Health workers face violence and mistrust in battle to stop Ebola
Kavu Mate was in bed at an Ebola treatment centre in Butembo, a scrubby town in the east of the Democratic Republic of the Congo (DRC), when rebels burnt it down.
At dusk on Feb 27, a group of men wielding machetes and guns charged into the centre. Mrs Mate woke up to the sound of gunfire but was hooked up to a drip and too weak to move. “I heard someone shouting, ‘bring the matches’,” she says, “and then I felt the heat of the fire from my bed.”
Luckily the tents where the confirmed Ebola patients stay were spared, but the pharmacy, hand washing station, archive room and four cars were set alight. Nurses crept past smouldering heaps of rubble an hour later to rescue Mrs Mate.
It is just one of a string of attacks on Ebola centres in the DRC’S embattled North Kivu province in the past month. Since Aug 1, the outbreak of the disease has been slowly seeping through the country’s most volatile region, which has grappled with conflict for more than 20 years and is home to 120 armed groups.
A new vaccine has significantly slowed the spread of the disease, now the largest outbreak after the West African epidemic that killed more than 11,000 people from 2013 to 2016.
“If it weren’t for the vaccine, the disease could have killed thousands by now,” says Dr Oly Ilunga, the DRC’S minister of health.
Together with the World Health Organisation (WHO), the ministry has inoculated more than 80,000 people. Still, the death toll is at 610 and rising.
Battling a contagious and deadly virus in a conflict zone is no easy task. Ebola is spread through bodily fluids and corpses can be highly infectious.
Tracing the contacts of patients is crucial, but some villages in rebel strongholds are virtually impossible to get into. “There is today a health zone called Vuhovi,” says Dr William Perea, the incident manager for WHO. “We are having huge troubles to access it.”
Research for Médecins Sans Frontières (MSF) found 43 per cent of patients did not have known links to other cases, showing how it has often been impossible to follow the spread of the infection. MSF was co-running two treatment centres but pulled out of Butembo after the attacks, which have been blamed on Mai Mai rebels
– a blanket term for many of the armed groups in the area. Health workers have also been attacked.
“They hit me with wooden sticks and they broke the car,” says Gilene Barati, an epidemiologist for WHO, tugging at her shirt to reveal a long cut. Her team had travelled to a village to trace contacts of a patient.
After decades of violence, it is hardly surprising that the people of Butembo do not trust the authorities. When health teams turn up with police escorts, people are wary.
“For one ill person, 10 cars come with the police and people in masks,” says mechanic Alexis Kassererka, lingering outside his garage. A friend suggests that the government has spread the disease, a theory that seems far fetched until he adds that his people have been massacred for years. Grace Mupepe, bouncing her newborn child on her knee outside her house, has another theory: “Ebola is a game bought by white people to make money from us.”
Others believe Ebola was imported to prevent them from voting in last December’s presidential election.
In such a difficult region, getting the communities on board is the only way to solve the Ebola crisis. “We need to really be able to join hands and work together on this,” says Dr Perea.