Kinshasa - At the end of October, after seven years of activity, Médecins Sans Frontières (MSF) ended medical activities in Salamabila, in Maniema province, Democratic Republic of Congo (DRC). MSF has provided care for thousands of victims and survivors of sexual violence, as well as many people with malaria and malnutrition, and significantly reduced mortality rates linked to malaria and pregnancy.
As part of the closure, we are handing over numerous sustainable healthcare facilities to the Ministry of Health. Given the immense humanitarian needs that remain in the area, MSF calls on local actors and authorities to facilitate healthcare and the distribution of humanitarian aid, as well as guarantee their safe access, in Maniema.
Our withdrawal from Salamabila took place on 31 October 2025. This withdrawal is not a change of course, but an acceleration of the process we had planned since the project began. We will continue epidemiological surveillance of the area, as well as maintain our capacity to rapidly respond to emergencies.
"We believe that the project's objectives have now been achieved," says Issa Moussa, MSF programme manager in Maniema. "After all these years of continuous presence, we must make the difficult operational choice, as an emergency organisation, to continue to deploy our medical aid where the needs are most pressing."
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During our seven years of working in Salamabila, MSF teams, in support of local health authorities, treated 16,445 victims and survivors of sexual violence, vaccinated 113,000 children against measles, treated 411,000 cases of malaria, and cared for 26,817 children with acute malnutrition. Between 2019 and 2024, the maternal mortality rate was reduced twenty-fold, and the malaria mortality rate was halved.
Within local communities, we trained 13 reproductive health workers to care for victims and survivors of sexual violence, and more than 100 health workers to detect the symptoms of malaria and provide treatment.
We have also transferred our infrastructure to the Ministry of Health. This includes the operating theatre at the Kayembé health centre, maternity wards and consultation rooms at several other health centres, and waste treatment facilities and drinking water wells in all eight health centres where we worked.
MSF has significantly developed the Salamabila hospital by rehabilitating the emergency and maternity wards and creating paediatric, neonatal, and acute malnutrition wards. 136 solar panels have also been installed to enable the facility to be electrically self-sufficient.
"Before MSF, Salamabila was just a small health centre," says Charles Bamavu, the chief medical officer for the area. "MSF built almost everything and turned it into the second largest hospital in the province."
In Salamabila, humanitarian needs remain significant. Maniema remains marginalised in terms of humanitarian funding. In 2024, it received only 2.5 per cent of the funds allocated by the DRC Humanitarian Fund.1 This chronic underfunding compromises people's access to healthcare.
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"Despite the tangible impact of our intervention since 2018, the scale of multisectoral needs remains immense," says Moussa. "Maniema province is one of the most isolated in the country. Insecurity, the remoteness of health facilities and the high cost of transport severely limit access to care."
"Since the armed conflict worsened and Bukavu airport closed, transporting medicines and staff to Salamabila has become more lengthy, more complex, and more expensive," says Moussa.
When MSF worked in Salamabila, we considered the entire care pathway for patients. First, we provided community support and general healthcare in health centres. We also provided secondary care support at the general referral hospital and, finally, tertiary care by taking full responsibility of medical referrals from Salamabila to Bukavu. In addition, MSF provided specialised, holistic support for the medical and psychosocial care of victims and survivors of sexual violence.
