“We heard gunshots and fled. I was seven months pregnant,” said Tantine, a 30-year-old mother of five children from Rusayo, in the North Kivu province. 

When armed groups attacked her village, she escaped with her family and sought shelter in a camp for people displaced by the conflict. They joined some 113,000 people taking refuge in makeshift tents – just a fraction of more than 800,000 who have fled increasing insecurity and violence that has embroiled the province since March 2022.

Sexual and reproductive health and protection needs, especially for vulnerable and displaced women, girls and newborns, are staggering, national maternal and newborn deaths and HIV prevalence are perilously high and the country has a legacy of sexual violence.

Tantine was one of an estimated 4,500 pregnant women in the Rusayo camp, all of whom were now living in cramped, unsanitary conditions with scarce access to the health services they so crucially needed. Soon after arriving, she travelled over four kilometres by motorbike to reach the nearest local health centre for a prenatal check-up. Despite waiting for hours, she was sent back without being seen: The centre was overwhelmed and could no longer provide adequate care for pregnant women.

Her luck took a turn for the better when another woman told her about a UNFPA mobile clinic operating in the camp: “When I heard, I went there instead and was able to do a prenatal consultation before my delivery.”

As of the end of March, assessments showed there were over 100,000 pregnant women in the North Kivu province, with concerns for their wellbeing mounting as violence escalates and access to health centres has become dangerously jeopardized.

When Tantine’s contractions started, she recalled, “I was in pain and went to the mobile clinic. I was greeted by two ladies who consulted me very quickly.” Biyombe Marie Mupali, the midwife on duty at the time, said, “She arrived with heavy bleeding and the child’s heartbeat wasn’t perceptible. The signs of danger were obvious. We had to stabilize her in order to evacuate her to the higher-level health centre in Rusayo.”

The medical team put Tantine on a drip and within half an hour she was on her way to the Rusayo health centre, in an ambulance provided by UNFPA’s partner Caritas and accompanied by a midwife from the mobile clinic. She was immediately taken into care and gave birth later that day – a complicated delivery made possible thanks to the quick actions of the midwives at the Rusayo site, which is also supported by UNFPA through supplies of reproductive health kits and training for health workers.

Tantine spent another day at the Rusayo centre before returning to the displacement camp, where her husband and children were waiting for her. Speaking to UNFPA about her delivery, she said, “The mobile clinic is important and necessary for us. It helps displaced pregnant women who have no resources. I benefited from free care at the clinic before my medical evacuation.”

The mobile clinic was set up by UNFPA in March 2023 to meet the sexual and reproductive health needs of women and girls displaced in the camp. The five staff – including three trained midwives – have since treated an average of three pregnant women every day.

So far, the team has performed over 20 deliveries on site and referred nearly 100 women to the Rusayo health centre. More than 200 women received prenatal consultations, and 55 survivors of gender-based violence sought medical care and advice from the clinic.

UNFPA Representative in the Democratic Republic of the Congo, Dr. Eugene Kongnyuy, was visiting the health centre just as Tantine gave birth. “The needs are enormous,” he said. “There are so many displaced people and pregnant women. There are many deliveries to be made; there are serious needs for family planning and protection against gender-based violence.”

Although a small number of women have also requested modern contraceptive supplies, unmet needs for family planning are worrying, and UNFPA is ramping up awareness-raising interventions among local communities to counter unintended pregnancies and potential spikes in sexually transmitted infections.

Civilians are paying the heaviest price of the conflict, especially women and children who are now sleeping out in the open, exhausted, traumatized and exposed to higher risks of sexual violence. In addition to Rusayo, UNFPA has mobile clinics in Bulengo and Bujari and has helped to rehabilitate two maternity hospitals in the province.

Since the onset of the crisis, more than 1,200 maternal deaths have been prevented and over 3,800 safe births assisted by qualified health personnel. Some 4,000 people have requested contraceptive advice and supplies across North Kivu province, 20 tonnes of reproductive health kits have been distributed as well as 5,000 dignity kits, and over 2,200 survivors of gender-based violence have sought and received medical care from UNFPA clinics.

All these interventions were made possible thanks to UNFPA’s collaboration with the government, local NGOs and funding from Japan. UNFPA continues to assist people across the Democratic Republic of the Congo and is expanding its programmes to ensure access to free and quality services for all women and girls in need in the months to come.

For 2023, UNFPA is seeking over $53 million to assist women and girls in the Democratic Republic of the Congo – just one-fifth of which has so far been funded.