Goma Under Siege: A Humanitarian and Health Catastrophe

VIEWPOINT

Patrick Ndeba, Faraan O. Rahim, Meriem Boukaabar, Mohamed Shilleh, Omar Shilleh, Alaa Shilleh, and Dang Nguyen

On January 27, 2025, Rwandan-backed M23 rebels entered the city of Goma in the eastern Democratic Republic of the Congo (DRC), unleashing a vicious attack that resulted in civilian casualties, sexual violence, and widespread looting.[1] Home to two million residents, Goma has since become a city of chaos and devastation. Terrified citizens are fleeing in search of safety, with many attempting to cross Lake Kivu in makeshift boats to escape the country.[2] Hospitals are overwhelmed, and at least 7,000 people have died.[3]

Civilians have been exposed to direct violence, as well as the breakdown of essential services and infrastructure. Electricity and water supplies have been disrupted and internet access cut off.[4] The rebels have blocked major roads, closed Goma’s airport, and shut down ports, effectively halting the flow of humanitarian aid and essential food supplies.[5]

This latest escalation is part of a long-standing conflict rooted in regional instability following the Rwandan genocide and the ongoing battle for control over eastern DRC, a region abundant in lucrative minerals. The M23 rebel group, originally formed by ethnic Tutsi fighters, has significantly evolved over time. In 2025, Corneille Nangaa, the former head of DRC’s electoral commission, assumed leadership of the group.[6] Under his command, M23 has sought to legitimize itself as a political authority by seizing control of local resources, imposing taxes, and establishing parallel governance structures—directly challenging the sovereignty of the Congolese state.[7] The Rwanda Defence Forces have reportedly supported M23 militarily and strategically, seeking to protect Rwanda’s political and economic interests in the region.

The recent siege of Goma has been met with strong condemnation from human rights organizations, which have cited grave violations of international humanitarian law. The United Nations (UN) has called for accountability for the serious breaches committed during the assault. Rwanda, as a principal sponsor of the M23 rebel group, along with other regional actors, must be held responsible for failing to protect the rights of civilians, as mandated under the Geneva Conventions and other binding international treaties.[8] UN Secretary-General António Guterres explicitly condemned Rwanda’s military support for M23, emphasizing the devastating impact of its actions on civilian populations.[9] In addition, the UN Security Council has demanded the immediate withdrawal of all foreign forces from Congolese territory.

Against this backdrop, violations to human rights in DRC continue. On the outskirts of the city, camps that housed more than 300,000 internally displaced people were emptied by the M23 rebels.[10] The displaced populations were forced back to their villages that were under M23 rebel control, without any safeguards, medical or psychosocial support, or essential services, in violation of the Guiding Principles on Internal Displacement and the Kampala Convention.

The situation is worsened by ongoing outbreaks of Mpox and cholera in the region, particularly in internal displacement camps.[11] The flight of patients and medical personnel will lead to a resurgence of these diseases in the community and their spread to previously unaffected areas. Moreover, the World Health Organization and the Ugandan Ministry of Health have confirmed an Ebola outbreak in Kampala, Uganda’s capital.[12] With large numbers of people fleeing the conflict and the absence of border health monitoring, there is a high risk of cross-border transmission into Goma and other parts of DRC, including Bunagana, a border town also occupied by M23 rebels.

The ongoing water shortage in Goma forces residents to draw untreated water directly from Lake Kivu, sometimes after traveling miles to get there. The lack of water purification measures increases the risk of waterborne diseases, particularly cholera, which is endemic in the region.[13]

Medical care, already fragile before the conflict, has deteriorated significantly. Reports indicate that more births are happening at home or in UNFPA-supported mobile health clinics due to the lack of medical facilities.[14] Hospitals face severe shortages of essential medicines, equipment, and personnel. The lack of fuel to power hospital generators threatens the ability to provide critical care to the wounded and other patients in dire need of medical attention.[15]

Food security in Goma and across DRC has reached a critical state. The World Food Programme has reported that several of its warehouses have been looted, leading to food shortages and rationing.[16] Prior to this crisis, nearly a quarter of DRC’s 25.6 million inhabitants were already in a food crisis, and an estimated 3.7 million children and pregnant and breastfeeding women are acutely malnourished.[17]

A mass prison break from Goma’s central Munzenze Prison in late January, coupled with abandoned weapons left by fleeing soldiers and allied volunteers, has increased concerns about armed banditry and lawlessness.[18]

The UN has warned of an impending humanitarian catastrophe and the increasing risk of a broader regional conflict in East Africa.[19] Rwanda must immediately cease its support for the M23 rebel group, and M23 must withdraw from DRC territory and respect its sovereignty. Additionally, the UN is urging international donors to collaborate not only in delivering emergency humanitarian assistance but also in ensuring long-term accountability, while safeguarding the human rights, health, and well-being of people in DRC and the wider Great Lakes region.

Patrick Ndeba, MD, is a Congolese physician and public health expert at the University of Goma, Democratic Republic of the Congo.

Faraan O. Rahim is a medical student and global health researcher at Harvard Medical School, Boston, United States.

Meriem Boukaabar is a public health researcher at the University of Pittsburgh, United States.

Mohamed Shilleh is a public health researcher at the University of La Verne, United States.

Omar Shilleh is a public health researcher at the University of La Verne, United States.

Alaa Shilleh is a public health researcher at the University of La Verne, United States.

Dang Nguyen, BS, is a master of epidemiology candidate at the Harvard T.H. Chan School of Public Health, Boston, United States.

