In eastern Congo, Vanny Birungi, a Red Cross volunteer, faces a perilous dual threat as she works to raise awareness about the latest Ebola outbreak.
With suspected cases nearing 1,000, she confronts not only the rare Bundibugyo strain of the virus, for which there is no vaccine or treatment, but also the anger and suspicion of residents who have subjected her to stone-pelting and verbal abuse in Bunia, the epicentre of the outbreak.
"We continue to tell them that the disease is out there. Some accept, and others don’t," Birungi told The Associated Press, speaking from a working-class neighbourhood where she and her colleagues engaged with groups under the scorching sun.
Aid workers operate in a region long plagued by armed groups, where thousands have been killed and many more displaced, fostering deep distrust among a traumatised population wary of outsiders. This suspicion is compounded by weakened disease surveillance, attributed in part to US and other aid cuts.
Pierre Basola, a 56-year-old Bunia resident, declared: "These people should stop bothering us. They just want to get rich. Let’s not forget that Ebola is a white man’s invention," before adding, "Stop talking to me anyway."
This sentiment fuels a dangerous environment for those attempting to contain the rapidly spreading disease, which experts believe was discovered weeks too late.
The escalating crisis has seen healthcare facilities repeatedly targeted. In the past week alone, three attacks have occurred. On Sunday, angry young men stormed a hospital treating Ebola patients, forcing medical staff to evacuate amid gunfire.
The day before, a Doctors Without Borders tent for suspected and confirmed cases in Mongbwalu was set ablaze by residents, leading to the escape of over a dozen suspected patients. A centre in Rwampara was also burned after relatives were prevented from retrieving the body of a man suspected to have died from Ebola.
This anger is amplified by virus prevention practices that prohibit loved ones from handling bodies during final rites, following an illness some describe as sudden and dramatic, marked by vomiting and bleeding.
The Ebola virus spreads through close contact with bodily fluids of sick or deceased patients, making healthcare workers and family carers the most vulnerable.
"Trust is almost as important as the health response, because if you get this massive distrust in the communities, they’re not going to go to the health centers," explained Heather Kerr, country director for the International Rescue Committee in Congo.
Travel between Bunia, the capital of Ituri province, and Mongbwalu carries the risk of attacks in a region over 1,000 kilometres from Congo’s capital, Kinshasa.
Meanwhile, the outbreak now accounts for over 900 suspected cases and more than 220 suspected deaths, according to Tedros Adhanom Ghebreyesus, director general of the World Health Organisation (WHO), who stated on Monday: "We are now playing catch-up with a very fast-moving epidemic."
The fear among residents is profound. Mado Nditamba, a 70-year-old Bunia resident, recounted seeing students fleeing from aid workers.
"The last time Ebola came, it was not on the scale that we see today," she said. "But this epidemic today is worse. We go to the doctors in the hospitals, but they also die. That’s what worries us. We don’t know what to do and we leave everything to God."
Despite Congo’s 17 previous Ebola outbreaks and the WHO’s assessment of the country’s response capacity, early tests in this outbreak were conducted for a more common type of Ebola, costing valuable time. Experts are still trying to pinpoint the outbreak’s origin.
Testing for the Bundibugyo type is limited in a region where clinics rely on generators and a major airport, a humanitarian hub, has been under rebel control for over a year. Health workers on the ground report being underprepared and underprotected, with an unknown number infected and some having died.
A Congolese doctor was reported dead on Sunday in Rwampara, according to Rubens Dhedgia, coordinator of the Ebola response in the region. In neighbouring Uganda, where a smaller number of cases have emerged after Congolese travellers, at least three health workers have been infected.
Most alarmingly, the International Federation of Red Cross and Red Crescent Societies believes three volunteers died in Mongbwalu after handling bodies on 27 March during work unrelated to Ebola.
If confirmed, this would significantly push back the outbreak’s timeline from the first confirmed death in late April in Bunia. Even as funeral homes prepare coffins, a lack of trust persists among some residents who deny the virus’s existence.
Action Aid, another humanitarian group, reported high levels of scepticism and misunderstanding among residents questioned in Ituri province in mid-May. "The only way to go, as far as this particular virus is concerned, is community engagement," said Yakubu Mohammed Saani, Action Aid’s country director in Congo.
How this will be rapidly improved remains unclear, as both the WHO and Africa Centers for Disease Control and Prevention believe the outbreak is larger than currently reported.
