BULENGO, Congo (AP) – A hooded man burst into the 42-year-old woman’s tent while her children were out searching for food, then raped her in the displacement camp where she had fled war in eastern Congo.

“I wanted to scream [but] he took my mouth and he threatened me with death,” said the mother of four, who was abandoned by her husband after she became disabled in a motorcycle accident several years ago.

Now, she says, she lives in fear and hesitates to let her children leave her side.

Sexual violence by armed men against displaced women is increasing rapidly in eastern Congo as yearslong conflicts continue. The trend underscores the disproportionate consequences for women and girls in the region’s perpetual state of war. The Associated Press is not identifying survivors who spoke to journalists in the Bulengo displacement camp.

In Bulengo and other displacement sites nearby, an average of 70 sexual assault victims each day visit clinics run by Doctors Without Borders, also known by its French acronym MSF.

Conflict has simmered in eastern Congo for nearly three decades. The United Nations estimates that more than 130 armed groups are active in the country’s northeast, vying for land or resources while some have formed to protect their communities. Sexual violence has long been used as a weapon of war by armed fighters in the region.

More than 4 million people were displaced within Congo because of conflict in 2022, the most in Africa and second in the world only to Ukraine, according to the Internal Displacement Monitoring Center. Of nearly 100,000 people who arrived at displacement sites near the eastern city of Goma in July, nearly 60 percent were women and girls, according to the International Organization for Migration.

Doctors Without Borders treated 1,500 female victims of sexual violence in just three displacement camps outside Goma in July, more than double the number in May, the organization said in a September 18 report.

Survivors and aid workers say displacement rips people from their livelihoods and leaves women and girls vulnerable to assault.

Like many other displaced single mothers, the 42-year-old mother of four is struggling to feed her family and is unsure when she might return home.

With the help of her two sons and two daughters, she had cultivated her fields of cassava, potatoes and beans. But in February, armed rebels and Congolese security forces clashed close to her home in the northeastern village of Karenga.

“We were forced to flee, leaving behind all our belongings,” she said. Limping, she walked an entire day to bring her family to one of more than 100 sites where displaced people have gathered around Goma.

One May evening, after three months of struggling to feed her family in a camp with tens of thousands of other displaced people, she sent her children to find food. They had not eaten all day, she said. That was when a stranger found her alone and raped her.

After the attack, she confided in a friend who directed her to a clinic run by MSF. The charity group along with United Nations agencies and local organizations help provide medical services, psychological treatment, latrines and other measures to improve conditions for survivors of sexual violence.

But their role is limited. Deliveries of food and other basic needs to the camp are infrequent, said Rebecca Kihiu, MSF’s regional sexual violence activity manager.

The camp’s conditions leave women vulnerable to abuse. Shelters are little more than plastic sheets, with no way of securing them from intruders, Kihiu said. Armed men lurk outside the camp, where women and girls are forced to venture to find firewood and other necessities.

“They know that they will go and find these assaults outside the camp. But they have no option,” Ms. Kihiu said.

Already scarred by fleeing their homes, survivors of sexual assault in camps like Bulengo live with the experience long afterward. “It’s a trauma that will stay for a lifetime,” said Esmeralda Alabre, coordinator for UNFPA gender-based violence programming in northeast Congo.

A mother of eight in the same displacement camp received some medical help after she was raped. But she is still afraid, especially at night. She now arranges her children around her when they sleep, hoping their presence will deter a future aggressor.

Kihiu says some groups of women band together on trips outside the camp for added security, but this tactic falters if they need to split up to collect resources more efficiently.

For hundreds of thousands of other displaced women in northeast Congo, escalating armed conflict stands in the way of a return to normal life. The two women interviewed by the AP said they think each day about how they can return to farming in their village.

And each night they fear for their safety.

“Let the government do everything to end this war so that we can give up this life of misery,” the mother of four said.