On Jan. 27, Rwanda-backed M23 rebels advanced on the Munzenze prison in Goma, a provincial capital in the eastern Democratic Republic of the Congo (DRC). More than 4,000 male inmates escaped in the mass prison break and reportedly raped at least 165 female inmates. Rebels set the women’s wing on fire, burning most of the rape victims to death.
Despite a unilateral ceasefire on Jan. 29, the rebels have continued to tighten their grip, blocking aid and investigative efforts, with the United Nations warning that the situation grows more volatile by the day. The atrocity at the Munzenze prison is just one dimension of the worsening crisis in Goma, where the M23 rebels seized strategic parts of mineral-rich North Kivu province, including the provincial capital. As policymakers convened on Feb. 7 for the United Nations Human Rights Council (UNHRC) to hold a special session on the human rights situation in eastern DRC, it was clear that coordinated international intervention is urgently needed. Yet sweeping foreign aid freezes imposed by U.S. President Donald Trump’s administration threaten to undermine these intervention efforts, endangering critical humanitarian programs in the DRC and causing devastating consequences for global healthcare protections.
The humanitarian crisis in eastern DRC is worsening not only due to armed violence but also because of a dramatic surge in gender-based violence. A rapid World Health Organization (WHO) assessment of health facilities in and around Goma revealed 45 cases of sexual violence among displaced persons and 21 gang rape survivors admitted to local hospitals in just a short timeframe. However, these cases only scratch the surface, as many survivors are unable to access medical care due to displacement, stigma, and ongoing insecurity. The U.N. has already warned that sexual violence is being strategically used as a weapon of war, and with limited medical supplies, survivors face high risks of untreated infections, unwanted pregnancies, and lifelong trauma.
With nearly 70 percent of humanitarian funding for the DRC coming from the United States, USAID has been a vital force in sustaining medical care, food security, and emergency response efforts in Goma. Prior to the aid freeze, USAID-funded programs supported emergency obstetric care, reproductive health services for sexual violence survivors, and disease prevention initiatives, including cholera and measles vaccination campaigns in displacement camps. However, with the aid suspension, many of these critical services have been forced to scale down or halt altogether, leaving thousands of women and children without life-saving medical and nutritional support at a time when humanitarian needs are imperative.
The mounting crisis in Goma demands an immediate and robust response, including humanitarian access, accountability for sexual violence, and reconsideration of foreign aid restrictions already have dire repercussions for reproductive health and human security.
A Fragile Ceasefire Amid Escalating Violence
As M23 rebels moved into Goma on Jan. 27, the group claimed it would halt further incursions. The reality has proved far different. By Feb. 1, the U.N.’s Deputy Special Representative for Protection and Operations in the DRC confirmed that M23 continued to “consolidate their hold” on parts of North Kivu, despite the group’s public statements about a ceasefire. M23, a predominantly Tutsi militia historically active in the region, has repeatedly clashed with Congolese government forces (FARDC) and other armed groups, driving massive population displacement.
The current conflict and ensuing chaos have serious health implications. The U.N. mission in the DRC (MONUSCO) has reported that both Goma and surrounding areas lack basic security, water, food, electricity, and internet access. Two local airports—Goma International Airport and Kavumu Airport in South Kivu—are critical lifelines for humanitarian supplies, including emergency obstetric care. The immediate reopening of the Goma airports is imperative for the survival of up to two million people in the aftermath of M23’s attacks on displacement sites and overwhelmed hospitals. There are also credible indications that Rwandan military personnel are active on Congolese territory, a claim Kigali denies. However, the restricted movements of U.N. peacekeepers have hindered the ability to fully verify Rwandan involvement.
Sexual Violence as a Tactic of War
The mass rape and murders at Munzenze prison underscore how sexual violence in conflict zones is both pervasive and strategic. Multiple sources have reported that hundreds of women were raped by male inmates who escaped during M23’s advance, many of whom were subsequently trapped and killed when male inmates torched the women’s wing. Although the exact number of victims remains under investigation, initial estimates hover between 100 and 165. Because of blocked access, neither U.N. officials nor Congolese authorities have been able to conduct a thorough site assessment or recover the victims’ remains.
