Every day, community health worker Gédéon Banga Ngbape sets out with his team across the towns and villages of eastern Congo, searching for anyone who may have crossed paths with the country’s fastest-growing Ebola outbreak on record. By the time he returns home, it is often close to midnight.
The work is relentless, and it is not enough. Health officials say the surveillance system meant to contain the outbreak is falling behind the virus itself. Between 60 and 70 percent of new Ebola cases are now being found among people who were never flagged as contacts in the first place, meaning infections are often discovered only after patients have already fallen ill and had chances to pass the disease to others.
“If surveillance does not work well, the entire response suffers,” Ngbape said. “Surveillance is the engine of a response.”
The toll has been staggering. More than 4,700 Ebola cases have been recorded, and over 2,200 people have died, according to the latest figures from Congo’s government. That death count has been reached nearly three times faster than during the 2014-16 Ebola epidemic in West Africa, which was the deadliest in history and claimed more than 11,000 lives.
“We are chasing the virus; the virus is ahead of us,” said Dr. Mohamed Yakub Janabi, the World Health Organization’s regional director for Africa, earlier this week. In response, the United Nations’ humanitarian chief, Tom Fletcher, announced an additional $30.5 million in emergency funding to support the fight against Ebola.
In Nizi, one of the hardest-hit health zones in Ituri province, Ngbape’s surveillance teams field between 60 and 70 alerts a day. They track down suspected infections, follow up with anyone who has had contact with confirmed or suspected patients, and steer those with symptoms toward treatment centers. Ituri province alone accounts for roughly 90 percent of Congo’s Ebola cases and 80 percent of its deaths.
“I leave in the morning at 8 a.m. and return around 11 p.m., sometimes midnight,” Ngbape said. “I feel really tired, but what matters to me is always being of service to the community.”
Workers going door to door face dangers of their own, and often without adequate protection. Ana Ndroy Kasime, a community health worker in Nizi, said she and her colleagues frequently lack boots, disinfectant and other basic supplies despite the risks of their work.
“When we go door to door, we don’t have protective equipment, like boots, disinfectant and other supplies, even though we are at risk,” Kasime said. “We buy disinfectant with our own money.”
Complicating matters further, the outbreak is caused by the rare Bundibugyo strain of Ebola, for which no vaccine or treatment has yet been approved, though trials are underway. The response has also been hampered by strikes among unpaid health workers, threats from armed groups, lingering mistrust in communities scarred by past crises, and misinformation claiming Ebola does not exist. On Thursday, staff at the Nizi Treatment Center went on strike and the facility temporarily shut its doors, with workers saying they had gone unpaid for more than three months.
Jean Kaseya, head of the Africa Centers for Disease Control and Prevention, has urged Congo’s government to release the overdue salaries, saying the funds are available. Officials say delays stem from efforts to clean up payroll lists and shift to mobile payments.
Despite it all, Ngbape said he has no plans to stop. “I am here to save the lives of the population,” he said. This shows that he is keen on protecting public health, fighting the Ebola outbreak, and serving his community despite severe exhaustion and challenging conditions.
