War in eastern Congo has wrecked dozens of clinics as cholera and mpox spread

Years of armed conflict in the eastern Democratic Republic of the Congo have degraded the health system to the point where the fighting's largest toll is now measured in preventable disease rather than battlefield wounds. A 2026 review synthesising peer-reviewed, World Health Organization and World Bank data through 2025 reports more than 70 health facilities completely destroyed in North Kivu and 15 partially destroyed in South Kivu, 7.3 million people displaced, and disrupted vaccination campaigns that are worsening outbreaks of cholera, mpox, malaria and measles [s1].

That combination — a collapsing health system and mass displacement into crowded, under-served settlements — is a well-documented engine of infectious disease, and eastern Congo now has both at scale. The review describes maternal and child mortality staying high because insecurity has destroyed maternity centres and cut antenatal care, while more than a quarter of the population faces severe food insecurity and over 2 million children are acutely malnourished [s1]. Malnourished, unvaccinated children in overcrowded camps are precisely the population in which measles and cholera turn lethal.

The evidence on displacement and disease

What the health outcomes of displacement look like in numbers comes from a separate line of evidence. A systematic review and meta-analysis of diarrhoeal disease among internally displaced and refugee-camp populations — pooling 23 studies and 121,037 samples — found a pooled diarrhoea prevalence of 29% (95% CI 24–33%) [s2]. The burden was heavier in refugee camps, at 32% (95% CI 22–42%), than among internally displaced people at 27% (95% CI 22–31%), and in Africa the pooled figure was 28% (95% CI 21–35%), rising to 35% in East Africa [s2]. Diarrhoeal illness on that scale is a marker of failed water and sanitation, and it is the same failure that lets cholera — one of the outbreaks the DRC review flags — establish and spread [s1][s2].

Neither source is a live surveillance count of eastern Congo, and both should be read for what they are. The DRC review is a narrative synthesis of figures reported by humanitarian agencies and journals, not a fresh field survey, and it presents them to argue for action [s1]. The meta-analysis is a global pooling of heterogeneous studies with wide confidence intervals, not a DRC-specific estimate [s2]. Together they establish the mechanism and its magnitude: destroy the clinics and displace the people, and the diseases that follow are enteric, vaccine-preventable and concentrated in children.

Attacks on health care as a driver

The review frames the destruction of facilities not as collateral damage but as a distinct public-health driver [s1]. International humanitarian law protects health care through the principles of distinction and necessity; attacks on medical personnel and facilities violate those rules and, in the DRC, have removed the very infrastructure that would contain an outbreak [s1]. When a maternity centre is destroyed, the immediate loss is obstetric care; the downstream loss is a fixed point from which vaccination, oral rehydration and case reporting would otherwise run.

The compounding factors the review lists are familiar from other collapsed systems: insecurity that blocks access, attacks on aid workers, ruined infrastructure, corruption, weak coordination and donor fatigue [s1]. Each one lengthens the time between a child falling ill and reaching care, and in cholera or severe malaria that interval is often the difference between recovery and death. The same insecurity has disrupted the vaccination campaigns that would otherwise blunt measles and cholera, which is why the review lists both among the outbreaks now worsening [s1].

What to watch

The review's central claim is that eastern Congo's crisis is now a health crisis as much as a security one, and that the response has to protect health services and frontline workers rather than treat each outbreak in isolation [s1]. That is a demanding prescription in an active conflict, and the piece is explicit that some humanitarian response is already under way but that sustained, coordinated investment is what is missing [s1].

The measurable signals worth tracking are the ones these sources point to: whether vaccination coverage in North and South Kivu recovers enough to blunt measles and cholera; whether the count of acutely malnourished children moves; and whether attacks on health facilities slow. Absent progress on those, the meta-analytic baseline is the grim default — roughly a third of people in camp settings living with diarrhoeal disease, in a population where the clinics that would treat it have been reduced to rubble [s1][s2].

This article is informational and is not medical advice.

Sources

• [s1] Public Health Challenges, "Dual Burden of Conflicts and Healthcare Collapse in the Democratic Republic of Congo: A Call for Action," published 13 August 2026. https://doi.org/10.1002/puh2.70334
• [s2] BMC Public Health, "Global epidemiology of diarrhea among internally displaced populations and refugee camp populations: an evidence-based systematic review and meta-analysis," published 15 October 2025. https://doi.org/10.1186/s12889-025-24166-1