KINSHASA, Congo (AP) — Doctors Without Borders treated more than 25,000 victims of sexual violence in the Congo last year, by far the highest level it has seen there and most of it in the east where armed groups vie for power, the aid group said Monday.

The vast majority of victims — averaging more than two per hour — were treated in displacement camps near Goma. the capital of Congo’s eastern province of North Kivu, the group said.

“According to the testimonies of our patients, two-thirds of them were assaulted at gunpoint,” Christopher Mambula, the group’s program manager in Congo, said in the report.

Eastern Congo has struggled with armed violence as more than 120 armed groups fight for power, land and valuable mineral resources while others try to defend their communities. Some armed groups have been accused of mass killings, rapes and other human rights violations. The violence has displaced some 6 million people in the east.

Congo alleges that neighboring Rwanda has been involved in aggression and war crimes in the region. It also accuses Rwanda of giving military backing to the M23 rebel armed group. Rwanda denies the claim, but in February admitted that it has troops and missile systems in eastern Congo to safeguard its security, pointing to a buildup of Congolese forces near the border.

M23, of the March 23 Movement, is a rebel military group mainly made up of ethnic Tutsis that broke away from the Congolese army just over a decade ago. They staged a large offensive in 2012 and took over the provincial capital of Goma near the border with Rwanda, the same city they are threatening again.

Earlier this week, Human Rights Watch said both Rwanda and Congo’s army have killed displacement camp residents, committed rapes and obstructed aid.

“While the massive presence of armed men in and around displacement sites explains this explosion of sexual violence, the inadequacy of the humanitarian response and the inhumane living conditions in these sites fuel the phenomenon,” Doctors Without Borders said in its report.

High numbers of sexual assaults have also been recorded this year by the charity, which treated more than 17,000 victims between January and May in the North Kivu province alone.

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Banchereau reported from Dakar, Senegal