Justin Kapitu is dying. He does not know it yet, and the doctors treating the 22-year-old rebel fighter are unlikely to tell him soon, but his chances of surviving more than a few months are virtually non-existent.
Kapitu was wounded in a clash between his rebel group and a rival faction in December. Even in the remote green forested valleys and hills of the far east of the Democratic Republic of Congo (DRC), where the battle took place, few paid much attention. Such scrappy, bloody confrontations have become an almost daily occurrence.
Bullets shattered Kapitu’s right arm and damaged his intestines. Emaciated and traumatised, he is being treated at the single hospital serving the half million inhabitants of Masisi territory, about a thousand miles east of Kinshasa, the capital.
Kapitu weighs only 30kg (4st 7lb), is in constant pain and can absorb just a fifth of the nutritional value of the small amount of food he can ingest. Abandoned by his former comrades, he is unsure of the whereabouts of his family.
“I was just a foot soldier so I don’t really know why we were fighting,” he said. “There are lots of reasons I think .... I don’t think the wars here will ever stop. They will probably get worse.”
Kapitu’s analysis is shared by many. The vast central African country has been hit by waves of violence, rebellions, protests and political turmoil in recent months, leading to worries about a new civil war like that which killed five million people between 1997 and 2003.
Across the country the security situation has deteriorated markedly as government authority has collapsed, emboldening rival militia groups who hold sway over large areas of territory, often competing for the DRC’s rich resources.
The president, Joseph Kabila, is desperately clinging to power as various groups and individuals use violence to gain cash, territory and support before possible elections later this year.
The humanitarian situation is dire. More than 13 million Congolese need humanitarian aid, twice as many as last year, and 7.7 million face severe food insecurity, up 30% from a year ago, the United Nations said in March. Many humanitarian officials complain that global attention has been diverted to more heavily reported crises in the Middle East.
More than 4.5 million people are displaced, the highest number in the DRC for more than 20 years, latest figures show. There are outbreaks of cholera. The fighting is, as Kapitu feared, getting worse.
In recent weeks, thousands of army soldiers attacked villages across the province of North Kivu, where rebel groups are based. Around the town of Beni, DRC’s army is fighting an Islamist-inspired militia blamed for killing 14 UN peacekeepersin November, the worst loss of life in a single incident for the organisation for 25 years. Dozens have died in frequent ambushes and skirmishes.
Though Goma, the biggest city in the east, remains calm, militias have clashed with security forces on its outskirts. Elsewhere in the east, ethnic tensions have led to massacres. Around the town of Bunia, hundreds have died.
There have been fierce battles west of the town of Masisi, as government troops attacked the base of a powerful local warlord known as General Delta.
Among the more than 1.4 million forced from their homes in North Kivu province by the recent fighting is Baraka Buira, who fled with her brother and sister when armed men from one of the most powerful local militia attacked her village near the small town of Nyabiondo shortly after government troops launched an offensive against its bases three weeks ago.
Hidden among the trees, the 14-year-old watched as men were beaten and women dragged screaming into huts. Buira saw several corpses on the ground but believes her parents also fled. She is unaware of their whereabouts.
“We are suffering. This is our unhappiness,” said Buira, who carried her two smaller siblings for 48 hours to reach the relative safety of a camp for displaced people.
The camp has no water and no food distribution since aid organisations withdrew from the region citing growing insecurity months ago. A family has allowed Buira to share their makeshift shack, but can provide little else.
One of the few international NGOs still working in the area is Médecins Sans Frontières. It supports, among other projects, a hospital with more than 300 beds at Masisi, where 17,000 people received care in 2017, a health centre in Nyabiondo, a network of mobile clinics and a fleet of ambulances. The work is increasingly dangerous. In the last two months, MSF personnel and vehicles have been attacked five times.
Logistics pose enormous challenges too. It can take an entire day to drive the 60km from Goma to Masisi on muddy dirt tracks. There are no paved roads and many remote communities can only be reached by motorbike, some only after days walking on forest tracks. Patients regularly die when roads are cut by landslides, torrential rains or fighting.
“The problem is that a volatile situation like we have now means people need us more than ever, but makes reaching them harder,” said Sebastien Teissier, who leads the MSF project at Masisi.
The crises have been exacerbated by an absence of international forces. The United Nations mission in the DRC is the largest and most expensive peacekeeping effort, but five UN bases near Masisi were shut last year, following a US-led push to cut costs.
Major Adil Esserhir, a spokesman for the UN peacekeepers, said the force was now “more agile”. “We have had to do the same work with less resources. The problem we are facing as a military [force] is that we must give a solution to a problem that is not military,” he said.
Meanwhile the country has been roiled by protests, often bloodily repressed, since Kabila’s second electoral mandate expired 15 months ago. A rebellion in central provinces cost thousands of lives last year and there have been a series of mass prison breaks.
“There is a lack of political will to crack down on the militia ... The only way this regime can keep power is to maintain a situation which allows them to keep pillaging. Each armed group can be tied to an official in Kinshasa, either in government or in the army,” said Fidel Bafilenda, an analyst in Goma.
Senior officials admit the problem.
“This is a country where anyone can exploit a militia. I can’t deny that there are contacts between politicians and the [armed] groups but there’s no proof that they are financing them. We are a young democracy,” said Julien Paluko, the governor of North Kivu.
Paluko, a Kabilia loyalist, blamed “an absence of state authority” for the problems in North Kivu, which lies more than 1,000 miles east of Kinshasa. The army and police are demoralised, corrupt and poorly trained. An economic downturn and soaring prices have hit salaries.
“Where there is no police, army or justice system, it’s the law of the jungle. We have to do better. We have had some difficult times but we’ve made a lot of progress too,” he said.
The renewed fighting has meant a wave of sexual violence.
Anastasia Icyizanye, an MSF health worker working in Nyabiondo, said fighters from one armed group raped 60 women in January when it seized a village market. MSF say they have recorded twice as many incidents of sexual violence each month in 2018 compared to last year.
“Whenever there is fighting there is systematic rape – in villages, at checkpoints on roads, wherever,” Icyizanye said.
DRC observers are particularly fearful of the growing tension between ethnic communities. Despite fertile soil and plentiful water, there is fierce competition for land in the heavily populated green hills above Lake Kivu, as well as for lucrative mines where gold, coltan and other key commodities prized in the developed world are scratched from the ground by artisanal miners.
Leaders of the many local rebel groups say they are acting in self-defence.
“We are simply protecting our villages. When the government and its allies stop trying to force us off our land then we will stop fighting. Until then the wars will continue,” Colonel Faustin Misibaho, a senior officer in the Patriots’ Alliance for a Free and Sovereign Congo (APCLS) told the Guardian.
Many of the fighters are very young. Kapitu was 14 when he joined the rebels, seeking revenge after government soldiers killed his father and grandfather during a raid on their village.
“My group killed a lot of people. We were really feared and respected,” he said. “I don’t think about those I killed personally. Why should I? They wouldn’t think about me if it was the other way round.”