The eastern province has been ravaged by conflict for almost three decades, resulting in widespread population displacement.

Unicef put the number at 31,342 nationwide cases contracted to date in 2023, with many children among the sufferers and North Kivu the worst-hit province accounting for some 21,400 cases alone, the organisation said, quoting a health ministry tally.

“The size of the cholera outbreak and the devastation it threatens should ring alarm bells,” said Shameza Abdulla, Unicef DR Congo’s senior emergency coordinator, based in Goma.

“If urgent action is not taken within the next months, there is a significant risk that the disease will spread to parts of the country that have not been affected for many years,” Abdulla said.

“There is also the danger it will continue to spread in displacement sites where systems are already overwhelmed and the population – especially children – is highly vulnerable to illness and – potentially – death.”

Unicef says the more than 8,000 cases of under-fives infected this year in North Kivu are more than six times as many as for all of last year.

A 2017 epidemic of the disease affected large swathes of the country, including the capital Kinshasa with some 55,000 cases and more than 1,100 deaths.

The International Organization for Migration said in June that around one million people had been displaced in the east owing to conflict in the first quarter of this year.

Unicef said camps holding those displaced did not have the capacity to cope and the wretched conditions were facilitating the spread of cholera.

The organisation has appealed for US$62.5 million in funding to bolster its prevention and response activities to stem the spread of the disease as it seeks to reach 1.8 million people, including one million children, by year’s end.

So far, it added, the cash appeal was just 9% funded.