Thousands of people have fled fighting between Congolese troops and soldiers loyal to dissident general Laurent Nkunda in the Masisi region, located in the eastern province of North Kivu of the Democratic republic of Congo (DRC). MSF immediately sent a surgical team along with 1.5 tons of medical material to Masisi. Since Thursday, August 30, the MSF team has been treating wounded and has been offering medical care in the Masisi hospital.

"During the days that followed the fighting we received 50 wounded people, both military and civilian," said Ann Willem, an MSF nurse who has been in Masisi since last week. "Most of these people have now been evacuated to Goma. Among them, a mother and her child (who) nearly died: a gunshot went between her and the child, hurting her spinal cord and the child's thighs."

"At the very beginning, the situation was extremely difficult," added Willem. "Most of the medical staff had fled and we had to start working using the material of the hospital. Now almost 90% of the hospital's workers are back; the MSF medical material has arrived, as well as an MSF surgeon and an anaesthetist. This is a huge relief for our team in Masisi."

Last weekend, the situation was relatively calm and the population of Masisi who had fled started to return to town. Small groups of people came first to check if the others could come back. Currently, about 75% of the population has returned and a lot of people have come to the hospital to receive free treatment. The MSF surgeon and anaesthetist have a lot to do.

"On Wednesday, September 5, they started working at 8 am and did not stop during the whole day," said Philippe Havet, MSF emergency team coordinator.

MSF is now offering free care to a highly vulnerable population. About 200 consultations have been carried out at the hospital. Currently, 82 people - including four wounded in the fighting - are hospitalized.

"We have already performed six caesareans," said Willem. "Many patients suffer from respiratory infections, mainly due to cold temperatures at night and because the rainy season has just began. The team also sees many cases of severe malaria. In addition, 15 children are treated in the hospital's nutritional centre."

The MSF team consists of a coordinator, nurse, surgeon and anaesthetist. They will soon be joined by additional staff for of logistics and administration. MSF has set up a logistical base in Goma, where MSF continues to organise the transport of medical material. Given the difficulties of access to Masisi, MSF is using a helicopter to transport personnel and supplies from Goma.

"Masisi is completely isolated," said Havet. "The main road between Masisi and Goma (60 km) is highly insecure. On top of this, the bad condition of the roads, due to heavy rains, probably impedes the return of other displaced people. We are concerned by the bad living conditions of these people. But we haven't been able to reach them because of the security situation."

MSF is working in Rutshuru, Kayna, Nyanzale, Walikale and Mweso in the province of North Kivu. MSF has worked in the DRC since 1981. More than 2,000 Congolese and 150 international staff provide medical assistance in over 20 locations across the country.