Kinshasa, Democratic Republic of Congo – Since 2019, Médecins Sans Frontières (MSF) has treated 16,445 victims and survivors of sexual violence in the Salamabila region of Maniema province in the Democratic Republic of Congo (DRC). This alarming figure reflects the scale of a silent crisis that is too often overlooked and forgotten by national and international authorities. As MSF leaves the project at the end of October, we urge donors and organisations to step in and ensure that progress in providing care to victims and education on sexual violence continues.
Sexual violence remains a public health emergency throughout eastern DRC, including in Maniema province, located west of North Kivu and South Kivu provinces. The conflict between armed groups in the region, as well as violence committed by groups outside the conflict, continues to lead to a high number of sexual assaults.
“This is the third time,” says a survivor treated by MSF in 2025. “They found me in my house again. I was with my child, who has epilepsy. We were both raped.”
In response to this scourge, MSF has been implementing an innovative community-based approach in Salamabila since 2019 to meet the needs of people who have been victims of sexual violence. The decentralised approach is based on the work of reproductive health workers (RHWs), women from the community who are often survivors of rape themselves.
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They are trained to provide rapid, confidential, and free medical care and psychological and socio-economic support within their communities. In 2024, three-quarters of people were treated/seen by these RHWs, illustrating the effectiveness and relevance of this decentralised model.
“The first time [I was assaulted], I was coming home from the fields… A reproductive health worker found me crying, listened to me, gave me medicine, and referred me to the hospital,” says a survivor treated by MSF teams. “I received treatment free of charge.”
MSF will be leaving the project at the end of October 2025. This planned end to our activities has been brought forward slightly to allow us to focus on responding to other urgent medical and humanitarian emergencies. Our refocus comes in a context of increased needs, a drastic reduction in humanitarian funding, and protracted crisis in eastern DRC.
“We consider that the project’s objectives have now been achieved,” says Idrissa Campaore, MSF programme manager in Maniema. “After seven years of continuous presence, we must make the difficult choice as an emergency organisation to provide our medical aid where the needs are more pressing.”
“Significant needs nevertheless remain in Salamabila, and national and international organisations must act and take over,” says Campaore.
MSF is calling for urgent action by the authorities, donors, and humanitarian partners to ensure the continuity of holistic care for victims and survivors of sexual violence, including medical care, psychological support, and socio-economic support.
“The model established in Salamabila is replicable, effective, and vitally important from a humanitarian perspective,” says Campaore. “It must not disappear with MSF’s departure.”
Victims’ treatment within 72 hours of their assault is necessary to prevent to pregnancy. Holistic care is also essential to ensure mental health care and emergency protection.
“We wanted to ensure that more women dared to seek care, and that is a victory in a context like Salambila,” explains Elodie Françoise, the project’s medical manager.
Among victims, many are stigmatised and rejected by their husbands. To avoid this double punishment, MSF also created a ‘husbands’ school’, where our teams have educated at least 1,520 men on a crucial message: rape is not infidelity but violence. The method is bearing fruit.
“Little by little, we have seen husbands encouraging their wives to come and see us and even accompanying them, which was unimaginable before,” says Françoise.
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However, without continuing support from other organisations after MSF’s departure, this progress is now under threat.
“What I fear is a return to square one,” says Charles Bamavu, Chief Medical Officer for the area. “Once MSF has finished its activities, there will be a breakdown in curative care, and even psychosocial care will disappear.”
Despite significant needs, Maniema remains marginalised in humanitarian funding. In 2024, it received only 2.5 per cent of the funds allocated by the DRC Humanitarian Fund.1 This chronic underfunding compromises the continuity of care and protection for victims and survivors. Furthermore, due to the conflict in the two neighbouring Kivu provinces, and the closure of the strategic airport in Bukavu since last February, the entire area has become isolated and difficult to access, dramatically exacerbating the needs of people.
MSF has been continuously present in Salamabila, Maniema, since 2019. Our teams support the health activities of the general hospital, five health centres, and 13 reproductive health workers.
