Fight against Ebola in DR Congo hindered by wary local communities
Issued on: Modified:
Health workers fighting the Ebola outbreak in the northeast of the Democratic Republic of Congo are being targeted by local communities in the towns of Beni and Butembo, in the province of North Kivu. The region has been in the grip of armed conflict for years. Our Observers say that the local populations’ hostility towards health workers is due to trauma from the conflict and the historical use of Ebola as a tool for political gains.
For the first time since the Ebola virus was discovered in 1976, health organisations are dealing with a severe epidemic in the heart of a conflict zone. Since the beginning of August 2018, 181 confirmed cases of Ebola have been recorded, and 139 people have died from the virus in the area of Beni, a densely populated area that is also home to a number of armed groups. In this dangerous context, the fight against the virus becomes even more difficult.
In a press release published October 17, the World Health Organisation reported eight “major security incidents” complicating the work of response teams on the ground in Beni over the last two months. On September 22, an attack attributed to Ugandan rebels from the Allied Democratic Forces killed at least 18 people and resulted in the health authorities temporarily suspending their anti-Ebola missions for several days.
>> READ ON THE OBSERVERS: Deadly attacks in DR Congo: 'The army always comes too late'
The World Health Organisation has also highlighted the problem of community mistrust leading to attacks on medical teams in Beni and Butembo – scenes which have been captured in images published on social media.
In Butembo, four photos shared on October 4 by the Red Cross of the Democratic Republic of Congo show injured volunteers. In a caption, the Red Cross explains that the workers were attacked while they were carrying out a “dignified and safe burial of an Ebola victim”.
Des volontaires de la Croix-Rouge blessés lors de l'enterrement digne et sécurisé d’une victime d'Ebola en RD Congo alors qu'ils effectuaient un enterrement digne et sécurisé dans la ville de Butembo au Nord-Est de la République Démocratique du Congo (RDC) pic.twitter.com/tSdjkb3U9eCroix-Rouge/RDC (@crrdc1) 4 octobre 2018
"When someone dies from Ebola, their body is really contagious so there are certain precautions that have to be taken when they are buried"
According to Doctor Jacques Katshishi, operations coordinator for the Red Cross Ebola missions in Beni, this incident on October 3 happened as a result of ignorance about the safety measures that need to be taken when someone contaminated with Ebola dies.
"When a person dies from Ebola, the body is very contagious: there are certain precautions that have to be taken when they are buried. The volunteers who deal with the burial have to wear a safety outfit with gloves, and the body is placed in a body bag, which is then put in the coffin. [Editor’s note: Since the epidemic began, more than 180 Red Cross volunteers, specially trained in ‘dignified and safe burials’, have buried more than 162 bodies in the province of North Kivu].
We had an initial consultation with the family of the woman who died in order to explain the protocol to them. Everything went as planned until the three volunteers dealing with the burial arrived in the cemetery in Butembo Ngesse neighbourhood, and found a group of people there demanding to see whether the body was actually in the body bag. The volunteers refused to open the coffin, and were violently beaten by several people. Two of the volunteers were badly injured and had to go to hospital."
A few days later, a similar incident happened in Beni, in the Mulekera district. In a series of photos shared in WhatsApp groups (and on a Facebook page covering Butembo news on October 9 – see below), one can see a crowd of people gathered around a coffin. In one of the photos, a man and a woman are opening the coffin. Two other photos show a woman – a relative of the deceased person – lying on the ground next to the opened coffin.
Germain Hassan Kyawere, a resident of Beni and freelance journalist, went to the scene when he heard what was happening. He says that the locals wanted to check that the body was still there.
"People from the neighbourhood of Ngongolio were angry after a young man contaminated with Ebola died. When the volunteers came to carry out the funeral, locals barricaded the road and wouldn’t let their vehicle pass. They stole the coffin in order to open it and check that it wasn’t empty. The health workers fled, and the police arrived soon afterwards to deal with the situation, but the family had already done the funeral by then.
The medical teams were suspected of having dismembered the body or of having disposed of it elsewhere. These kinds of rumours are very common because the population is still traumatised by the years of conflict here and so are extremely mistrustful. A funeral regulated by health and safety regulations is very difficult for some families to deal with, as they want to bury their loved ones in the traditional way, which means touching the corpse to say goodbye before closing the coffin again.
