Doctors on the front lines of the Ebola outbreak in the Democratic Republic of Congo are facing increasing difficulties as they deal with shortages of basic supplies, attacks on health facilities, and patients fleeing isolation wards while the virus continues to spread rapidly.
At least three such incidents have occurred in the northeastern province of Ituri, where the first cases of the current Bundibugyo Ebola outbreak were reported. Two of the attacks targeted the same hospital over the weekend, resulting in more than two dozen patients escaping.
The attacks are reminiscent of the widespread violence directed at health facilities during the major 2018-2020 Ebola outbreak in eastern Congo, which killed more than 25 health workers. Some of those earlier attacks were carried out by civilians angered by restrictions on burying their loved ones or who believed the outbreak was a hoax. Others were linked to militia groups seeking to exploit the crisis.
A similar dynamic appears to be emerging now, according to Dr Richard Lokodu, medical director of Mongbwalu General Referral Hospital.
“There is denial of the disease within the population, with some members wanting to claim the bodies of suspected and/or confirmed cases,” Lokodu said.
Weekend Attacks at Mongbwalu Hospital
On Saturday, unidentified individuals burned tents erected by Médecins Sans Frontières (Doctors Without Borders) for isolating Ebola patients at Mongbwalu General Referral Hospital. Eighteen patients fled during the chaos. Of four patients later tested, three were negative and one positive for Ebola.
“So we have one confirmed case of Ebola that continues to circulate in the community and evade the response,” Lokodu said.
On Sunday, the hospital came under four waves of attacks by young people mobilized by relatives of a Christian religious leader who had died from Ebola. Seven more patients escaped. Congolese police and soldiers were deployed to restore order.
During the second wave of attacks, a suspected Ebola patient in critical condition with hemorrhaging died while trying to flee from his bed, Lokodu added.
The perpetrators demanded that bodies of Ebola victims be released for traditional burial. Unsafe burials, in which family members handle the body without proper protective equipment, are a leading driver of Ebola transmission.
The World Health Organization has declared the outbreak of the rare Bundibugyo strain of Ebola a public health emergency of international concern. It is the third-largest Ebola outbreak on record.
As of Monday, WHO Director-General Tedros Adhanom Ghebreyesus said there had been more than 900 suspected cases, including 101 confirmed cases, and 220 suspected deaths. He noted that delays in detecting cases meant responders were “playing catch-up.”
Uganda has reported seven confirmed cases so far, including two new ones announced on Monday.
Health workers also faced occasional attacks during the 2013-2016 West Africa Ebola outbreak, but such violence became far more frequent during the 2018-2020 eastern Congo outbreak. In that period, both spontaneous community anger and organized militia attacks targeted Ebola treatment centers in a region long marked by conflict and mistrust of authorities.
The current outbreak is believed to have started in Ituri province before spreading to North and South Kivu provinces including areas under the control of Rwanda-backed M23 rebels and crossing into neighboring Uganda.
