Complicating Factors in Ebola Fight Include Anger

Arson attacks on Ebola treatment centers in eastern Congo underscore the serious challenges authorities face—including a backlash in affected communities—as they try to stem an outbreak of the infectious disease that has been declared a global health emergency, experts say. The burning last week of the centers in two towns at the heart of the outbreak exposed the anger in a region beset by violence linked to armed rebel groups, the displacement of a large number of people, the failure of local government, and international aid cuts that experts say have stripped health facilities in vulnerable communities, the AP reports. "A devastating set of emergencies are converging," said the Physicians for Human Rights nonprofit.

On Sunday, Congolese authorities announced that suspected Ebola cases have passed 900 in the east of the country. The Ministry of Communication, in a post to X, said there have been 119 suspected deaths. Authorities had previously announced more than 700 suspected Ebola cases, and more than 170 suspected deaths, mostly in Ituri province, where the outbreak is centered. Cases have been reported in two other eastern provinces, North Kivu and South Kivu, where the M23 rebels are in control, and in the neighboring country of Uganda. Efforts complicating the Ebola battle include:

• Persistent violence: Eastern Congo has for years seen attacks by dozens of separate rebel and militant groups, some of them with links to foreign countries or the extremist Islamic State group. The Rwanda-backed M23 rebels are in control of parts of the region. While the Congolese government still largely controls the northeastern Ituri Province, which is the epicenter of the Ebola outbreak, that control is tenuous. The Allied Democratic Forces, a Ugandan Islamist group linked to IS, is one of the dominant rebel groups there and responsible for violent attacks against civilian targets. Before the outbreak, Doctors Without Borders said insecurity in Ituri had worsened recently, causing doctors and nurses to flee overwhelmed health facilities and, in some places, "catastrophic conditions."
• Displacement: The UN humanitarian office says almost a million people have been displaced from their homes in Ituri by conflict. That means this Ebola outbreak is "unfolding in communities already facing insecurity, displacement and fragile health care systems," said Gabriela Arenas, a regional coordinator of relief efforts. The outbreak in Congo is being managed by the government and in part by rebel authorities, with an array of aid agencies helping.

• Aid cuts: Health experts say international aid cuts last year by the US and other rich nations were devastating for eastern Congo because of its multiple problems. The cuts "reduced the capacity to detect and respond to infectious disease outbreaks," said Thomas McHale, public health director at Physicians for Human Rights. Aid groups say they don't have the equipment they need, such as face shields and suits to protect health workers from infection, testing kits, and body bags and other materials needed to safely bury the bodies of victims, which can be highly contagious. "We have made requests to different partners, but we have not yet really received anything," said Julienne Lusenge, of Women's Solidarity for Inclusive Peace and Development, an aid group operating a small hospital near Bunia. "We only have hand sanitizer and a few masks for the nurses."
• Anger: Colin Thomas-Jensen of the Aurora Humanitarian Initiative said the attacks on the two treatment centers may reflect the "built-in skepticism and anger" of people in eastern Congo over how the region has been treated, with years of violence and a failure of their government and international peacekeepers to protect them, he said. Another source of anger has been the strict protocols around the burial of suspected victims of Ebola, which authorities are taking charge of wherever they can to prevent further spread of the disease in traditional burials—when families prepare the bodies and people gather for a funeral. Many Catholics attended Mass in Bunia on Sunday despite a ban on large gatherings, per Deutsche Welle.