Ebola Outbreak in Congo Worsened by Public Mistrust of Healthcare System
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Ebola Outbreak in Congo Worsened by Public Mistrust of Healthcare System

The Ebola outbreak, caused by the Bundibugyo virus, was officially confirmed on May 15th, although it had been circulating for several weeks or even months. In the gold-mining town of Mongbavu, local authorities estimate that over 80 people died before anyone raised the alarm. Since there is no approved vaccine or treatment for this strain, the response is primarily based on behavioral measures: reporting cases, isolating patients, and safely burying the deceased.

Misinformation directly undermines these measures. According to ActionAid, nearly one in three residents in the Ituri epicenter do not believe Ebola is real. Patients either delay seeking care or do not come at all. Crowds have invaded treatment centers, refusing to accept a relative's death from the disease, which allows suspected patients to flee. Last Saturday, a nurse was killed while responding to an alert in the Tchopo province.

The World Health Organization (WHO), through its Director-General Tedros Adhanom Ghebreyesus, warned that disinformation is 'almost as dangerous as the virus itself.'

It is easy to dismiss these beliefs as ignorance, but available data suggests otherwise. A survey conducted by the journal Lancet Infectious Diseases among 961 adult residents of Beni and Butembo during the 2018 outbreak showed that more than a quarter of respondents believed Ebola did not exist. One third believed the disease was invented for money, and 36 percent thought it was intended to destabilize the region. People holding such views were less likely to seek medical help or agree to vaccination.

Between August 2018 and November 2019, researchers recorded 386 attacks on healthcare workers and facilities in Congo, resulting in seven deaths. Eight years later, the same theories have resurfaced, now mixed with mineral interests. These beliefs are not random fantasies; they represent conclusions drawn by people in a region neglected by Kinshasa, affected by armed groups, and visited for decades by outsiders arriving with vehicles and promises, only to leave.

Studies conducted during the previous outbreak revealed resistance due to poor care in treatment centers, the cancellation of traditional burials, and distrust of foreigners who seemed to profit from the crisis. When a family is notified of a relative's death and the body is removed in a sealed manner, rumors fill the silence.

Last year provided a contrasting example. The outbreak in the Kasai province led to 64 cases and 45 deaths, after which it was declared over on December 1, 2025. Authorities implemented a community protection plan alongside the medical response, deploying engagement teams to communicate with residents, and over 35,000 people were vaccinated.

The author does not claim this proves everything. The strain circulating in Kasai was one for which a vaccine had been developed, and there was no armed conflict plaguing Ituri. Nevertheless, the comparison offers certain lessons. A response that includes a vaccine offers people something in return for cooperation. The current situation largely demands sacrifice: isolation, abandonment of rituals, and obedience to a stranger. Without a vaccine, trust becomes the main tool, and it is being squandered.

The stakes here are not abstract. This outbreak has already exceeded one-third of the 28,652 cases registered in the West Africa epidemic from 2014 to 2016, which claimed 11,325 lives.

Leaflets and radio spots will not solve this problem. Four changes are necessary. First, timely payment of staff salaries. Last week, monitoring and community outreach staff in the Nia Nia health zone announced a strike over unpaid bonuses dating back to late August. A healthcare worker who is not paid is the best evidence for those who claim money is disappearing.

Second, allowing families to properly bury their dead. Relatives must be present, and rituals must be adapted, not simply banned. Third, highlighting authoritative local voices. Pastors, traditional healers, and survivors are already transmitting accurate information, and they should be allocated funding, not just thanked.

Fourth, funding engagement work as seriously as beds and protective gear. Donors readily pay for isolation wards but are much less willing to pay for slow listening work that encourages people to enter the ward.

Ebola is a virus, but this epidemic is also a debate about whom to trust. Until the response system wins this debate, the virus will continue to win in everything else.

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Skepticism and violence hinder control of Ebola epidemic in the Democratic Republic of Congo
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Skepticism and violence hinder control of Ebola epidemic in the Democratic Republic of Congo

Health experts warned Lusa that local population distrust and a history of violence in eastern Democratic Republic of Congo (DRCongo) are complicating the fight against Ebola, causing the epidemic to advance underreported in official statistics.

Mohamed Yakub Janabi, Regional Director of the World Health Organization (WHO) for Africa, reported that on October 20, DRCongo registered 9,704 confirmed cases and 4,687 deaths, resulting in a mortality rate of 48.3%. However, field perception indicates that the real numbers are considerably higher.

Tomás Bandeira, head of tropical medicine at Médecins Sans Frontières (MSF), warned that available data likely underestimate the reality, allowing the disease to spread 'in the shadows' and indicating that the problem is 'far from being solved.'

The MSF representative reported that many cases do not reach treatment in time, in inaccessible areas, either because communities do not accept the teams or due to security conditions.

The Portuguese doctor explained that the local population showed distrust towards international teams because they had no history of contact with humanitarian organizations and were accustomed to seeking help from foreigners linked to mining or using traditional treatments.

To overcome this lack of trust, which led to attacks on treatment centers, such as occurred in Nyankunde in July, the WHO and its partners intensified work with community leaders, religious figures, traditional medicine practitioners, survivors, and local health agents, as detailed by Mohamed Yakub Janabi.

In Nyankunde, 32 dialogues involving over 1,500 leaders and influential figures were held. This action raised daily community alerts from a peak of 11 to something between 60 and 70 in September, and there have been no new attacks in the area since July.

