Doctors Without Borders (MSF) has made public that the Congolese militias of the March 23 Movement (M23) are obstructing access to medical care for survivors of sexual violence in the areas under their control in eastern the Democratic Republic of the Congo, by ordering that only women with "visible signs of rape" be treated.
The organization stresses that this situation is observed with particular clarity in the province of North Kivu, whose capital, Goma, has remained for months in the hands of these militias.
MSF details that "among these measures is the restriction of the recognition of sexual violence only to people who present visible signs of injuries, with the aim of reducing the number of victims and survivors recognized as such".
Furthermore, the NGO denounces that the M23 forces "demand intrusive and medically unnecessary physical examinations to prove that there has been violence or an assault; force victims and survivors to report to the Police before seeking care; and restrict access to care only to those who arrive within 72 hours after the assault".
In the case of MSF projects, M23 imposes the use of forms with "intrusive, stigmatizing and non-essential questions", among them the names and addresses of the survivors, as well as data about the alleged aggressors.
The organization recalls that this type of information "violates medical confidentiality, exposes survivors to additional risks and goes against the international standards of medical ethics". MSF indicates that it has received testimonies from patients, mostly women, who say they have been interrogated or intimidated so that they do not go to centers supported by humanitarian organizations.
Health professionals have told MSF that they have been threatened with suspensions and even prison sentences if they do not obey these directives, which is already leading part of the staff to refuse to provide essential services to victims and survivors of sexual violence and, in some cases, to abandon their work altogether for fear of reprisals.
Drastic decline in the search for care
As a result of this climate of intimidation, the analysis of data from several health centers supported by MSF in North Kivu reveals a 41% drop in the number of people who requested care for sexual violence in August 2026 compared to January 2026.
Other health facilities supported by the organization in the province also show sharp reductions: they have gone from attending around 80 victims and survivors per month in 2025 to only nine monthly in 2026. Communities report a growing fear of going to these services.
"That the crisis is less visible does not make the underlying violence disappear," warns MSF Operations Director Akke Boere. "A decrease in the number of reported cases does not mean that sexual violence is decreasing. It simply means that victims are facing obstacles to accessing safe and confidential care," she warns.
Boere insists that "the priority must be to eliminate barriers to access to care, strengthen protection and access to justice, and address the conditions that allow sexual violence to continue. The current restrictions are not the way to achieve this: they only cause more harm to the victims".
MSF recalls that in 2024 nearly 45,000 victims and survivors received care in centers supported by the organization in the DRC, a figure that rose to 53,000 in 2025. In the first half of 2026 alone, its teams attended to more than 19,400 people for sexual violence in North Kivu.