Gunfire tore through the dark. Night after night, the 44-year-old physician from Guinea clung to the hope that the besieged city would hold somehow. Then, one morning in late January, the call came: he and the remaining international staff had to be evacuated immediately.

“We took the last flight out,” he recalled.

Hours later, Goma was in the hands of M23. The Tutsi-led rebel group, backed by neighbouring Rwanda, had just landed its boldest military victory in the region yet.

For most, that would have been the end of the story: a narrow escape, a mission cut short. But, as the aircraft lifted from the runway, he knew he would return. The only question was: how soon?

Dr Thierno Baldé, 45, led the WHO response in Goma after the city fell to M23 rebels in early 2025. (file)

A reluctant interlude

Back in Dakar, where he heads the World Health Organization (WHO) emergency hub for West and Central Africa, Dr. Balde grew restless. Reports of civilian massacres kept trickling out of North Kivu, each new detail cutting deeper. The colleagues he had left behind haunted him. With every grim report, his conviction deepened: his place was at their side.

Two weeks later, on the day he turned 45, he was tapped to lead the agency’s response in eastern DRC. He kept the assignment from his parents in Conakry, his hometown, to spare them the dread.

“I only told them once I was already there,” he admitted, almost sheepishly. His wife and two children had long since grown used to watching him vanish into the world’s most dangerous crises.

Return to ruins

It took him five days to reach Goma. By then, the airport had been shut and the roads pocked with checkpoints.

The city he found was hollowed out. Power lines were down, hospitals crammed with the wounded and talk of the streets being littered with bodies. Fear had settled like ash after a blaze on every face. “In 15 days, everything had changed.”

His team was broken. Some 20 Congolese staffers, gaunt from exhaustion, had been trying to hold the city’s fragile health system together. He gave half of them time off to recover, despite knowing every pair of hands was desperately needed. It was the least he could do.

And yet, amid the wreckage, there was one stroke of good fortune. Unlike most other UN agencies, the WHO warehouses had not been looted. They became lifelines, providing fuel to power hospitals, surgical kits for the wounded and cell phones to coordinate emergency evacuations.

Still, the numbers were crushing, with as many as 3,000 dead, according to initial reports. The bodies needed to be dealt with swiftly before disease spread.

“We had to bury everyone intensely, in a very specific timeframe,” he said, noting that WHO ended up paying local gravediggers to collect the corpses.

Bodies are being buried with the assistance of WHO personnel in the aftermath of the fall of Goma to M23 rebels in early February 2025. (file)

The spectre of cholera

On the day of his return, another illness announced itself: cholera. The first cases had just been confirmed in a MONUSCO camp, where hundreds of disarmed Congolese soldiers and their families had sought shelter after losing the city to the M23 militia. The UN peacekeeping mission’s bases, designed for Blue Helmets, were not built to accommodate a large number of civilians. Sanitation conditions were dire, and the disease spread fast.

That night, Dr. Balde could not sleep.

The next morning, he walked into the camp and saw patients stretched out on the floor. There were 20 or 30 people, with only one doctor, he remembered. Two were already dead.

For days, his team scrambled to hold back the tide, with chlorine for disinfection, protective gear, makeshift triage and staff recruited and trained on the spot. Vaccines were rushed in from Kinshasa.

Rumours rippled through the city

Still, rumours rippled through the city.

“People began saying ‘cholera is exploding in Goma and WHO is overwhelmed.’” He, who had come for humanitarian relief, now found himself with an epidemic on his hands.

“We had to completely re-orient ourselves,” he said. The ghost of another Haiti, where the UN played a role in a cholera outbreak in 2010, hovered over his every decision.

As if on cue, another disease was spreading. Mpox, once confined to the sprawling camps of displaced people on Goma’s outskirts, now spilled into the city itself. Those camps, home to hundreds of thousands uprooted by earlier waves of violence in the region, were emptied in the chaos of Goma’s fall.

“The patients ended up in the community,” he explained.

Dr Thierno Baldé (center left) and colleagues visit a WHO-supported health centre providing care to the population around Goma. (file)

Sitting across from rebels

Then came the men with guns. One afternoon, they barged into the WHO compound without warning. Were they under M23 orders, fighters acting on their own or mere criminals? It hardly mattered. The staff talked them down, persuading them to leave, but the incident made one thing clear. Without some understanding with the de facto authorities, the agency’s work could be compromised overnight.

So, Dr. Balde sought them out.

“We mustered the courage and went to meet them,” he said. At the North Kivu governor’s offices, now run by the rebels, he laid down his WHO “Incident Manager” card.

“I told them Ebola can affect everyone, cholera can affect everyone. We are here to contain them.”

A channel was opened. Fragile, but enough.

The cost of altruism

There’s a stiff price to pay for helping others. In Goma, the days blurred together. Hours were spent in fevered meetings and evenings spent alone in a hotel where heavily armed men dined at nearby tables.

During Ramadan, with the city under curfew, he broke the fast each night with the same simple meal, the city outside trembling with uncertainty.

When he returned to Dakar two month later, his blood tests were a mess.

“It was a real personal sacrifice,” he said, “and I’m not even talking about mental health. As a humanitarian, you have to take care of yourself, too.”

A veteran, still marked

Dr. Balde is no stranger to disaster zones. Trained in Guinea and Quebec, an associate professor at the University of Montreal, he cut his teeth with the Canadian Red Cross in Haiti after the earthquake, then in Guinea during the Ebola outbreak. Since joining WHO in 2017, he has faced emergency after emergency, including COVID-19.

I did everything I could to go back, but I paid a price.

And yet, he admitted, Goma left a mark that few other crises had.

“I did everything I could to go back, but I paid a price.”

In the Senegalese capital, his family bears that price, too. His children know their father disappears into places where the world is breaking apart. His wife has learned to live with the absence.

Still, when he speaks of those feverish weeks in eastern DRC, one sentence returns again and again, insistent and unshaken: “I had to be there.”