A Medecins Sans Frontieres (MSF) medical team working with local staff operate to remove bullets from the leg of a wounded female patient at Virunga Hospital. On 20 November 2012 a force, mainly made up of disaffected Tutsi soldiers (calling themselves M23) who deserted from the Congolese Army earlier in the year, marched into Goma causing many of its panicked inhabitants and the Government Army to flee. Staff at the hospital have been overwhelmed by many civilians caught in the crossfire.