Patient names have been changed to protect anonymity.
In January 2025, after years of fighting against the Congolese army and allied armed groups in North Kivu, the M23/Congo River Alliance (AFC)—backed by Rwanda—seized control of Goma, which is home to over a million people. During the first week of the offensive, hospitals rapidly became overwhelmed by a surge in casualties, both military and civilian. Morgues filled quickly as the Congolese army and its allies retreated, allowing M23/AFC to take over as the new authorities in the city. Heightened insecurity, increased crime, and rampant violence—including a continued high prevalence of sexual violence—became the new normal.
MSF teams are recording alarming numbers of sexual violence cases. From January to April 2025, more than 7,400 survivors of sexual violence received treatment at Ministry of Health facilities supported by MSF in Goma. West of the city, in Saké, an additional 2,400 survivors were treated during the same period.
Sexual violence remains prevalent under the new order
Every morning female survivors of sexual violence of all ages gather at health centers where MSF works in Goma. They need healing, support, and to be heard. Nasha* was among many patients to visit in May. Like many women, her life has been turned upside down by persistent conflict in North Kivu.
Originally from Masisi, a territory to the west of Goma, Nasha fled ahead of clashes in the province from 2021 to 2024. She and her family moved to a displaced persons camp alongside some 650,000 others on the edge of Goma. But in February 2025, the M23/AFC armed group ordered the dismantling of camps, effectively forcing their residents to leave.
Large numbers of people are unable to return to their homes because they lack the resources to do so or because their lands have been seized. This has led many to seek refuge with host families or in low-cost housing in Goma and the surrounding suburbs.
“I lived in the Rusayo displaced persons camp,” said Nasha. “After it was destroyed, we moved to the courtyard of a school where we built a shelter. Armed men broke in one evening at 10:30 p.m. They attacked me. When my husband tried to protect me, they shot him dead.”
Nasha’s story is far from unique in Goma and its outskirts. Every day, before nightfall, women travel to the city from the neighboring territory of Nyiragongo in a bid to stay safe—too often in vain. Attacks on shelters, whether on small plots of land, rooms rented out by Goma residents themselves, or public places, are frequent.
Angélica* survived repeated rapes, and is receiving care at health center in Goma. DR Congo 2025 © Jospin Mwisha
Nowhere is safe
“In recent years, most rapes happened during daily activities—particularly when women left the displaced persons’ camps to search for firewood or to engage in small-scale trading activities,” explained Armelle Gbagbo, who runs women’s health activities for MSF.
“Today, many attacks happen at sites where women are living—whether in a house or in a refuge—and particularly during the night when insecurity increases. They are attacked wherever: in their homes, with their families, alone, in the streets of Goma, or during outings on the edge of town.”
Not all sexual violence is committed by armed men, in military uniform or otherwise. Many cases are also committed by those closest to the victims themselves. “We shouldn’t discount the very significant proportion of sexual violence committed by family members, other members of the survivors’ entourage, or within host families,” said Gbagbo.
Exploiting vulnerabilities
“The population of Goma has been gripped by fear since the city was taken,” said Frédéric Germain, MSF project coordinator. “There is significant insecurity in the city. Many criminals commit attacks, rapes, and murders by night. The high availability of weapons means that bandits and armed groups pose a constant threat. The economy is slowing down and the population is facing a system of violent predation.”
Sarah* also recently visited one of the health centers in Goma. Her husband had recently been kidnapped by men armed with rifles and machetes who stormed into the small house where she and her family were staying after the camps were dismantled.
“It was a few weeks ago and I haven’t had news since,” she said. Others around her recounted stories of killings, looting, kidnapping, and similar forced disappearances of fathers and brothers.
A recent study by Épicentre, MSF’s epidemiological research center, highlights a surge in violence in Goma, with the number of violent incidents reported in the first six months of this year being more than five times higher than the same period in 2024.
“The proportion of violent deaths recorded in this study is very high, representing one in four deaths,” said Dr. Brahima Touré, an Épicentre epidemiologist. “Incidents of physical violence and verbal threats are also occurring in large number, as testified by the number of people witnessing such events. The results show high levels of sexual violence which are likely to be significantly underestimated given that in this kind of study on violence, survivors find it difficult to speak out.”
Targeted support that cannot meet immense needs
The offensive on Goma led many civil society figures to flee. Several humanitarian organizations that had been working to support sexual violence survivors also left, in part due to the impact of US foreign aid budget cuts.
“In Goma, we are practically the only association providing health services to these women, but the needs are immense,” said Germain.
Among the survivors seen by MSF, close to 20 percent are unable to seek medical attention within 72 hours of being attacked—a critical window during which the administration of post-exposure-prophylaxis medication can significantly reduce the likelihood of contracting sexually transmitted diseases (STDs).
“There is a high percentage of women suffering from STDs,” said Gbagbo. “This is also linked to the phenomenon of gang rapes or the practice of trading sex to survive. Many women say they are sexually exploited by the people housing them in exchange for food or a roof over their head.”
Congolese women are also suffering the consequences of the dismantling of the US Agency for International Development (USAID) under the Trump administration. An order of 100,000 post-rape kits—which include medication for preventing infection from HIV and other STDs —that were set to be distributed to multiple organizations treating sexual violence survivors in the eastern DRC was cancelled this year, with catastrophic consequences.
“In May, the United Nations Population Fund (UNFPA) in North Kivu, which helped sexual violence survivors with support from USAID, only had 2,500 emergency kits for the entire province, while thousands of women are attacked every month,” said Gbagbo.
Sexual violence is not limited to Goma or its suburbs. Survivors travel tens of miles to seek treatment in the city.
“It is essential that other international partners step up to support these women,” said Germain. “Thousands are in need of urgent medical assistance.”
*Names have been changed.
