Attacks on Ebola Clinics in Congo Rooted in Deep Mistrust, Fear of Death and Body Bags, Aid Workers Say
Congolese police stood guard at an Ebola treatment center in the Democratic Republic of Congo after it was attacked by local villagers. Efforts are now underway to defuse anger fueled by untrue rumors and mistrust of medical authorities. Dr. Babou Rukengeza, Ebola Response Health Lead for Save the Children in his native Democratic Republic of Congo, described footage he saw on social media of flames and charred bedframes at the facility as shocking.
Community Anger Sparks Multiple Attacks
Community members attacked the treatment center in eastern Democratic Republic of Congo on Thursday, May 21. By the end of the weekend, two other attacks targeted a different medical facility treating Ebola patients. Staff and suspected Ebola patients fled amid the chaos. Rukengeza said he asked himself, "What will be our response?" and concluded, "We have to build trust." The attacks have occurred less than two weeks after the World Health Organization declared the Ebola outbreak a public health emergency of international concern. Rukengeza admitted that while he was shocked, he was not entirely surprised, noting that similar tensions have arisen during past Ebola outbreaks, particularly around the death and burial of patients.
Misinformation and Panic Fuel Violence
Dr. Micaela Serafini, president of Doctors Without Borders Switzerland, has worked on Ebola response since 2007. She recalled when an Ebola treatment center her organization ran in the Democratic Republic of Congo was attacked in 2019. "They believed that everyone that came in [to the clinic] was killed," she said. Because the death rate of Ebola patients was "extremely high," people imagined aid workers were murdering them. Serafini stated that this type of panic, fear, and misinformation fuels tension during a growing outbreak. Currently, rumors on social media in the Democratic Republic of Congo include false claims that Ebola is not real, that humanitarian workers are descending solely for profit, and that aid groups are withholding the best care. Dr. Jean Kaseya, director general of the Africa Centers for Disease Control and Prevention, who is visiting the Democratic Republic of Congo to assist with the Ebola response, said, "They believe that medicines and vaccines exist, but we don't want to give them." He added that his sense is only a minority of the community believes the false information.
Building Trust as a Priority
Serafini emphasized that taking time to build trust must be a priority to avoid repeating past incidents. If aid groups do not do so, she warned, "then it will backfire." Strategies to address the breakdown in trust include embedding in the community over the long term, hiring local staff, and engaging community leaders. Kaseya noted that some leaders will be given motorbikes to travel across the community dispelling rumors and educating residents about the virus. Efforts are also underway to distribute accurate information through WhatsApp groups, churches, and community radio stations.
Death and Burial Practices as Flashpoints
Death often provokes communal anger during outbreaks. Although the Democratic Republic of Congo has roughly 450 tribes with varied death customs, Rukengeza said it is generally "very important culturally to take the body and to honor this relative." Funerals often last multiple days and can involve washing the body and sitting with or sleeping beside the corpse. During an Ebola outbreak, this is risky behavior because when someone dies of Ebola, their body remains highly contagious for about seven days, with the virus spreading through bodily fluids. Burial practices must be adapted to prevent further transmission, which can clash with cultural traditions and fuel resentment.
Context
Similar attacks have occurred during previous Ebola outbreaks. In 2019, an Ebola treatment center run by Doctors Without Borders in the Democratic Republic of Congo was attacked based on false beliefs that patients were being killed. During the 2014-2016 West Africa Ebola epidemic, health workers faced violent resistance in some communities due to misinformation and fear surrounding treatment centers and burial practices.