Throughout 2009, the civilians suffered continuous violence from different armed groups in eastern Democratic Republic of Congo. Hundreds of people were killed, thousands of women, children, and, sometimes, men were raped and hundreds of thousands of people fled their homes. Guerilla warfare has replaced armed clashes in North Kivu where combatants spread terror by looting and burning houses in reprisals against the perceived support of communities to different factions.

In October, civilians gathered with their children at MSF vaccination sites in North Kivu, came under attack by government forces. The attack threatened to severely undermine the trust necessary to carry out independent medical humanitarian work in conflict settings.

At the same time, the people of Haut-Uélé and Bas-Uélé, in northern DRC, were caught in a dramatic cycle of violence linked to attacks perpetrated by the Ugandan rebel group the Lord's Resistance Army (LRA), and the Ugandan and Congolese offensive against the LRA. Civilians also find themselves facing increasing banditry. Hundreds of thousands of people have been displaced over the last year. Ongoing attacks continue to send thousands fleeing to seek shelter and greater security in towns.

As one of a handful of humanitarian organizations on the ground, providing surgical, nutritional, psychological and basic medical care to thousands of displaced people, MSF called on humanitarian organizations to respond with a greater presence in the rural areas most affected by this extreme violence.

Two women in Kitchanga camp, North Kivu, Democratic Republic of Congo (DRC). [ DRC 2009 ? Martin Beaulieu/MSF]

A plate of beans in a camp for internally displaced persons. Kahe Camp, Masisi District, North Kivu, Democratic Republic of Congo (DRC). [Democratic Republic of Congo 2009 ? Michael Goldfarb/MSF]

A man takes shelter under an umbrella at the Mweso hospital in North Kivu province, where MSF provides surgical, pediatric, obstetric, and nutrition support. [Democratic Republic of Congo 2009 ? Michael Goldfarb/MSF]