Médecins sans Frontières (MSF) has treated 7,000 cases of cholera since January in the province. "There is a lack of access to latrines and clean drinking water," Romain Gitenet, field coordinator for MSF's project in Rutshuru territory, said on 20 November.
Constant population movement and crowded conditions in displacement camps have also contributed towards the spread of the disease.
Cholera cases are being reported in more locations than usual, said MSF. In Kibati, north of Goma, about eight to 10 cases of cholera were reported each day for the week ending 14 November. The number has since gone up to 16 cases daily.
Some of the displaced are also not able to access treatment. "If you don't do anything, 30 to 50 percent of those who have cholera die," Gitenet said. The few health facilities available are overcrowded.
According to the UN Children's Fund (UNICEF) office in Goma, the main town, there is a continued risk of cholera spreading around the Rutshuru territory.
"Insecurity continues preventing the provision of clean water, latrines, and hygiene promotion to contain the spread; as people keep moving the disease will keep spreading," said UNICEF.
Increased gunshot injuries are also leading to more amputations, according to Gitenet. "The use of heavy weapons is more common now," he said.
In October, 406 surgeries were performed at Rutshuru hospital; of these, 110 were gunshot injuries.
Providing medical care was thwarted by access problems. "Although we are managing to work in most of the areas we cannot go everywhere," he said. "Every day is a headache ... We have to find a new way of doing things. You have to be very flexible."
Insecurity in the north has prevented the dispatch of mobile clinics to Kanyabayonga, one of the areas worst affected by fighting between militias allied to renegade army general Laurent Nkunda and the national army.
A feeding centre and a hospital in Kayna, also in the north, had reportedly interrupted "critical assistance to severely malnourished children", according to UNICEF.
The fighting in North Kivu has been characterised by mass displacement and increasing rape cases. Since January MSF has attended to at least 5,700 rape survivors.
"Most [rape survivors] however don't come in to the hospitals as they do not want to be stigmatised," Gitenet said.
In the town of Kanyabayonga, Oxfam reported a tenfold increase in the number of rapes reported at local hospitals and clinics between May and the beginning of November.
Malnutrition on the rise
The number of children suffering from severe malnutrition has also risen dramatically, humanitarian agency, World Vision warned in a statement on 18 November.
Between eight and 10 children have been arriving every day at the agency's nutrition centre in Rwanguba, east of Rutshuru, against one or two a day before the conflict.
"The cause of malnutrition used to be poverty," said Suzanne Kahamba, a nurse working at the Rwanguba clinic. "But now so many people are displaced, they don't have land to grow crops. The conflict has intensified the effects of poverty 10 times over and the situation has become dire."
Fighting in the area cut off the delivery of therapeutic food for nearly three weeks. "We have had no supplies at the centre for a week," said Kahamba. "This morning we had 53 children in need of treatment, but we had nothing to give them." The centre in Rwanguba is one of four across North Kivu.
Meanwhile, MSF has launched a one-year web campaign to highlight the crisis.
The website tells the personal stories of people struggling to survive in a region that has become the frontline of a conflict raging for years, said MSF.
On 20 November, UK aid agencies launched a joint appeal for funds. Launching the Disasters Emergency Committee (DEC) Congo Crisis Appeal, chief executive Brendan Gormley said while aid was getting through to those affected, a massive scale-up was required.