International aid organizations are warning that the Ebola outbreak in DR Congo could worsen in the face of instability, public distrust and a critical shortfall in funds to contain the deadly virus.
Over 1,000 people have died of the highly contagious hemorrhagic fever since the outbreak was declared in August 2018. Treatment facilities and health workers have come under frequent attack by militia groups in the region, where local people are unwilling to accept help.
The World Health Organization (WHO) has warned that the Ebola outbreak is "unlikely" to be contained in North Kivu and Ituri unless the militias are stopped. The two provinces are adjacent to the borders with Uganda and Rwanda.
The Red Cross has also warned it could be forced to cut its work in the affected area due to critical underfunding. The organization said it received less than half of the $31.2 million (€28 million) it requested to fund its response in the DRC and neighboring Burundi, Rwanda, Uganda and South Sudan.
"The scale and quality of activities that will be performed by Red Cross volunteers will dramatically diminish within the next two weeks unless funding is provided," Emanuele Capobianco, health director of the International Federation of the Red Cross, said on May 16, 2019.
Despite the massive international response in the region so far, 1,147 of the 1,600 people infected with Ebola have died, according to WHO. Sixty-eight percent of the deaths were recorded outside of the treatment centers that the agency established in the region.
Attacks on medical staff and the treatment and transit centers dealing with suspected Ebola cases are making work harder. "We work for two days, then there's a new attack and the colleagues from the Ebola teams have to stay home for five days. Meanwhile, our main enemy – the Ebola virus – is left out there," Dr Aruna Abedi, the Ebola treatment coordinator for the health ministry told DW.
"When we cannot work for five days, the virus has an advantage. The illness gets ahead and we have to catch up on the time lost. It's a really tough fight."
Militias targeting helpers
An Ebola transit center in Katwa in North Kivu was torched recently. In April, a WHO doctor was killed in an attack. Aid organizations usually temporarily suspend operations in the wake of such attacks and put tighter security measures in place. In these instances, the number of new infections inevitably rises.
Dr Babou Rukengeza is the team leader of the Save the Children charity, which has been assisting in volatile North Kivu. In an interview with DW, Rukengeza said the work of doctors is being hindered by ongoing demonstrations and rioting, particularly in the city of Beni.
"With this unrest there are obstacles to our work, as well as delays," he told DW. Under the circumstances, it is no wonder that the number of Ebola cases in the region continues to rise. "We can get a good handle on the Ebola problem if we are allowed to do our work."
In a bid to contain the outbreak, some 110,000 people have been given an experimental Ebola vaccine. The WHO has recommended wider implementation of the program, saying it is saving lives.
Superstition beats conventional medicine
Public distrust in those at the forefront of the medical intervention and the government is high. The medications used for Ebola are also looked on with suspicion. Misinformation and rumors have been doing the rounds that the drugs being administered to patients in the transit centers cause infertility or even death. Doctors and aid agencies are seen as intruders who are using the virus to make money. In turn, others cast doubt on whether Ebola even exists or whether it was manufactured or introduced by demons from elsewhere.
"Many people give false information that is more readily believed than correct information. That has consequences. As you know, even politicians have disseminated misinformation, saying that Ebola does not exist and other statements such as 'it is all made up.' Sometimes it is that someone was poisoned, sometimes something else, or it is magic," Dr Aruna Abedi explained.
The reality, however, is that Ebola keeps claiming more lives and spreading among the population. Another big problem: The corpses are highly contagious. Relatives of the dead are not easily convinced to refrain from touching them - behavior which carries a high risk of infection, says Abedi.
"We repeatedly call for adherence to hygiene measures, we call on those with symptoms to seek help and for people not to touch the dead. But acceptance comes hard to people. Denying the illness comes with great danger. There is a saying that the people will perish due to ignorance. That is why we try to combat this ignorance with the community."
Liberia was the worst affected country in West Africa's 2014-2016 Ebola epidemic, followed by Sierra Leone and Guinea
Involving traditional leaders
Medical teams deployed in the crisis zone now want to boost the involvement of traditional village leaders to fight Ebola. King Mfumu Difima, one of the reigning traditional monarchs in DR Congo, noted in an interview with DW that it is really hard to fight prejudice. "We want to make our contribution in convincing people to undergo treatment at the official treatment centers. We also tell them they should report all cases to the authorities, but we are fighting against huge resistance."
In the affected regions especially, rabble-rousers tried to convince people that Ebola was a mere excuse to postpone the general election of December 30, 2018, saying it was a trick to prevent them from exercising their right to vote. Days before the key vote, the electoral commission announced a postponement in the constituencies of Beni and Butembo due to the epidemic.
The eastern DRC voted in a general election on March 31, three months after the rest of the country due to the Ebola outbreak
People infected with Ebola are repeatedly being advised not to trust official health services but to consult traditional healers – who are often charlatans, according to King Mfumu Difima.
The outbreak in eastern DR Congo is the second deadliest since the West African Ebola outbreak of 2014, which led to an epidemic that claimed more than 11,000 lives. For the DR Congo, this is the tenth recorded outbreak. Previous outbreaks occurred in peaceful regions and could be contained relatively quickly.
John Kanyunyu and Wendy Bashi contritubed to this article.