Faced with this situation, Doctor Bathe Ndjoloko, the director general of the fight against the virus and coordinator of the Ministry of Health’s response to the epidemic, called the mayor of Beni to discuss what was rapidly becoming an unmanageable situation. Two days later, the group of people who had stolen the coffin apologised to the health workers. They also had to get vaccinated because they had been exposed to the virus.”
"Local communities don’t know the health teams, and they don’t always speak the same language"
Our Observer Umbo Salama, a journalist in Butembo, told the FRANCE 24 Observers that other incidents had taken place in Beni and Butembo, events which hadn’t been documented on social media. He says that the spread of rumours and the importance of tradition aren’t the only possible explanations for the locals’ resistance. He says that there have also been mistakes in communication on the part of the health NGOs, and even cases of the epidemic being used as a tool for political ends.
There have been other incidents during the funerals of other Ebola victims in Butembo. Every time there is the same rumour: that Ebola is an illness invented by international organisations in order to make money. There are also rumours that the vaccines are manufactured in order to exterminate the population. I personally saw a scene of total panic in a school where the children thought they were going to be forcibly vaccinated, when in fact it was just a health team who had come to speak to the students and raise awareness about the virus. [Editor’s note: Similar rumours also circulated in Beni, leading the health minister to post a public refutation of the rumours (see below)].
⛔️STOP RUMEURS⛔️Ministère de la Santé RDC (@MinSanteRDC) 17 septembre 2018
Il n'y a aucune vaccination forcée des enfants à #Beni sans le consentement ferme et éclairé de leur parent. La #vaccination reste la meilleure prévention contre #Ebola.
???????? Soyons responsables & évitons de diffuser des rumeurs sur les réseaux sociaux pic.twitter.com/Tc5Oez9g8K
Translation: “STOP RUMOURS. There is no forced vaccination of children in Beni without the informed consent of their parents. Vaccination is still the best prevention against Ebola. Let’s be responsible and stop spreading rumours on social media.”
I don’t think there has been enough education about how the vaccination works, and that mistakes were made at the beginning in not involving representatives from the local communities [notably traditional healers, who are usually the first people locals go to when they are ill]. What’s more, the health workers who carry out vaccinations and fight against Ebola usually don’t come from the region themselves, and so are strangers to the local communities. They don’t speak the same language as the communities in Beni and Butembo. There are also politicians who have taken advantage of the situation to stoke fears and uncertainties.
Ebola and local politics
In a press release published on September 26, the World Health Organisation drew attention to this politicisation of the illness. “Some families have chosen to care for sick relatives at home, often because they have been misinformed, and because a natural fear of the disease is now being exploited by local politicians,” the release says.
At a press conference in late August, Butembo MP Crispin Mbindule Mitono described Ebola as a new “murderous force” targeting the residents of Beni and Butembo. “Scientifically, I don’t think it’s possible to have people in Beni being murdered, and now [Ebola], without [the two] being linked,” he said in Kiswahili, according to a blog article by journalist Merveille Kakule Saliboko.
The MP’s words were quickly criticised by rival policiticans, and with only a few months to go until general elections (presidential, legislative and provincial elections are set to take place on December 23), they called on the public not to re-elect him.
The FRANCE 24 Observers team contacted Mbindule Mitono, who said that his words had been “misinterpreted” by “political opponents” and that he does not deny the existence of the Ebola disease.
Other politicians are working to raise awareness about the virus. The governor of the province of North Kivu got vaccinated on October 3 “to set an example”.
EBOLA : comme tout citoyen, je viens d’être vacciné contre le virus EBOLA à Butembo, deuxième ville du Nord-Kivu. Appel est lancé à toute la population de se mobiliser pour observer les orientations faites par les professionnels de la santé. #EBOLA est très dangereux et tue. pic.twitter.com/75jE1H5Gz2JULIEN PALUKU (@julienpalukucom) 3 octobre 2018
Translation: “EBOLA: Like any other citizen, I’ve just been vaccinated against the Ebola virus in Butembo, the second city of North Kivu. I call on all the population to come together to follow all of the instructions given by health professionals. #EBOLA is very dangerous and it kills.”
The Democratic Republic of Congo has already experienced nine Ebola epidemics. On October 17, the director of the World Health Organisation struck an optimistic note, saying that this new wave of Ebola in the east of the country could be “under control this year” and that 18,000 people, 4,000 of whom were children, had already been vaccinated since August.