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A recent increase in the number of Ebola cases in the geopolitically contested regions of the Democratic Republic of Congo has caused great concern over the possibility of its spread. According to the figures released by the World Health Organization (WHO) on October 12th, 165 confirmed and 35 probable cases of Ebola were registered since the outbreak began on August 1st. According to the CBC, the rate of new cases (both confirmed and suspected) has doubled over the past month, indicating that the virus is spreading. This includes the city of Beni, home to 1.3 million people and seen as the epicentre of this outbreak.
Beni is located in the North Kivu province along the borders of Rwanda and Uganda. According to the UN, more than 100 armed groups have been in conflict with the Congolese army in the region. According to Aljazeera, this is one of a series of cyclical conflicts in the region over the past 23 years, with rebel groups arising in response to government and rebel fighting. In 2018, half a million people fled from their homes due to the violence.
Such conditions create new complications for health care workers attempting to contain the Ebola virus, as the nature of violent conflict hinders relief efforts. The WHO believes that there are a far greater number of cases than those confirmed. Furthermore, there have been at least 32 incidents of “community refusals” since the beginning of the outbreak. During one such refusal, an infected body was seized by an angry mob, injuring two red cross burial team workers in the process. Commentary from The International Federation of Red Cross and Red Crescent Societies (IFRC) assured that they would minimize risk to volunteers, however IFRC Secretary-General Elhadj As Sy has confirmed that the organization would not provide armed escorts to volunteers. These threats to health care workers have made other aid organizations hesitant to join in the efforts.
Michelle Gayer, Senior Director of Emergency Health at the International Rescue Committee commented on the situation:
“We are operating within a highly volatile environment where the security situation continues to deteriorate, threatening the lives and livelihoods of the community and disrupting the response… Teams are not able to trace the contacts of patients, vaccinate those in need and ensure safe burial practices. We are at a critical moment in the response and our teams are highly concerned that the number of new cases could continue to escalate. It’s vital that over the coming days, organizations continue to work alongside the local community to strengthen the relationship and work to increase access to people in need.”
The situation in Congo epitomizes the effects of conflict on a population – existing not only as a threat in and of itself, but posing danger as a state of being. The threat of conflict has exasperated an already volatile situation, as potential carriers expose others to the violence. While pestilence has always been entwined with war, the logistic mess resulting from violent combat has never be so apparent as in these current circumstances.
More shocking however, is the threat to healthcare volunteers. While the position of the IFRC Secretary-General seems negligent, the lack of further support to workers is understandable considering the situation at hand. Health care workers should be given the resources to operate as they feel necessary in order to minimize collateral harm, but the mistrust of others makes this a dangerous proposal. Armed escorts may only cause more harm, as the volunteers may be mistook as a potential threat. Healthcare workers need to establish rapport with the citizens, but the time necessary to do so in these critical virus-fighting periods leaves very few options.
At the end of the day, the consequences are borne by the civilians, not the parties at war. One can only hope that a détente will be reached between rebel and government groups, allowing healthcare workers to provide the necessary support.