In early September, Médecins Sans Frontières (MSF) was obliged to evacuate some areas and redeploy teams in others as a result of heavy fighting which started on August 28 in the province of North Kivu in the Democratic Republic of Congo (DRC). The people of North Kivu, already suffering from near constant violence, find themselves once again on the battlefield.

Now MSF staff are witnessing a serious increase in hostilities - no longer minor skirmishes, but sustained fighting with heavy weapons. Although the United Nations has deployed a peacekeeping force to North Kivu, MONUC, with its 14,000 blue helmets, is unable to maintain peace.

MSF has completely withdrawn its teams from Nyanzale and Kabizo, and has partially evacuated teams from Rutushuru Hospital, leaving a medical and a surgical team to treat the wounded and emergency cases. In Mweso, proximity to the frontline has made it impossible for teams to retain a full-time presence, and 55 patients requiring 24-hour care were transferred to the hospital in Kitchanga. MSF continues to provide assistance in Kitchanga, Mweso, Masisi and Rutshuru.

The humanitarian situation is extremely worrying. The fighting has caused massive movements of the population. In the space of three days, an estimated 250,000 people living in camps on the Katsiro-Butare axis fled, along with residents of the villages in this area. Thousands have fled north to Kayna, Kanyabayonga and further. MSF has redeployed some of its teams in Butembo to assess the situation in this area. Thousands have also fled the Kachuga and Mweso areas.

Where possible, MSF is providing increased medical care and other assistance to prevent outbreaks of disease, such as cholera, but there is serious concern for people who have fled into areas cut off by the fighting.