(LONDON) — At least 200 people have been killed and thousands have been forced to flee following a sharp uptick of violence in eastern Democratic Republic of Congo (DRC).

In a “dramatic resurgence” of violence, the March 23 Movement (M23) armed rebel group is advancing towards Goma, the capital of North Kivu province, forcing thousands of civilians caught in the crossfire to flee as fighting intensifies between M23, the Armed Forces of the Democratic Republic of Congo (FARDC) and various other armed groups.

Aid organizations tell ABC News that they are seeing an influx of wounded civilians in Goma and Sake — a small city around 12 miles from Goma considered the last line of defense to the capital — amid reports of intensified use of heavy artillery, shelling and indiscriminate bombing in civilian areas.

“Patients just keep arriving on motorcycles and buses,” says the International Committee of the Red Cross (ICRC). “Continuous fighting is making the delivery of aid increasingly difficult or even impossible, especially in the case of medical supplies, in the isolated areas of Rutshuru and Masisi.”

According to the United Nations, over 200 civilians have been killed in Ituri province in eastern DRC and over the last few weeks, more than 52,000 people have been forced to flee from their homes. The new escalation of violence has destroyed over 2,000 homes and closed or demolished 80 schools.

Doctors without Borders (MSF) says many of the war-wounded civilians have come in with gunshot wounds and injuries from explosions.

“The situation is extremely concerning,” said Çaglar Tahiroglu, project coordinator at the MSF from Mweso General Hospital, where at least 2,500 people are seeking refuge form fighting. “The hospital is overwhelmed, with thousands of people crowded inside … Alongside the Ministry of Health, we are doing our best to help everyone, but we do not have enough necessities, such as food.”

What’s causing the conflict?

The primarily Tutsi-led M23 movement — one of the estimated 100 armed groups operating in the eastern DRC according to American and U.N. officials — has been fighting for decades in eastern DRC against primarily ethnic Hutu militia groups as they battle over power, land and mineral resources and trade routes, with others fighting to defend their communities from attacks.

The complicated mix of historic ethnic and national rivalries and geopolitics coupled with competition for DRC’s extensive mineral resources — a country which is considered one of the world’s most mineral-rich — has fueled conflict and heightened regional tensions in the Great Lakes, leading experts to warn that this may hinder prospects for peace and stability in the region.

DRC President Félix Tshisekedi has accused Rwanda of backing the M23 revels through military support.

“I’ve had enough of invasions and M23 rebels backed by Kigali,” said Thisekedi in December.

In a call with Tshisekedi and Rwandan President Paul Kagame, U.S. Secretary of State Antony Blinken urged both nations to take measures to de-escalate the situation, including removing troops from the border.

The Human Rights Watch says the human rights situation “remains dire,” documenting various abuses by government security forces and armed groups including “massacres, abductions, rape, sexual violence, recruitment of children, and other attacks on civilians with near total impunity.”

The cycle of ongoing violence has led to the world’s largest internal displacement with an estimated seven million people displaced, according to the International Office of Migration.

In the DRC’s capital of Kinshasa, protesters have recently taken to the streets outside Western embassies, including that of the United States, accusing them of failing to intervene in the offensive that has caused havoc in eastern DRC.

Protesters set tires on fire and burned flags as they expressed their anger before police fired tear gas to disperse the crowds.

“The U.S. Embassy in Kinshasa has sent three security alerts to U.S. citizens about protests throughout the city of Kinshasa since February 9, 2024,” a State Department Spokesperson tells ABC News. “Protests this past week have occurred at foreign embassies, international organization offices, and foreign-owned businesses. The alerts stated that protesters are targeting foreigners living in Kinshasa and other major cities, diplomats, and employees of international organizations and their vehicles.”

The embassy has since advised U.S. citizens to keep a low profile and limit their movements.

Meanwhile, Tshisekedi and other East African leaders continue talks under the Nairobi and Luanda processes — regional initiatives aimed at resolving the conflict in eastern DRC through diplomatic and negotiation efforts.

“We reaffirm our support for the Luanda and Nairobi Processes and call on all parties to adhere fully to commitments made under regional mediation processes,” said the State Department.

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