By Hereward Holland
GOMA, Congo, Nov 11 (Reuters) - Packed into squalid refugee camps or roaming in the bush, hundreds of thousands of Congolese children face hunger, disease, sexual abuse or recruitment by marauding armed factions, aid workers said on Tuesday.
Weeks of violence have forced more than 250,000 people from homes or ramshackle camps where they had taken shelter, bringing to over 1 million the number of internal refugees from years of fighting in Democratic Republic of Congo's North Kivu province.
Most are children.
"North Kivu is quite possibly the worst place to be a child. There is no question that children have been the most severely affected by the recent conflict," said George Graham, spokesman for Save the Children in the provincial capital, Goma.
Fighting between Tutsi rebels and pro-government troops and militia fighters has subsided into sporadic clashes in recent days as African leaders staged summits and leant on both sides to avert a repeat of Congo's devastating 1998-2003 regional war.
"When children flee fighting they become more vulnerable to contracting diseases, to becoming malnourished, and vulnerable to predators like sexual abuse, exploitation, violence and recruitment into armed groups," U.N. Children's Fund (UNICEF) spokesman Jaya Murthy told Reuters in Goma.
Sixty percent of the 1.1 million displaced are children, he said. "We estimate that there's around 2,000 to 3,000 children in armed groups and recruitment is going on right now."
"This has been a silent emergency for children for the last five years, only now it is re-exploding -- again."
Fighters on both sides have attacked, looted, raped and murdered civilians in raids the U.N. peacekeeping force in Congo, known as MONUC, says include war crimes.
U.S.-based Human Rights Watch quoted local sources and civilians as saying at least 50 civilians were killed last week in Kiwanja, 70 km (45 miles) north of Goma.
Nyrarukundo Rivera, 42, told Reuters she lost her children when fleeing violence in Kiwanja and hadn't seen them since.
CHOLERA ON THE RISE
At least 1,000 cholera infections have been reported since the start of October, the World Health Organisation (WHO) said.
"We fear this is a direct result of the spreading insecurity," WHO spokesman Paul Garwood said. "As yet we have seen no explosion in cholera cases but the risks are very high."
At least 100,000 refugees are cut off from aid, U.N. Secretary-General Ban Ki-Moon said. "Because of the ongoing fighting, these people have received virtually no assistance," he added.
World Food Programme spokeswoman Emilia Casella voiced concern for those cut off: "We are looking to take advantage of any lull in fighting to deliver food in 'hit and run' operation."
Renewed violence in the conflict-riven province since a January peace deal collapsed in August has spread instability to the provincial capital Goma and remote localities alike.
In Kanyabayonga, 120 km (75 miles) north of Goma, Congolese army troops fled when they heard rumours of a rebel attack.
"On their way back they looted everything from four villages on the way (north) to Lubero last night and this morning," MONUC spokesman Lt-Col Jean-Paul Dietrich said.
As violence has increased the misery of some 250,000 people displaced by fighting since September, Tutsi rebel chief General Laurent Nkunda has vowed to pursue his campaign and topple President Joseph Kabila if he doesn't accept talks.
"We are going to overthrow him," Nkunda told the British Broadcasting Corporation. "Being elected is not a white card to do what you want ... We have to liberate Congo."
Nkunda has said he may fight an African intervention force proposed at a regional summit on Friday that urged a ceasefire.
European Union members have also discussed sending troops.
The U.N. Security Council was due to meet later on Tuesday to discuss Congo and Secretary-General Ban's month-old request for 3,000 extra soldiers and police for MONUC, already the world's biggest peacekeeping force with 17,000 personnel.
"Civilians need protection now from the killing and raping," Human Rights Watch's Anneke Van Woudenberg said in a statement.
(Additional reporting by Emmanuel Braun in Kiwanja, Laura MacInnis in Geneva, David Lewis in Kinshasa, Rebecca Harrison in Johannesburg and Louis Charbonneau at the United Nations; writing by Alistair Thomson; editing by Michael Roddy)