It was past midnight when Amina felt the first contraction. In a makeshift tent on the outskirts of Goma, surrounded by thousands displaced by the escalating conflict, she gripped her belly, praying for the pain to subside. But war does not pause for new life.
Bombs struck her IDP camp, forcing Amina to flee once again. Her second displacement in weeks. The road to the nearest clinic was no longer safe, and even if she could make the journey, there was no guarantee that supplies or medical staff would be available. In the darkness, she braced herself for childbirth—alone.
The hidden casualties of war
Amina is one of 12,192 pregnant women recently displaced by the ongoing conflict in North Kivu, where violence has left 88,000 women of reproductive age in dire conditions within internally displaced persons (IDP) sites.
With key humanitarian supply corridors blocked and access to healthcare severely constrained, the needs of women and girls are growing at an alarming rate. They bear the brunt of the devastation, facing heightened risks of sexual and gender-based violence, unintended pregnancies, and the loss of essential health services. The increasing reports of rape from conflict zones are alarming, while humanitarian access remains dangerously constrained.
It is estimated that there are around 20,000 pregnant women, 15 per cent of whom are at risk of serious complications. More than 2,000 women are at risk of increased sexual violence and STI/HIV transmission because of their vulnerability. Access to Sexual and Reproductive Health (SRH) services is severely affected by the worsening of the security situation, lack of supplies and access to service delivery points by service providers, including frontline midwives.
To make matters worse, bombs have started falling inside IDP camps, forcing thousands to flee again, moving even deeper into unsafe, unstructured settlements. This secondary displacement removes them from the minimal safety nets they had built, amplifying their vulnerability to sexual violence, intimate partner violence, and exploitation.
With supply corridors blocked and humanitarian workers struggling to access affected areas, women like Amina are being pushed into life-threatening situations, forced to give birth in unstable environments where survival is uncertain.
Layers of crisis
On 21 January 21, the M23 rebel group captured Minova and Sake, two strategic towns dangerously close to Goma, effectively cutting off key humanitarian supply routes. Now, as fighting inches even closer to the city, panic has set in, and the humanitarian crisis is spiraling further out of control. More than 400,000 people have been displaced in just three weeks, adding to the millions already uprooted across eastern Congo.
The Office of the UN Resident Coordinator has warned that if the violence persists, it could further deteriorate conditions in Ituri, North Kivu, and South Kivu, where 900,000 newly displaced persons were recorded between January and April 2024.
UNFPA on the ground
Despite the challenges, UNFPA remains on the ground, working with the national health counterpart, implementing partners and other members of the SRH Working Group to sustain critical sexual and reproductive health (SRH) and GBV services for displaced women and girls. UNFPA's response within the last weeks:
- Seven mobile clinics across North Kivu, including one in Minova, staffed by dedicated medical teams, including 27 midwives. These clinics are lifelines for displaced women, offering maternal health services and family planning support.
- Three static health facilities strategically placed near IDP camps to provide life-saving care.
- Community-based distributors ensuring continued access to contraceptives and reproductive health commodities, despite supply chain disruptions.
- A GBV hotline provides survivors with immediate support, referrals, and guidance to safety.
- Safe spaces for women and girls, offering psychosocial support and a haven from the violence surrounding them.
- Sexual and reproductive health services for over 8,190 people
- Gender-based violence prevention activities have reached 12,354 people
Even with these efforts, the needs are immense. Ambulance services for emergency obstetric care are heavily constrained due to fuel shortages, and humanitarian actors face mounting difficulties in accessing high-risk areas.
The situation in Goma and surrounding regions is rapidly deteriorating. Every moment counts for women and their unborn children—all dependent on timely access to healthcare.
The urgency and action
The conflict between the Armed Forces of the Democratic Republic of Congo (FARDC) and M23 rebels has intensified since December 2024, creating an unprecedented humanitarian disaster.
- Over 400,000 displaced in just three weeks
- 900,000 newly displaced persons recorded in early 2024
- Rising reports of rape and gender-based violence
- Severe shortages of healthcare supplies and essential services
UN agencies have scaled down operations due to security concerns, with some organizations suspending activities entirely. However, UNFPA remains committed to delivering life-saving care in the most dangerous conditions.
Amina’s story is just one of many. But it is a harsh reminder that in the middle of conflict, millions of women and girls continue to fight for survival and dignity.
