The doctors and nurses at Ndosho hospital in Goma in the Democratic Republic of the Congo are working round the clock with a stream of injured people arriving each day. People trying to escape the fighting between the rebel militia group M23 and government forces have been arriving in the regional capital of North Kivu province in their thousands over the past 10 days.
Moustapha Ngabo, 36, is standing outside a ward, watching anxiously as doctors examine his two-year-old daughter. His shirt is splattered with her blood. “There was fighting between the M23 and the army in the hills,” he says. “We took nothing with us as we left.”
Ngabo and his family have been displaced twice. First, they left their home village in the Masisi region of North Kivu to take refuge in Saké, a town about 15 miles from Goma.
On 13 February, with rebels closing in and shells falling on the town, Ngabo and his wife made the decision to take their two children and run again. But they hadn’t made it out of Saké before an artillery blast badly wounded his eldest daughter in her back.
M23 rebels, backed by Rwanda, have controlled chunks of North Kivu since their resurgence as a meaningful force in 2022. On Monday, Rwanda rejected US calls for the withdrawal of troops and missile systems from eastern Congo, accusing DRC of carrying out a “dramatic military build-up” near the border.
Goma, a city of about 2 million people, lies on the Congolese-Rwandan frontier, wedged between Mount Nyiragongo, an active volcano, and Lake Kivu. Two roads lead out from it on the Congolese side: one going north and the other north-west.
Last week – amid an increase in clashes after a tentative US-brokered ceasefire collapsed – M23 rebels advanced from strategic positions in the jagged volcanic hills overlooking Saké and began fighting in the town itself, according to an internal UN document seen by the Guardian. At the weekend, DRC’s army accused Rwanda of carrying out a night-time drone attack on Goma’s airport.
The advance has cut off the road leading north-west, trapping hundreds of thousands of people who had fled earlier waves of violence.
Goma’s outskirts alone host about half a million people who live in squalid camps, according to the UN’s Office for the Coordination of Humanitarian Affairs (Ocha). More and more people are arriving. About 135,000 people moved towards Goma between 2 and 7 February alone, the humanitarian agency said, mostly from the highlands around Saké.
The government-controlled pocket around Goma is now an active conflict zone that contains an array of different armed militias pledged to battle the M23.
The Congolese army is supported by loyalist militias known as Wazalendo – or “patriots” – as well as European private military contractors. Neighbouring Burundi has also contributed troops to the fight against the M23, and a regional force of soldiers from South Africa, Tanzania and Malawi has recently deployed. South Africa lost two of its soldiers in an explosion on 14 February. UN peacekeepers are present too.
On the Goma-Saké road, artillery and Grad rocket launchers are positioned just hundreds of metres from the densely populated displacement camps, occasionally firing towards the front.
Civilians are being caught and killed in the crossfire. Some of the survivors end up in Goma’s Ndosho hospital, run by the International Committee of the Red Cross (ICRC), where the wards are full of bandaged men, women and children, most of them from Saké.
Abdou Rahmane Boubacar Sidibe, a surgeon at the hospital, said that Ndosho had doubled its capacity to 120 beds and was receiving up to 25 people wounded by small-arms fire or explosions every day. The ICRC said on Friday 9 February that of 58 people who arrived at the hospital with injuries sustained on the preceding Wednesday, 31 were civilians.
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On a hospital bed, with bandages on her head, legs and abdomen, Nitagni Maombi, 30, said she had left Masisi and gone to Saké for her safety. But on 12 February, a blast knocked her unconscious as she was running errands. She woke up in the hospital to be told her nine-year-old child had been killed. “It was my only child,” says Maombi, breaking down in tears. Like others, she said she had nowhere to go now.
The M23 group traces its roots to earlier rebellions in eastern DRC, a mineral-rich region plagued by brutal conflict three decades.
M23 claims to protect minorities such as Congolese Tutsis from alleged government attacks and from ethnic Hutu militias. But the rebels have also committed brutal massacres: in 2022, its fighters killed at least 171 civilians in two neighbouring villages in North Kivu, according to the UN.
Independent investigators from the UN group of experts on DRC have documented drone footage and photographs showing that Rwandan troops have crossed the border to reinforce the M23. The regime of Rwanda’s president, Paul Kagame, denies that it supports the group.
Civilians have paid a particularly heavy toll during the latest battles. Before the rebel advance on Saké, shelling killed at least 19 people in the town of Mweso on 25 January, according to the Congolese army. Both sides accused the other of firing indiscriminately.
In the displacement camp of Bulengo – home to more than 100,000 people in shoddy tarpaulin shelters on the Goma-Saké road – there is a constant influx of new arrivals, says Ely Amani over the sound of artillery.
“They keep coming,” says Amani, 40, who arrived in Bulengo last year and is a member of its internal administration. “We have nothing to give them.” Next to Amani’s improvised office dozens of people of all ages huddle on the ground, wrapped in blankets. They had just arrived from Masisi, by way of Saké.
“We came here because we were fleeing war,” says Feresiyane Sehazungu, 73, who had had nothing to eat since arriving the day before. As an ear-splitting artillery round interrupts him, he adds: “When I hear the firing it feels as if my head will explode. I feel my heart breaking into a thousand pieces.”