Similarly, in Mongbwalu, almost six months after MSF's arrival, engagement with local authorities and community leaders helped ensure the treatment center was accepted by the population, leading people to return to the hospital.

Ebola is characterized by being highly contagious, transmitted through direct contact with bodily fluids of infected individuals, including vomit and blood, or by touching contaminated surfaces and materials, such as bedding and clothing.

The epidemic, caused by the Bundibugyo virus—about which clinical uncertainties persist due to a lack of comparative data—is classified by Tomás Bandeira as 'a crisis within a crisis.'

The doctor recalled that the situation in the country, neighboring Angola, occurs in a context of armed conflict, with the presence of various paramilitary groups, which generates high levels of population displacement and concomitant outbreaks of cholera and malaria.

The WHO director stressed that while Ebola requires reliable access to patients and contact tracing, cholera demands potable water, sanitation, and specific vaccination.

Additionally, the Portuguese doctor observed that the exclusive focus on Ebola is diverting attention and resources from vaccination campaigns and the fight against other deadly diseases, such as malaria.

To contain transmission, the WHO regional director advocated for urgent needs, including ensuring safe humanitarian access, securing predictable funding, providing reliable support and payment to frontline professionals, in addition to supplying appropriate supplies and materials.

Kenya Ministry of Health Confirms Ninth Ebola Infection Case
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noticiasaominuto.com

Kenya Ministry of Health Confirms Ninth Ebola Infection Case

Kenya has officially confirmed the ninth case of Ebola virus infection in the country, which first registered the virus on October 6. The ninth confirmed case is a 24-year-old man who is a 'close relative of the first case' and became ill while already in quarantine, according to a statement from the Ministry of Health of this African nation.

The first Ebola case in Kenya was identified the day after the death of a businessman in Nairobi, who had previously been in the Democratic Republic of Congo (DRC), where an Ebola outbreak was declared in May.

Most cases confirmed so far in Kenya are linked to individuals who had close contact with the first victim. The Ministry emphasized that 'all nine cases belong to one cluster of infection, and there is currently no evidence of transmission outside this group.'

With the discovery of each new case, the contact investigation is expanded: out of 135 registered contacts, 134 have been identified and placed in quarantine, the same source reported.

The United States today warned its citizens about travel to Kenya, advising them to 'reconsider' visiting this East African country.

The DRC is facing its 17th Ebola epidemic, which has become the deadliest in the country's history in a few months. Kenya has become the fourth country to record a case linked to the DRC epidemic, joining Uganda, France, and the Netherlands.

The Ebola virus has also spread to Uganda, where the World Health Organization (WHO) announced on August 26 the end of the outbreak after registering 20 confirmed cases, including 15 imported from the DRC, and two deaths.

The epidemic in the DRC is the second deadliest in world history, causing 9277 confirmed cases, including 4478 deaths, according to the latest report from the Congolese government.

Ebola is highly contagious and is transmitted through direct contact with the bodily fluids of an infected person, such as blood and vomit, or through contact with contaminated materials and surfaces, such as bedding and clothing.

African Union offers technical and logistical support to Kenya due to increase in Ebola cases
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noticiasaominuto.com

African Union offers technical and logistical support to Kenya due to increase in Ebola cases

The African Union's public health agency announced the dispatch of technical and logistical assistance to strengthen Kenya's response to the Ebola outbreak, following the confirmation of four new cases. With these new records, the total number of infections in Kenya has reached seven, one of which was imported from the Democratic Republic of Congo (DRC).

In a statement released this Saturday, the Africa Centres for Disease Control and Prevention (Africa CDC) reported that they are collaborating with the Kenyan government on crucial aspects of the emergency. The focus is on epidemiological surveillance, technical coordination, risk communication, and community engagement.

The continental health body emphasized the urgency of providing protective equipment to healthcare professionals working on the front lines. This is because three of the four new infected individuals were healthcare workers who provided assistance to the individual classified as 'patient zero' in the hospital.

Africa CDC stressed the importance of intensifying infection prevention and control measures, ensuring healthcare workers have 'adequate protective equipment, training, and continuous support.' Given the progression of the epidemic in the DRC, the origin of the first case detected in Kenya, the organization reaffirmed its commitment to intensifying cross-border surveillance and early detection among member states, aiming to contain viral spread regionally.

For its part, the Kenyan Ministry of Health stated in a document that the risk to the general population remains low, as there are 'no evidence of community transmission of the disease.' It was noted that out of the 130 people who came into contact with 'patient zero,' 128 (98.5%) were traced and quarantined, exceeding the global target of 85% for contact tracing, which is essential to interrupt the chain of transmission.

Kenya had confirmed its first imported Ebola case on October 5: a 40-year-old man who had resided in the DRC for the past seven years. This 'patient zero' received treatment in several Congolese hospitals before traveling overland to Kampala and subsequently flying from Uganda to Nairobi, arriving on October 3 and dying two days later. Since then, health authorities have initiated contact tracing to locate individuals potentially exposed to the virus during the patient's travel and treatment.

Kenya became the fourth country to report a case related to the Ebola epidemic in the DRC, joining Uganda, France, and the Netherlands. Furthermore, Ebola also spread to Uganda, where the World Health Organization (WHO) declared the end of the outbreak on August 26, after accounting for 20 confirmed cases, including 15 imported from the DRC, and two deaths.

The epidemic in the DRC is cited as the second deadliest in world history, having caused 9,277 confirmed cases, including 4,478 deaths, according to the latest report from the Congolese government.

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