This tragedy reflects a broader trend in the region. Both M23 rebels and other armed groups, including some elements of the FARDC, stand accused of using rape as a weapon of war. Reports indicate that Congolese soldiers in South Kivu, for example, may have committed gang rape against dozens of women, adding to an already staggering toll of sexual violence. The U.N. High Commissioner for Human Rights has highlighted the deepened risk of conflict and gender-based violence, including mass rape, since late January. Further, the Commissioner notes that “the worst may be yet to come,” raising serious concerns that the sexual violence will continue to escalate. The prevalence of sexual violence as a tactic of war must be documented. These reports can help investigations for transitional justice that are critical to ensure that perpetrators of conflict-related gender-based violence are held accountable for their crimes.
Implications for Public Health and Reproductive Rights
The widespread use of sexual violence in this conflict is creating profound public health emergencies. According to the WHO, Goma is now on the brink of multiple disease outbreaks—from cholera to measles—as the city’s vital infrastructure crumbles under conflict. More than 2,000 bodies have been buried in mass graves, while an additional 900 remain in morgues, raising the threat of epidemics if health systems cannot safely dispose of remains.
When sexual violence occurs in a setting of severe resource shortages, reproductive health care becomes even more difficult to access. Clinics and hospitals are damaged or understaffed, health workers are forced to flee for safety, and supply chains for essential medications are disrupted. In the DRC, emergency contraception, post-exposure prophylaxis (PEP) for HIV, and safe abortion care for survivors are often in short supply during conflict. The rebels’ control of key access points, including Goma’s airport, further complicates efforts to move necessary supplies into the region.
The Trump Administration’s Aid Freeze and Its Global Ripple Effects
Trump’s executive orders issued on his first day in office have thrown the lifeline foreign aid programs provide in conflict zones into disarray. A broad 90-day freeze on U.S. “foreign development assistance” has created catastrophic waves of health crises, jeopardizing the health of more than 20 million people worldwide. The administration claims the freeze does not affect all federal assistance and that life-saving humanitarian aid is exempt. Yet the scope of the freeze remains murky; reports indicate that crucial global initiatives like the President’s Emergency Plan for AIDS Relief (PEPFAR) were instructed to cancel appointments and halt the delivery of lifesaving HIV medication.
For Congolese communities, the timing could not be worse. Many NGOs and international agencies operating in Goma or eastern DRC rely on a steady flow of U.S. funding to provide clinics with medication, staff health outposts, and gender-based violence prevention programs. If the freeze impedes or significantly delays those funds, health facilities will struggle to treat an influx of patients with bullet wounds, infections, or complications from sexual violence. Funding cuts may also hamper efforts to prevent HIV and other sexually transmitted infections.
Members of the U.S. House Foreign Affairs Committee have highlighted several of the critical implications of the broad freeze, including the potential to undermine U.S. leadership, damage alliances, disrupt global stability, and cede influence to adversarial powers. The crisis in Goma underscores the real-world impacts of abrupt funding suspensions on vulnerable populations overseas.
Sexual Violence and the Right to Health
When conflict exacerbates the scarcity of reproductive healthcare, sexual violence becomes an even more devastating tool. Survivors who become pregnant from rape can face life-threatening complications if they cannot access prenatal care or safe termination services. Those who contract HIV or other sexually transmitted infections need immediate medical intervention to prevent lifelong disease, yet these services depend on external funding.
According to Sofia Calltorp, Chief of Humanitarian Action at U.N. Women, women and girls are “bearing the brunt” of both direct and indirect consequences of the ongoing clashes, stating, “As the clashes unfold in a country that has endured prolonged instability, women and girls are bearing the brunt of both direct and indirect consequences, with their rights, safety, and dignity increasingly under threat.”