Please address correspondence to Patrick Ndeba. Email: patndeba@gmail.com.

Competing interests: None declared.

Copyright © 2025 Ndeba, Rahim, Boukaabar, Shilleh, Shilleh, Shilleh, and Nguyen. This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (http://creativecommons.org/licenses/bync/4.0/), which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

References

[1] A. Bashizi, D. Al-Katanty, Y. Kombi, and S. Bujakera, “Rwandan-Backed Rebels Enter Congo’s Goma in Major Escalation,” Reuters (January 27, 2025), https://www.reuters.com/world/africa/rebels-enter-centre-congos-goma-after-claiming-capture-city-2025-01-27/.

[2] United Nations, “Hospitals Overwhelmed in DR Congo, Food Running Out: Goma Faces ‘Devastation’” (January 30, 2025), https://news.un.org/en/story/2025/01/1159631.

[3] P. K. Dutta, D. Lewis, R. Levinson, et al., “A Tinderbox Conflict in Congo Is Ready to Explode,” Reuters (March 5, 2025), https://www.reuters.com/graphics/CONGO-SECURITY/MAPS/movaykzaava/.

[4] Office for the Coordination of Humanitarian Affairs, “Democratic Republic of Congo: Flash Update #3” (January 29, 2025), https://www.unocha.org/publications/report/democratic-republic-congo/democratic-republic-congo-flash-update-3-escalation-violence-significantly-affects-humanitarian-situation-north-kivu-and-south-kivu-28-january-2025.

[5] World Food Programme, “Displaced Again: People Forced to Flee Fear Hunger as Violence Grips the East of DRC” (February 21, 2025), https://www.wfp.org/stories/displaced-again-people-forced-flee-fear-hunger-violence-grips-east-drc.

[6] J. Kabumba and M. Banchereau, “Red Cross Escorts Hundreds of Stranded Congolese Soldiers from Rebel-Controlled City to Capital,” Associated Press (February 23, 2025), https://apnews.com/article/congo-m23-8e567e2a8b010df974489af5c419923f.

[7] “DR Congo M23 Rebels Have ‘De Facto Administration,’” BBC News (September 19, 2012), https://www.bbc.com/news/world-africa-19651888.

[8] United Nations, “Statement Attributable to the Spokesperson for the Secretary-General on the Democratic Republic of the Congo” (January 23, 2025), https://www.un.org/sg/en/content/sg/statement/2025-01-23/statement-attributable-the-spokesperson-for-the-secretary-general-the-democratic-republic-of-the-congo-scroll-down-for-french-version.

[9] United Nations, “Guterres Voices Alarm over M23 Rebel Offensive in DR Congo, ‘Devastating Toll’ on Civilians” (January 23, 2025), https://www.un.org/sg/en/content/sg/statement/2025-01-23/statement-attributable-the-spokesperson-for-the-secretary-general-the-democratic-republic-of-the-congo-scroll-down-for-french-version.

[10] C. Stafford, “Humanitarian Crisis in Eastern DRC: Addressing Rising Displacement and Critical Needs in Goma and Beyond,” Corus International (February 6, 2025), https://corusinternational.org/blog/2025/humanitarian-crisis-eastern-drc-addressing-rising-displacement-and-critical-needs-goma.

[11] V. Mishra, “Eastern DR Congo Crisis Increasing Risk of Mpox Transmission, WHO Chief Warns,” United Nations (February 3, 2025), https://news.un.org/en/story/2025/02/1159701.

[12] E. Biryabarema, “Uganda Confirms Outbreak of Ebola in Capital Kampala, One Dead,” Reuters (January 30, 2025), https://www.reuters.com/business/healthcare-pharmaceuticals/uganda-confirms-outbreak-ebola-capital-kampala-2025-01-30/.

[13] International Rescue Committee, “DRC: Waterborne Diseases Threaten to Compound Escalating Humanitarian Crisis, Warns the IRC” (January 30, 2025), https://www.rescue.org/press-release/drc-waterborne-diseases-threaten-compound-escalating-humanitarian-crisis-warns-irc.

[14] UNFPA, “Giving Birth Under Fire in North Kivu, as Conflict Grips the Democratic Republic of the Congo” (February 12, 2025), https://www.unfpa.org/news/giving-birth-under-fire-north-kivu-conflict-grips-democratic-republic-congo.

[15] L. Kiennemann, “Saving Lives ‘in Whatever Way We Can’: Amid Power Crisis, Sudan’s Hospitals Strive to Keep Running,” France 24 Observers (February 28, 2025), https://observers.france24.com/en/africa/20250228-saving-lives-in-whatever-way-we-can-amid-power-crisis-sudan-s-hospitals-strive-to-keep-running.

[16] United Nations, “DR Congo Crisis: WFP Condemns Looting in Bukavu after M23 Rebels Take Key City” (February 17, 2025), https://news.un.org/en/story/2025/02/1160186.

[17] World Food Programme, “Democratic Republic of the Congo,” https://www.wfp.org/countries/democratic-republic-congo.

[18] C. Mureithi, “Mass Prison Escapes Stoke Panic in DRC After Rebel Advance,” Guardian (March 10, 2025), https://www.theguardian.com/world/2025/mar/10/mass-prison-escapes-stoke-panic-in-drc-after-rebel-advance.

[19] United Nations, “Security Council Press Statement on Democratic Republic of Congo” (October 25, 2024), https://press.un.org/en/2024/sc15866.doc.htm.