The last war fought on Congolese soil involved seven countries from across the continent and various Congolese factions. It started in 1997 and ended in 2002 with the official and gradual withdrawal of foreign troops and the beginning of a transitional period. The conflict left more than three million people dead from violence and the consequences of the war, particularly access to medical care.According to previous estimations

The transition signaled the end of fighting at the national level and the establishment of a government in which the enemies of yesterday now work side by side. The transitional period, originally projected to last two years, did not end with elections in June 2005 as planned. It has now been extended for an initial period of six months until the end of 2005.

While the war is officially over, the fact remains that insecurity and violence against populations prevail in the eastern portion of the country. In the Kivus, Katanga and Ituri regions, civilian populations still have not seen the possible benefits of the end of the war. For them violence is a part of daily life.

Ituri District has a population of six million people. It is located to the east of Oriental Province along the Ugandan border. Within an already unstable context, in 1999 a local war, fueled largely by regional powers, broke out in Ituri. Since then the entire district has been the site of an extremely bloody conflict. At least 500,000 people have been displaced and more than 50,000 have died.

Efforts by the international community (Operation Artemis, in June–September 2003; MONUC under Chapter VIIFor relevant texts, cf. http://www.monuc.org/ , in July 2003) did not change the status quoJuly 2003. MSF report "Ituri : Unkept Promises ? A Pretense of Protection and Inadequate Assistance.": Bunia Town is secure; however, a large part of the region is subject to the control and violence of various armed groups.

The gradual deployment of the Armed Forces of the DRC (FARDC) and troops from the UN Mission in the DRC (MONUC) outside Bunia and the process of voluntary disarmament have had only a very minor impact on violence against civilians.

Since the beginning of the conflict, humanitarian workers have faced enormous difficulties in working with populations even though the needs have been so great. The primary reason for the limited access has been the insecurity, which also affects humanitarian workers. In 2001, six members of the International Committee of the Red Cross (ICRC) were murdered in their car near Fataki, 70 kilometers from Bunia.

MSF has been trying since 1999 to provide medical assistance to Ituri's civilian population. On several occasions, teams had to evacuate for safety reasons.