In recent days, the security situation around the city of Uvira, in South Kivu province of Democratic Republic of Congo (DRC), has rapidly deteriorated, reaching a critical point on 15 February. Residents describe scenes of looting, increased violence, and clashes within the city between the Congolese army (FARDC) and the Wazalendo fighters. Medical facilities have not been spared from gunfire, impacting patient care. Staff from Médecins Sans Frontières (MSF) who were present at the onset of the clashes testify to the situation.

“When we heard the shots, we had to take cover quickly, as did the patients, and we had to stop our activities, which delayed their care and treatment,” says an MSF colleague. “The next day, gunfire was coming from everywhere, so we had to stay at home. But the hospital [Uvira’s general referral hospital] was starting to receive a lot of wounded, so we came to the hospital as reinforcements, taking the risk of catching a stray bullet.”

Since 17 February, the region's hospitals have been faced with an influx of wounded people, receiving around 10 people a day, including civilians, per structure. Despite the insecurity, Ministry of Health staff continue to provide emergency care, and a large number of staff from other hospital departments have come to help with surgery and the operating theatre. In all, more than a hundred injured people have been treated in just a few days.

“This week, the city became unlivable, with gunfire from morning to night,” explains an MSF staff member. “Personally, I’ve lost track of the days because we have all been affected. Some of my colleagues were victims of all this chaos, some have been robbed at home by armed men.”

The chaos in the city and the incessant gunfire have severely impacted the roads and people’s ability to move. This lack of mobility prevents even emergency responders from intervening in time. Ambulances face difficulty moving around, but they continue to pick up lifeless bodies on the roads whenever they can.

On several occasions, Uvira general referral hospital has been caught in the crossfire, seriously endangering patients and staff. On Thursday 20 February, medical activities had to be interrupted again, and patients had to take shelter to avoid being hit. Armed men also entered the hospital premises roaming around and firing inside.

“These violations and the extreme climate of insecurity that has persisted for several days are unacceptable,” says Caglar Tahiroglu, MSF activities coordinator in Uvira. “We call on all parties to the conflict to respect the protection of civilians, medical personnel, and infrastructure as soon as possible so that we can continue to provide medical care to the population.”

The city of Uvira, which shares a border with Burundi, is on the brink of chaos. Several waves of displacement have been observed amid a climate of distress. Burundian authorities estimate that more than 35,000 people have been on the move since the beginning of February.

“The first days, I saw entire families leaving their homes with luggage, heading in different directions,” says an MSF medical staff member. “Then I saw the streets empty and become completely deserted. People are afraid. They have very little information about what is actually happening, and they have been affected by the rapid escalation of the crisis in the country, and they imagine all possibilities. Access to food is becoming critical because economic activities have been blocked for six days. We do not know what tomorrow holds for us.”

Amid persistent insecurity, MSF was forced to reduce its teams in Uvira, where we had been supporting the Ministry of Health in diagnosing and treating patients suffering from mpox for several months. Faced with the influx of wounded and the shortage of equipment, MSF is redirecting some activities to support the care of war-wounded people by delivering vital medical equipment to several medical facilities in the Uvira health zone.