Congolese women’s organizations have reported widespread sexual violence, forced displacement, and acute gaps in basic social and protection services. U.N. Women called for immediate action by state and non-state actors in the DRC to combat sexual and gender-based violence and end impunity for perpetrators.
Displacement camps in North and South Kivu, which house hundreds of thousands of people uprooted by the fighting, often lack adequate sanitation or menstrual health supplies. Women and girls in these camps face heightened risks of sexual exploitation by armed groups. Without robust international aid, the cycle of abuse is likely to intensify.
Under international law, sexual and gender-based violence can constitute war crimes or crimes against humanity (CAH). Although the DRC has adopted legislation to combat gender-based violence, accountability remains weak. Calls have grown for the International Criminal Court (ICC) to open investigations into atrocities committed by M23 and its alleged backers, including the Rwandan military. Whether that approach would deter future abuses depends on active cooperation from regional states and substantial international support for transitional justice in the DRC.
A Tense Regional Context and the Need for Renewed Diplomacy
The DRC’s eastern provinces have faced chronic instability for decades, fueled by competition over valuable mineral resources such as gold, coltan, and diamonds. Rwanda and Uganda have each intervened in Congolese conflicts in the past—both indirectly through proxy groups, and directly with their own troops. Rwandan officials deny their country’s current involvement, which stands in tension with evidence from the U.N. and U.S. officials indicating Rwandan forces are backing M23.
Diplomatic efforts to address the underlying conflict are fragmented. The Luanda and Nairobi processes, launched to de-escalate tensions in eastern DRC were both stalled due to regional divisions and Rwanda’s continued support for M23. The Luanda Process, backed by the AU, focused on state-to-state diplomacy between Rwanda and the DRC but collapsed when Kinshasa refused to negotiate with M23; the Nairobi Process, led by the EAC, aimed at disarming local armed groups but lost credibility after the DRC withdrew support for its peacekeeping force. The upcoming African Union summit from Feb. 15-16, represents a vital opportunity to refocus attention on the crisis and pressure Rwanda to withdraw support for M23. Past experience shows that financial sanctions or diplomatic pressure can prompt Rwanda to reconsider its military engagements in eastern Congo but competing global crises have dampened attention.
Moving Forward: Addressing Impunity and Aid Shortfalls
The barbaric mass rape of Congolese women in the Munzene prison amid the ongoing crisis in Goma underscores the urgent need for unfettered humanitarian access, robust diplomatic engagement, and immediate accountability for sexual violence. Opening Goma airport, ensuring safe corridors for aid workers, and reversing U.S. foreign aid freezes are all necessary steps to avert further catastrophe. At the same time, regional stakeholders—including Rwanda, Uganda, and the DRC—must engage in good-faith negotiations to tackle the root causes of the conflict, from ethnic tensions to competition over mineral wealth.
The Feb. 7 U.N. Human Rights Council meeting corroborated the extreme suffering caused by sexual and gender-based violence amid ongoing U.S. aid freeze. The deprivation of essential services and rising food insecurity coupled with the spread of infectious diseases is clear evidence of severe international humanitarian law and human rights violations. Members called for “safe and unhindered humanitarian access,” while U.N. officials and humanitarian organizations have urged the Trump administration to exempt critical aid programs from the freeze, emphasizing that continued inaction could cost thousands of lives. As Goma teeters on the brink of famine, epidemic outbreaks, and mass displacement, international pressure is mounting to ensure that humanitarian assistance remains unhindered by political and bureaucratic roadblocks.
The United States and the international community have a critical responsibility to mobilize resources and demand compliance with international humanitarian law to support transitional justice mechanisms. Sexual violence must be prevented and there must be proper mechanisms to provide critical aid toward the displaced and vulnerable. Anything less risks abandoning a population already reeling from mass sexual violence, displacement, and disease outbreaks—with consequences that will reverberate well beyond the borders of the DRC.