Marie Kanyere’s face reflects a mother’s anguish as the youngest of her four children, feverish and weak, shivers in their flooded tent.
She knows the signs – it could be another bout of malaria. The despair worsens with the knowledge that the clinic has no medicines left.
"I fled my village when the fighters came. They killed my brother and burned down our home," Marie tells TRT Afrika. "Here, we sleep in mud, the children are sick, and there’s no food. I don’t know if staying back and dying there would have been a better choice than coming here and suffering each day.”
The Musenyi refugee site in eastern Burundi, meant to be a temporary shelter, has become a place of impossible choices.
The camp, a five-hour drive from Burundi’s volatile border with the Democratic Republic of Congo (DRC), is overcrowded, gets flooded after every spell of rainfall, and is starved of aid.
Marie is among the 71,000-odd Congolese refugees who have fled to Burundi since January, escaping escalating violence in eastern DRC.
The humanitarian response, already stretched thin by a global funding crisis, is buckling under the weight of new arrivals.
Root of the crisis
The violence in eastern DRC has been fuelled by rivalries between armed groups and a turf war to gain control of the region’s vast mineral wealth.
More than 130 armed factions operate in the area, including the M23 group, which has seized territories in recent months with the alleged backing of neighbouring Rwanda. Kigali denies the claim.
"The conflict is a toxic mix of geopolitical proxy wars, local power struggles and foreign exploitation," explains Emmanuel Masamba, a political analyst in the DRC.
"Civilians are caught between militias, government forces and foreign interests, while the world looks away."
The Congolese government, backed by UN peacekeepers and regional troops, has struggled to stabilise the region. Massacres, sexual violence and forced displacement have become routine.
The continuous advances by M23 armed group are overshadowing chances of a ceasefire in eastern DRC.
Crisis begets crisis
The Musenyi refugee site, now home to 16,000 people, was never meant to hold so many.
The sprawl of emergency tents across waterlogged lowlands, initially reserved for farming, illustrates the mess. With the rainy season in full flow, stagnant pools breed disease, and makeshift shelters sometimes collapse under the force of a downpour.
"We are seeing spikes in malaria, cholera and respiratory infections," says Dr Jean-Christophe Niyonzima, a physician working with a healthcare NGO.
"The clinics are overwhelmed, medicines are running out, and pregnant women are giving birth in flooded tents. Without more support, people will die from preventable causes."
Schools are non-existent, sanitation facilities have long been overrun, and tensions simmer between refugees and host communities struggling to share scarce resources.
Hobson’s choice
Dire living conditions and dwindling supplies have forced some refugees to return to the war zone.
UNHCR reports that some families have already crossed back into DRC, risking violence to reunite with relatives or salvage what remains of their homes.
"My husband went back to DRC last week to see if our land was still there," Sifa Ntamwenge, a 27-year-old mother of two, tells TRT Afrika. "I told him not to go, but what else can we do? Here, we eat one meal a day if we are lucky."
Yet, even as some refugees leave the Musenyi camp, hundreds more arrive weekly, trapped in a cycle of displacement.
The financial shortfall has forced UNHCR and partners to slash critical services.
Dignity kits for women and girls – containing soap, sanitary pads and underwear – are no longer distributed, leaving 11,000 without basic hygiene supplies.
Programmes to reunite separated children with their families have been scaled back, and safe spaces for women and children have all but vanished.
"Earlier, we had a women’s centre where survivors of rape received counseling and medical care," says Florence Niyonkuru, who has worked with victims of gender-based violence in Burundi. "Now, they come to us, but we have nothing to give them. Many suffer in silence."
Reports of fleeing women being raped in DRC have surged, with a 60% increase in disclosures to aid workers.
The severe humanitarian situation in Goma, the capital of North Kivu province which borders Rwanda, has also drawn the attention of the International community.
Burundi’s burden
The Burundian government has shown what UNHCR terms "commendable leadership” by granting displaced Congolese refugee status and allocating land. But the country’s capacity is exhausted with regional instability, inflation and its own economic struggles.
"Host communities are sharing whatever little they have, but patience is wearing thin," says Pierre Ndayishimiye, a local official in Cankuzo Province. "If the world doesn’t help, this crisis will spill over."
UNHCR’s appeal for US $76.5 million to address the emergency in Burundi is part of a broader regional refugee response plea for Congolese refugees across seven African nations. Without it, experts warn of catastrophic consequences.
"We are in triage mode, choosing who gets help and who doesn’t," says a UNHCR volunteer in Burundi. "This isn’t humanitarian work anymore; it’s crisis management at its most brutal."
