Helen O'Neill is an Operational Advisor with emergency medical aid agency Médecins Sans Frontières (MSF). She recently returned after having worked with the MSF teams in the Kivu region of northeastern Congo where, today, thousands of people are desperately fleeing violence as the 15 year conflict escalates into outright war.

Here Helen describes the situation on the ground.

"The situation in the Kivu region is rapidly deteriorating and it's changing hour by hour. Repeatedly displaced by conflict, the people I met in MSF clinics, in the camps or by the roadside were already sick, exhausted and frightened. Now people are being forced, in their thousands, to flee for their lives yet again.

Several thousand people fled Kibumba and the Kibumba-Rutshuru axis this last week to go to Kibati. MSF has set up a mobile clinic to respond to the needs in medical health care but also in water. Most common sicknesses are malaria, diarrhoea and respiratory infection. Three MSF trucks have been bringing water in Kibati to give access to clean water to thousands of refugees fleeing the fighting. Several thousand people fled Kibumba and the Kibumba-Rutshuru axis this last week to go to Kibati.

MSF has set up a mobile clinic to respond to the needs in medical health care but also in water, using trucks like the one pictured here. The most common illnesses are malaria, diarrhoea and respiratory infection.

"The northeastern part of the country is torn after years of conflict and bloodshed and the health needs of the population are enormous. Despite the current escalation of violence, our teams continue to provide independent emergency medical aid to people in towns and camps throughout the conflict zone, namely in and around Kitchanga, Masisi, Mweso, Nyanzale, Rutshuru and Kayna. In many areas, MSF is the only remaining international organisation providing medical and humanitarian assistance to a terrified and desperate population.

"Last week, the MSF teams in the villages of Mweso and Rutshuru were trapped in our two hospitals, listening to heavy shelling outside whilst providing life-saving medical treatment inside. At the weekend, intense fighting erupted around Rutshuru town, some 70 kilometres from the provincial capital, Goma. Our team treated 80 war-wounded people and since then has been working around the clock to try to save the lives of severely injured patients.

"Yet again, this current escalation of violence has caused widespread panic. The terror across the Kivu region is palpable. People are grabbing their children, goats if they have any, and bundling their belongings on top of their heads to flee, once more, to wherever they can find some level of safety. One week there is a bustling village and the next week our mobile medical teams return to discover it's completely empty - a ghost town. Thousands are on the move - a constant stream of humanity on the road.

"Who knows where all these people will end up? The families settle in inhospitable areas, many of them in the bush, where there is no chance of accessing healthcare. They build shelters out of whatever local materials they can find, like banana leaves, completely exposed to the damp of the current rainy season and the cold of the Congo nights.

"The violence is having a devastating impact. After years of displacement, people's health is fragile, particularly the children's. Malaria is endemic in the country, as is cholera, which increases whenever people are on the move like this or crowded into unsanitary camps. The harsh reality is that those children who managed to escape the current violence this week could die over the next few weeks from the bite of a mosquito, simply because they lack access to medical care. The injustice of this is hard to bear. Several thousand people fled Kibumba and the Kibumba-Rutshuru axis over the last week to go to Kibati.

"The people I met are also hungry, as they can't go to their fields to harvest. It's just too dangerous. If you are out alone trying to get to your land you can be shot or raped. So, malnutrition is another very real concern. In some places, it's extremely difficult to find the displaced people. They can't reach us, so whenever we get information on their whereabouts we try to reach them with mobile medical clinics.

"Clearly, the situation is desperate and we're extremely concerned. These people need immediate humanitarian assistance. They need medical aid, shelter, food and clean water - urgently.

"We are sending extra international staff to the region to support the relief efforts. However, the violence needs to stop. These people have already suffered so much. Most of them have only ever known war and displacement in this cycle of violence. The civilian population are prisoners in a humanitarian crisis not of their making, caught in a conflict that is stealing everything from them - their dignity, security, health, homes, livelihoods and ultimately, for too many, their lives."