With the world focused on the COVID-19 pandemic, few noticed a milestone in the Democratic Republic of Congo's battle with Ebola - a full month with no new infections. Since August 2018, an Ebola virus outbreak in northeastern Congo had infected more than 3,400 people and killed 2,264.
As Congo now grapples with COVID-19, its troubled experience fighting Ebola highlights the importance of effective communication, community engagement, and comprehensive care, even in the most challenging environments.
The Ebola outbreak most seriously hit the area around Beni territory, an active conflict zone where armed groups have killed more than 1,700 civilians since 2014. The region has a very weak health infrastructure, and access to clean water is scarce. Malaria, measles, cholera, and other diseases claim thousands of lives each year.
In this context, many residents reacted with distrust and suspicion when they saw international aid agencies dedicating immense resources to respond to the Ebola outbreak when much less attention had been paid to other health concerns or the persistent insecurity. At the same time, residents were given new directives about burying the dead and conducting their daily lives to prevent a disease that most had never heard of or experienced. The use of the Congolese army to escort field response teams and allegations of large-scale corruption of resources dedicated to the response effort fueled further suspicions. Months into the outbreak, elections in the region - an opposition stronghold - were postponed, and residents never had the chance to participate in the December 2018 presidential vote.
Misinformation, skepticism about the disease's existence, and speculation about the government's or aid agencies' involvement in the virus spreading made responders the target of violence. Local militia groups and other assailants have carried out 420 attacks on health facilities since the start of the outbreak, resulting in 11 deaths and 86 injuries among health workers and patients. Several organizations and treatment centers suspended activities.
Congo's Ebola outbreak may finally be coming to an end, perhaps due to the use of new experimental vaccines and treatments that slowly seem to have made a difference. But it would likely have been less deadly and ended sooner if more attention had been focused initially on understanding community resistance to the response.
The COVID-19 pandemic poses its own, unique challenges that could threaten people's health, the economy, and social fabric of not just a single territory or region but entire countries. Nevertheless, some lessons can still be drawn from the Ebola experience. Involving locally respected individuals and institutions and communicating in local languages to explain the disease, its prevention, and the response efforts should be central when seeking to contain viruses as contagious and dangerous as Ebola or COVID-19. It's also critical to ensure universal access to health care, clean water, and sanitation. Government authorities should listen to what communities say are their most urgent healthcare needs, and be responsive.
As COVID-19 is likely to spread in the coming days and weeks to areas in Congo and elsewhere with weak healthcare infrastructure, armed group activity, or deep-seated community distrust of government officials and outside interventions, governments and aid partners should heed these lessons. Time is not on their side.