Goma - In the most volatile parts of DRC's North Kivu province, violence has reached its highest levels in years, while assistance is hardly reaching those most in need, according to the international medical organisation Médecins Sans Frontières (MSF).

Hundreds of thousands of people have been forced to flee their homes since full-scale war resumed at the end of August and are living in fear, without the means to meet their most basic needs.

The international community has failed to address the on-going conflict in the region as a priority. Even though one of the largest peacekeeping forces in the world is currently deployed in DRC, the United Nations peacekeeping force (MONUC) is clearly failing to fulfill its mandate to protect the civilian population in North Kivu.

Most UN agencies and NGOs are also failing to provide an adequate humanitarian response whereas the already disastrous humanitarian situation is dramatically deteriorating. Despite the presence of a large number of humanitarian organisations in Goma, the province's capital, few are active in the areas most affected by the war.

Many people who now need assistance have been forced to flee several times. They have repeatedly lost their homes and belongings - often as a result of looting - and are losing their capacity to cope. In addition to the extensive needs of the population - food, shelter, access to water, medical care and protection - the risk of epidemics is high, and many health clinics have been looted.

Some of the people who flee reach relatively established camps, while others gather in isolated pockets of calm or with host families. Still others have become 'invisible' - hiding in the bush, trapped between armed groups.

"We were assisting over 100,000 displaced persons in Nyanzale and Kabizo. We have no idea where they have fled in the past few weeks," said Anne Taylor, MSF Head of Mission in Goma. "Only 25,000 people arrived in Kayna and Kanyabayonga. Where are the others? We are extremely worried about their fate."

In other areas, MSF found groups of newly displaced people. In Ngungu, thousands are living in terrible conditions, without any health care. Thousands of people also arrived in Kitchanga during the last weeks.

"Reaching these people is extremely difficult because of the volatile security context and because they are constantly on the move," said Taylor. "But it is not impossible. We just keep trying and trying until we can find them and provide some vital assistance. But we are aware that we are only dealing with a small part of this humanitarian catastrophe: hundreds of thousands are out of reach."