Ten civilians have been killed in a recent attack in the DRC’s Eastern Province. According to the Kivu security tracker, which tracks ongoing clashes in the region, the rebel group the Allied Democratic Front (ADF) were responsible for the deaths alongside the kidnapping of 21 other victims in a village raid on the 5^th November. The attacks come less than a week after the DRC launched a large-scale offensive, primarily targeting the ADF who have been responsible for hundreds and thousands of deaths in the region.  The attacks emerge in the background of the ongoing Ebola outbreak in the region, threatening public health efforts to contain the virus.

Commencing in August 2018, the current outbreak is the second deadliest after the 2014-2016 Ebola crisis in West Africa. According to WHO’s latest statistics, there have been 3167 confirmed cases of the virus with 2191 deaths. Despite recent reductions in the number of cases of the virus, with only 15 new cases reported in the last week, the situation still remains fragile. WHO says the virus should still be classified as a ‘global health emergency’ due to the high risk of a resurgence of the virus. They have reported a shift in the concentration of the virus from urban centres to more rural, hard to reach areas, which are more vulnerable to violent clashes. This poses difficult challenges for health workers trying to access affected populations. Delays in responses can generate mistrust and miscommunication between community health workers and local populations, further hampering relief efforts.

The Ebola outbreak is closely intertwined with the conflict situation. A special report published in the NRHM found that major violent events were linked to upsurges of the virus, such as the February 2019 attacks on Ebola centres. Attacks on healthcare facilities result in not only reduced operational capacity but also reduces the likelihood of infected patients seeking care due to fear of future attacks. Health workers have been direct targets of the violence, with local health worker Papy Mumbere Mahamba murdered in a home invasion last month. The deliberate violence against health workers is making it extremely difficult and increasingly unsafe to work in high-risk areas. The protection of healthcare workers and facilities in conflict-inflicted areas is a requirement of international humanitarian law governing conduct between warring parties. In the landscape of the Ebola outbreak, the protection of these sites as ‘safe’ zones is even more vital to reduce the spread of infection.

Violence in the DRC has been ongoing between armed groups following the official end to the Second Congo War in 2003. The proliferation of armed groups with over 130 armed actors makes for a highly volatile and complex security situation, largely concentrated in the Eastern Province. According to a recent report published by the Congo Research Group, 1.8 million people were displaced by violence just last year and 12.8 are currently in need of humanitarian assistance. Alongside displacement from the conflict, food insecurity and the health crisis are some of the most pressing concerns the country is facing. Despite the pressing situation, the predicament in the DRC has been labeled as the ‘forgotten humanitarian crisis’, receiving comparatively limited international media attention and aid funding. The UN Secretary-General Antonio Guterres called for efforts to be stepped up to respond to the outbreak in his visit in September.

Even with the tools and resources for preventing the spread of disease, global health protection efforts cannot be achieved without cooperation and trust with communities and an environment conducive to humanitarian relief.  Political will and cooperation of multiple players including the government and armed factions to protect health workers and allow safe access to conflict zones are needed to contain the virus and prevent a resurgence of further outbreaks.