed men as the perpetrators, with some specifically naming the M23.



Testimony from Zawadi: We left Binza fleeing the war. My husband was shot and killed on 3 August. They were in the field when armed men killed them on the spot. After his death, I fled on foot with nothing. Twenty-five of us women farmers fled, each making our way back to our own families.



They banned the population from accessing their fields. This further worsens the survival situation for these people. When the M23 comes in, they say: “to prevent the population from continuing to collaborate with rival groups, we must cut off their access to the fields”.



Rural communities depend entirely on farming. And when they can't access their fields because of armed groups, it drives the population into malnutrition.



Testimony from Zawadi: I'm here because of my child's malnutrition. They were twins. One died in Mapendo, three and a half weeks ago. I don't have money to feed my child - that's why he's malnourished. The price of cassava flour has doubled.



On the issue of malnutrition, there are things we simply cannot solve. The population trapped between warring parties around Kibirizi, Bambo — it's beyond us. And with the suspension of USAID funding, many organisations that were active in the area have stopped operating. MSF is now the only major actor in the zone, and it cannot do everything.



Many activities have ground to a halt. Commerce, agriculture, economic activity — all stopped or slowed, because of the ongoing operations between the government and the M23, and between the M23 and the resistance groups still operating in M23-controlled areas.



In Rutshuru, along the main road, with the banks and Goma international airport closed, people are forced to travel to Beni and Butembo, and they know they have to use the RN2. And that's where crime has surged: armed groups seize the opportunity to rob people, knowing they're carrying money.



Testimony from Bisimwa: I'm a motorcycle driver. I wanted to go to Goma to pick up spare parts. On my way back, I ran into M23 soldiers. One of them grabbed a machete and struck me on the head. Blood was pouring out. At the health post, they said: “this man could be dead within minutes”. So they told them to bring me here, to Rutshuru Hospital.



The surgical caseload at Rutshuru Hospital has also increased, because of all these attacks we are now recording on the RN2.



The rules of war are not being respected. Health facilities are being looted, humanitarian spaces that should be protected by warring parties are not. And there are communities being denied access to medical care — that is the reality we are living right now.



Testimony from Éléonore: Armed men had invaded our village. After taking everything, they shot me in both legs. When some of them realised we recognised them, they killed my husband. When they shot me, I fell. They thought I was dead. They left, and the neighbours came to help me after they were gone.



Because some people are labelled as belonging to one faction or another, and that's the reason they're denied access to care. Others are afraid of being seen as affiliated with armed groups, and they too find themselves barred from certain areas.



Testimony from Zawadi: We have no work. Before, we were farmers, but because of the insecurity, we no longer go to the fields. We're afraid of being raped. Some women are raped and even killed in the fields. The security situation has worsened — women are being abducted in the fields. They're held for days, then released, sometimes killed. That is what happened to my younger sister.



The situation regarding sexual violence in the city of Goma remains alarming. Even before the M23 took Goma, rates of sexual violence were high — and since then, the situation has stayed much the same, though, how to put it, the context of the rapes has changed.



We are now seeing sexual violence occurring within Goma itself, inside homes — armed men targeting vulnerable women in the outlying neighbourhoods. There is sexual violence on a large scale, and behind it all, sexual exploitation as well, beyond the violence committed by armed criminals.



MSF received tens of thousands of survivors of sexual violence in Goma in 2025. The majority were assaulted by armed men, but a significant share of this violence also occurs within families and communities.



Women's access to healthcare in Goma is becoming increasingly difficult, due to the rise in sexual violence but also to the scarcity of free medical care. Humanitarian funding cuts — especially USAID funding — mean that these women are finding it harder and harder to access care precisely when they need it most.



In our consultations, we are seeing a rise in STI cases [sexually transmitted infections], which is of course linked to all these high rates of sexual violence, as I mentioned. The precariousness of women's lives in Goma right now has opened the door to sexual exploitation — many women are being sexually exploited simply to survive.



Hope came with the peace agreements brokered by Donald Trump between Rwanda and the DRC, aimed at peacefully ending these conflicts. But unfortunately, to this day, no positive signs have been seen on the ground. Fighting and shelling continue.



The government believes there has been significant progress on this agreement brokered under Washington's mediation. But unfortunately, on the ground, nothing has changed. Fighting continues, positions are hardening, and localities keep falling one after another.


The priority is peace - a return to peace. I think that's what they want above all else: to see a better tomorrow. But today, it's despair, because they don't believe the situation will get better — not today, not tomorrow.