140,000 people have fled violence in the Democratic Republic of Congo since mid-November, with over half a million displaced since April.
This week, armed groups captured the strategically important city of Goma, pushing a conflict that has killed 5.4 million people since 2008, into a new and dangerous stage.
Above (top): Oliva Noalla, 6, with her younger sister on her back, Mugunga camp. Above (left): People have built shelters out of leaves and materials they have managed to find nearby. Above (right): Forced child recruitment is on the increase across the east of the country. Above: Oxfam supplying water in Kanyaruchina.
Violent clashes between armed groups and government forces has already led to a widespread collapse of state control in large areas of the east, where the humanitarian situation is deteriorating rapidly.
Power and water is gone in the main city of Goma, which means people are taking water from the lake instead of the municipal system. There are large fears of a cholera outbreak.
Meanwhile, forced child recruitment is on the increase across the east. Annie, 22, questions if her children will be next.
“Although they are young, I know that child recruitment is happening and I would not put it past the rebel groups to take my tiny children. I know what they are capable of” she says.
She fled her own home in August with her husband and two children and came to Goma to escape the violence in her own area.
“We have lived in a state of fear for months” she says.
She says she lives each day tormented by thoughts of what might happen to her family.
“My children know something is wrong. They react badly to things which they did not do when we were at home. Is it a surprise? They sleep without a roof over their head and eat one meal a day.”
Oxfam, which has been in the region for many years providing clean water and sanitation to tens of thousands of people, is on the ground assessing the needs of people
However the job is made difficult not just by the current security situation.
In 2002 Mount Mount Nyiragongo erupted and covered the city of Goma and its suburbs with volcanic rock. The hard terrain makes it extremely difficult to dig for water and to dig latrines. This means Oxfam has to truck water to meet the urgent needs of thousands of people.