Clashes have escalated since the start of the year in towns and villages around the provincial capital as rebels seized territory, forcing thousands to seek refuge in the city.

The use of heavy artillery and shelling has killed dozens, and hospitals in Goma have struggled to cope with the influx of injured civilians.

The United Nations and other aid agencies have warned that the fighting risks worsening the humanitarian crisis in the eastern Congo region, where more than 5 million people have been displaced in the four provinces of the region due to conflicts.

The government of Congo, United Nations officials and Western powers have accused Rwanda of supporting the resurgent rebels who claim to defend ethnic Tutsi interests against Hutu militias whose leaders participated in the 1994 Rwandan genocide of more than 800,000 Tutsis and moderate Hutus.

Rwanda has refuted the claims.

The U.S. urged Rwanda on Saturday to immediately withdraw all of its military personnel from Congo and remove surface-to-air missile systems, saying these threatened the lives of civilians, U.N. and other regional peacekeepers, humanitarian workers, and commercial flights in eastern Congo.

With the rebels advancing towards the town of Sake, approximately 25 km (15.5 miles) west of Goma, the city now relies on scant food supplies brought in by canoes from villages around Lake Kivu.

The Kituku market, on the lake’s banks, has become a critical source of food for Goma.

CONCERN OVER FOOD SHORTAGES

Esperance Nyota, a banana seller, warned of an impending famine if the conflict persists and the routes supplying Goma from surrounding farmlands remain cut off.

“The entire city of Goma depends on this small market for supplies of cassava, corn, and bananas,” Nyota said.

Approximately 135,000 internally displaced people have fled Sake in the past week, according to the United Nations refugee agency. They join the hundreds of thousands already displaced around Goma since 2022 due to the ongoing conflict.

The UN agency has warned that the conflict, including indiscriminate bombing, risks exacerbating the strain on limited resources to cater for more than 800,000 internally displaced people, and 2.5 million already displaced in the North Kivu province.

The Norwegian Refugee Council said on Thursday that the advance of the armed groups towards Sake, a crucial link to Goma, posed an imminent threat to the entire aid system in eastern Congo, with potentially devastating consequences for the civilian population.

The Kyeshero hospital in Goma, which provides free treatment to conflict victims, has seen an influx of patients injured by gunfire and bombings, doctors said.

Kasalemba Akilimali, a displaced 20-year-old, was injured on his left leg by bomb shrapnel while fleeing his village. He said seven people were killed on the spot and many others injured when the bomb hit his group.

In the same ward on the bed next to Akilimali, medical staff helped bandaged and bruised Chance Mwishuko, a 38-year-old motor-bike taxi driver, to sit up.

Chance said he was injured when shelling from rebel-held positions hit a residential area in Sake.

“I am here because from their high positions in the mountains, the M23 had dropped bombs on the civilian population. Many of us were injured,” he said.

(Reporting by Djaffar Al Katanty, Additional reporting by Ange Kasongo in Kinsasha Writing by Bate Felix; Editing by Sharon Singleton)