The situation in Ituri, North Kivu, and South Kivu in eastern Democratic Republic of Congo (DRC) has evolved significantly, with civilians across these provinces continuing to bear the heaviest toll of the violence, despite the distinct types of conflict in each region. In the wake of a new wave of violence in Ituri province, compounded by years of conflict that have led to severe harm against civilians and displacement, MSF is set to release a report titled "Risking Their Lives to Survive." The report underscores the urgent needs of communities facing repeated attacks and displacement, with medical facilities constantly under threat in a context of dwindling aid. MSF teams are deeply shocked by the severity, brutality, and frequency of the injuries they are treating, many of which involve attacks on babies, children, and pregnant women. Tens of thousands of people remain on the move, desperately seeking safety and the means to survive. According to the UN, violence in Ituri has displaced around 100,000 people in Ituri since the beginning of the year. In January and February alone, it also reported an intensification of violence against civilians, with attacks leaving more than 200 people dead and dozens injured. More than half of the 30 victims of violence MSF treated at Salama clinic, Bunia, in the first two months of 2025 were women and children. Recent clashes between Ugandan forces and militia members threaten to destabilize what is already a highly volatile situation for civilians.

For decades, people in Ituri have been both direct targets and treated as collateral damage in a complex conflict characterized by violence, ethnic divisions, and the participation of various armed groups.

MSF is releasing a public advocacy report documenting violence by armed groups against civilians in Ituri in a bid to draw more attention and resources towards the situation in this province. The report bears witness to what MSF has observed through its activities in Ituri. It is not an exhaustive representation of all violence committed against civilians in Ituri and all its impacts. However, MSF’s presence in Ituri since the beginning of the most recent conflicts gives the organization a particularly close view of the devastating impact of the conflicts on civilians. These testimonies and reflections can drive thoughtful discussion with authorities, UN agencies, NGOs.

It is important to note that this report was finalized at the beginning of January 2025, before the crisis in North and South Kivus. However, the observations remain relevant: the civilian population pays the heaviest price for the violence in Eastern DRC and atrocities continue during spikes of violence.