DAKAR, Senegal (AP) — The number of children and women who are survivors of sexual violence in Congo surged over four fold over the first half this year, Save The Children said on Thursday, amid a reduction in humanitarian support following aid cuts.

The charity said it treated 2,702 child and women survivors of sexual violence between January and July, compared with 612 in the same period last year. Some survivors faced unwanted pregnancies, stigma and suicidal thoughts, it said.

Congo’s health ministry has reported a 16% increase in cases of sexual violence to about 73,400 over the same period. Almost one-third involved girls aged under 16, it said.

The decades-long conflict in the central African nation of Congo escalated in January, when the M23 rebels advanced and seized the strategic eastern Congolese city of Goma, followed by the town of Bukavu in February. The fighting has killed some 3,000 people, raised the fears of a wider regional war, and created one of the world’s most significant humanitarian crises.

The findings from Save The Children echoed similar statements from the U.N. Earlier this year, the U.N. children’s agency said that children made up between 35% to 45% of the nearly 10,000 cases of rape and sexual violence reported in Congo in January and February this year.

Sexual violence in Congo is used as “a weapon of war and a deliberate tactic of terror,” James Elder, the head of the UNICEF said earlier this year.

Aid cuts from the United States and Europe have curtailed the ability of humanitarian agencies to help the thousands of survivors of gender-based violence, who would normally receive items including sanitary pads and soap.

With 7 million people displaced in Congo, the U.N. has called the conflict in eastern Congo “one of the most protracted, complex, serious humanitarian crises on Earth.”

The United States and others have been trying to achieve a permanent ceasefire since fighting between M23 and Congolese forces escalated.

The Congolese and Rwandan foreign ministers signed a peace deal at the White House in July. But M23 was not directly involved in the negotiations and said it could not abide by the terms of the agreement.

The final step was meant to be a separate deal between Congo and M23, facilitated by the Gulf state of Qatar, that would bring about a permanent ceasefire. However, a deadline for the deal was missed and there have been no public signs of talks between Congo and M23 on the final terms.