Muslim women wait to receive iftar food during the month of Ramadan at the Mugunga camp for internally displaced people, outside Goma in the North Kivu Province, DRCÂ on March 17, 2024.Â
Across Eastern Africa, conflict and displacement continue to devastate communities, with women and girls disproportionately affected.
Rape and other forms of sexual violence are often widespread in conflict settings, where they can be used to humiliate, punish, control, injure, inflict fear, and destroy communities.
Long-running crises in Democratic Republic of Congo (DRC), Sudan and South Sudan, expose women and girls to harrowing challenges, including widespread sexual and gender-based violence (SGBV), disruptions to maternal health and other sexual reproductive health services and the trauma of forced displacement.Â
The resurgence of violence in DRC, particularly involving the M23 armed group, has displaced over 500,000 people since January 2025.
Families seeking refuge in overcrowded camps around cities like Goma face dire conditions, with a lack of food, clean water, and sanitation exposing women and girls to heightened risks of violence and health crises.
That’s more than two patients every hour and the highest number on record for MSF in the country. 91 per cent (22,905) of the survivors came from North Kivu Province where MSF had increased its emergency response in Goma and surrounding territories due to the intensification of fighting. 68 per cent of the survivors were attacked by armed men.Â
This data highlights the grim reality faced by women and girls during times of conflict. They are particularly vulnerable when they leave the camps for displaced people to gather food or firewood. With many armed men present around the sites, these outings carry a high risk of sexual violence. Â
In 2024, the number of survivors of sexual violence treated by MSF in and around Goma continued to rise, with an average of 100 victims received per day during March 2024.
The women and girls of DRC deserve a future free from violence, a future where they can rebuild their lives with dignity. With the current resurgence in violence, this new displacement will increase the vulnerability and risks to people who had already been left with nothing.Â
Parties to the conflict must respect international humanitarian law, in particular the absolute prohibition on committing acts of sexual violence. MSF will continue to provide vital medical and humanitarian assistance, but lasting solutions demand a concerted and sustained effort from the global community.
Sudan: The human cost of violence
The war in Sudan has led to a collapse in the protection of civilians with communities facing indiscriminate violence, killings, torture and sexual violence amid persistent attacks on health workers and medical facilities.
Sexual violence has been perpetrated against women in their homes and along displacement routes, a characteristic feature of this conflict.
Data from MSF facilities supporting Sudanese refugees in Chad, hints at the widespread and large-scale use of sexual violence as a feature of the conflict, particularly targeting women and girls. In MSF’s hospital at the Chadian border, 135 cases of SGBV, most of them occurring in Sudan during the conflict, were disclosed to staff between July and December 2023.
All survivors were women and girls between 14 and 40 years old. 90 percent were abused by an armed man.
Cases of sexual violence reported to MSF teams and treated in our facilities remain limited and are most likely underreported. The diminishing availability of protection services and safe spaces has reduced the opportunities for survivors to break the silence in Sudan.
Additionally, stigma and security concerns around incidents of sexual violence often prevent survivors from seeking care safely.
In light of the scale of displacement in Sudan, protected and safe evacuation and movement routes must be guaranteed for the people fleeing violence, as well as for humanitarian workers responding to the needs.
South Sudan: A fragile health system on the brink
South Sudan’s healthcare system remains crippled by years of war and underdevelopment, with two-thirds of health facilities non-functional.
The situation has worsened due to the ongoing Sudan conflict, which has driven over 900,000 people—80 percent of them South Sudanese returnees—into already strained communities.
In South Sudan, the echoes of conflict from neighbouring Sudan reverberate with a particularly cruel intensity for women and girls. Women, already vulnerable on the journey to South Sudan, arrive at camps with limited access to shelter, food, and clean water, and at risk of exploitation and abuse.
The conditions in transit and reception areas are particularly challenging for women and girls, who arrive in a country where two-thirds of health facilities are non-functional, a grim reality that magnifies the challenges of forced displacement.
The most devastating consequence is the collapse of maternal healthcare. Women and girls face significant barriers to accessing essential maternal healthcare services, including antenatal care, contraception, safe delivery, and postnatal care.
Pregnant women, facing security risks and logistical nightmares, are denied access to essential prenatal, delivery, and postnatal care.
This lack of access, compounded by malnutrition and the trauma of conflict, has created a deadly environment for mothers.
In addition to the physical threats, the continuous cycles of conflict, displacement, food insecurity and extreme poverty have created overwhelming stress for many people.
The burden of conflict on women and girls in Eastern Africa is a failure of global responsibility. Every statistic represents a life shattered by violence, displacement, and inadequate healthcare.
Governments, international organisations, and civil society organisations must prioritise funding for maternal health, strengthen protections against sexual violence, and address the systemic inequalities that leave women and girls vulnerable in conflict zones. Silence is complicity—action is the only path forward.
The abrupt freeze on funding from the US government is already having devastating consequences for the most vulnerable—children, pregnant women, the elderly, and displaced populations—who are now at even greater risk.
Across communities where foreign assistance played a crucial role, medical services have been disrupted overnight, leaving many without access to lifesaving care.
Patients relying on essential medicines for conditions like HIV, tuberculosis, and malaria are suddenly left without treatment, while pregnant women face increased risks of life-threatening complications due to the shutdown of maternal health programs.
Local health centres, once sustained by international funding, are closing their doors, creating a massive gap in care that cannot be filled quickly enough. Aid organisations on the ground are scrambling to adapt, but the speed and scale of these cuts have left little time for alternative solutions.
The ripple effects of this funding freeze extend beyond immediate medical needs—it is deepening suffering, worsening health crises, and eroding years of progress in humanitarian assistance.
A decisive response is needed to prevent a catastrophic loss of life and ensure that the most vulnerable are not abandoned in their time of greatest need.
A fundamental shift in priorities is required—one that amplifies the voices of affected women ensures accountability and directs resources toward strengthening healthcare systems prioritising maternal health and providing comprehensive care for survivors of sexual violence.
Without these efforts, the suffering of women and girls in conflict zones will only deepen, leaving them to bear the brunt of crises they did not create.
Judith Elavian Achieng is Reproductive Health, Sexual Violence and Survivor of Violence Training Coordinator, MSF
