This morning, thousands flooded out of Kibati camp, just outside Goma, when shooting broke out nearby. About 15,000 people had taken shelter there after last week's fighting.
"This illustrates just how on edge the population is," said UNICEF Communications Specialist Jaya Murthy in Goma. "These people have fled several times. Today could have been their fifth or sixth time."
UNICEF was in Kibati camp administering an emergency measles vaccination programme for 13,000 children when the exodus began. The vaccination program is now on hold.
"We just don't know what's going to happen, never mind from day to day but from hour to hour," said Mr. Murthy.
Secretary-General in region
UN Secretary-General Ban Ki-moon, who is in Nairobi for a regional summit on the crisis, has registered his concern about the ongoing violence. In a statement, Mr. Ban urged all armed groups "to avoid activities that result in the further displacement and suffering of the civilian population."
But Mr. Ban's statement has done little to ease the humanitarian disaster or curb the violence. Over the last two days, fighting in Rutshuru town and Kiwanja has left dozens dead at least, according to the Congolese Red Cross, news reports and human rights groups.
UNICEF staff members were in the area around Rutshuru and Kiwanja when the fighting broke out. "We had a humanitarian convoy in at that time," said Mr. Murthy. "They had to be evacuated. Right now, there is no humanitarian access to the entire Rutshuru territory."
Cholera cases doubling
Without sustained access to displaced communities, UNICEF and its partners are worried about massive health risks - especially from malnutrition, measles and cholera.
"In virtually all displacement areas in the last week, we've had increasing cases of cholera," said Mr. Murthy. He added that even in places with some humanitarian access, such as the enormous displacement camps west of Goma, UNICEF is seeing large increases in disease.
According to Mr. Murthy, cholera cases in the Mugunga camps have doubled. "We're extremely concerned that in areas that we can't reach, cholera epidemics could reach catastrophic levels," he warned.
Children at greatest risk
Apart from disease and malnutrition, displacement results in serious disruptions to normal life, especially for children.
"All schools in the Rutshuru territory are closed, and many schools in the Masisi territory are closed, " said Mr. Murthy. UNICEF is providing school kits and plastic sheeting to set up emergency classrooms in displacement settlements. But for families and children who are forced to continually flee fighting, consistent access to education is impossible.
UNICEF is also worried about children who have been separated from their families during displacement, as well as continuing evidence of forced recruitment of child soldiers by all armed groups.
"We know that there were 37 children that were recruited by armed groups during the fighting in Rutshuru and Kiwanja," said Mr. Murthy. "We're extremely concerned with the serious tensions in the area, that those children that were recently recruited could be used in fighting."