Hospitals across eastern Congo that were once at the forefront of the country’s response to the mpox outbreak are facing a setback in detecting the disease and offering treatment following the advance of Rwanda-backed rebels in the region.

The mpox global health emergency is worsening as the fighting between the M23 rebel group and Congolese troops escalates in eastern Congo, which has been the epicenter of the health crisis.

Many patients have fled and can’t be found. Recently arrived vaccines are running short as supplies can’t reach combat zones. Hospitals have been under attack.

The Associated Press visited one of the mpox hot spots, which is now under control of M23 rebels backed by neighboring Rwanda. Health workers and remaining patients described a growing disaster.

“The situation has been very difficult. Insecurity has disrupted everything,” said Dr. Serge Munyahu Cikuru, medical officer in charge of the Miti Murhesa health zone in South Kivu province’s Kabare territory.

The country, meanwhile, continues to battle other diseases in the east, including cholera and measles, in addition to mysterious outbreaks that recently started in the northwestern region.

Cases are not being reported as before

Congo saw a 31% weekly increase in mpox cases last week, bringing the total to 16,255, according to the Africa Centers for Disease Control and Prevention.

However, that is only one side of the story: Only seven out of the 26 provinces reported cases last week, the public health agency said at its last briefing, partly blaming the security crisis.

Although Congo has seen a surge in the current vaccination phase as compared to the previous one, much of that success is in other regions while eastern Congo remains cut off.

The Miti Murhesa treatment center is fast running out of supplies.

Mubake Buroko Patrick, an mpox patient at the facility, said it was difficult to get drugs in the weeks following the fighting.

“The war has complicated our access to medicines,” he said. “I’m feeling a little better, but the treatment needs to be improved.”

Africa CDC’s mpox incident manager Dr. Ngashi Ngongo told reporters last week that authorities have started negotiations for a humanitarian corridor, which would require the suspension of hostilities to allow for humanitarian access in conflict zones.

Patients are fleeing in fear

More than 600 mpox patients fled different hospitals in eastern Congo as the fighting escalated, the Africa CDC said.

Many of the fleeing patients were in the Miti Murhesa health zone, one of the hardest hit in the mpox outbreak.

At least 4,700 cases were reported there as of the end of 2024, according to the zone’s chief medical officer Dr. Cikuru.

Only two of the four treatment centers in the zone are currently functional while others are among numerous health facilities affected by the fighting between government forces and M23, he said.

As M23 seized Goma and Bukavu, their fighters were expanding their presence in the region, including in other parts of North Kivu and South Kivu provinces where they had been present for years.

Many patients in Miti Murhe have had to “choose between staying under fire or fleeing” the rebels, Dr. Cikuru said.

Tracing patients to prevent spread of mpox has become more difficult and health workers are running out of options on how to make the best of remaining medical supplies, he said.

“Our fear is an increase in the number of cases due to the current situation,” the doctor said. “Patient care in the treatment centers continues, but the shortage of medicines is a major concern.”