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Measles vaccines have arrived in a rebel-held area of eastern Congo nearly a year after a deadly outbreak of the highly contagious disease began.

The seizure of parts of the region early this year by Rwanda-backed M23 rebels has affected the delivery of health care in one of the world’s most dire humanitarian crises, residents and aid groups have said.

This week, anxious parents clutching small children have been lining up in Kachehembe in North Kivu province to receive the vaccine from medical charity Doctors Without Borders, also known as MSF.

“Children are suffering greatly from this disease,” said Silas Bazimaziki Rugiriki, a father who brought his son.

Africa has seen measles outbreaks across multiple countries. Congo has reported over 36,000 suspected cases and 565 deaths across nearly all of its 26 provinces this year as of July.

The outbreak is stretching resources in Congo, which also has dealt with outbreaks of Mpox and Ebola in recent months, along with the rebel threat.

Since January, the M23 rebel group has seized key cities in the mineral-rich east. Thousands of people have been killed. Peace efforts led by the United States and Qatar continue.

MSF said it has treated at least 1,000 children for measles this year in Kachehembe alone, and 11 have died.

Its vaccination campaign targets children under 5. Such campaigns are challenged by mass displacement in eastern Congo as attacks by multiple rebel groups continue.

“The area is experiencing a constant influx of displaced families, which is increasing demand,” Dr. Toussaint Selemani, medical director of the measles response at MSF, told The Associated Press.

In a nearby hospital, Selemani said 53 children were being treated for measles.

Sarah Noëlla, 37, watched her 2-year-old son Fariji Jacques, who she said came down with a fever last week. His eyes turned red, and specks appeared around his mouth.

“I thought it was the flu,” Noëlla said.

Other mothers recounted a rapid deterioration in their children. Without financial resources, they said they depend on MSF’s help.

“We are living in a war zone, we have nothing,” said Irène Shashire, 21, a mother of two.