Congo bans large gatherings as Ebola outbreak escalates; WHO raises risk to 'very high'

In the mining town of Mongbwalu, in Congo's Ituri Province, a father named Lokana Moro Faustin watched his sixteen-year-old daughter die of Ebola without being able to say goodbye. She had fallen ill with what the family first thought was malaria—fever, vomiting, nosebleeds, bloody diarrhea—and died on May 15th. When the hospital's specialized burial teams took her body directly to the cemetery, Faustin was in isolation. He was not permitted to touch her, to wash her, to speak words over her grave. A stranger buried his child.

This is the human cost of what the World Health Organization now calls a "very high" risk outbreak in northeastern Congo. As of late May, authorities had confirmed 82 cases of Ebola and seven deaths, but the actual numbers are far larger. There are 750 suspected cases and 177 suspected deaths, with more expected as surveillance expands. The virus is a strain called Bundibugyo, for which no vaccine exists. It spread undetected for weeks while authorities tested for a different, more common Ebola virus and came up negative. By the time they understood what they were facing, the disease had already taken hold.

On Friday, the provincial government in Ituri banned funeral wakes and any gathering of more than fifty people. Funerals must now follow strict health protocols. The restrictions are meant to break the chain of transmission—Ebola spreads through contact with the dead, and traditional burial rites, where families wash and prepare bodies, are a known vector for infection. But the rules collide directly with how people in this region mourn. On Thursday, youths angry at being blocked from retrieving a friend's body set fire to an Ebola treatment center in Rwampara. In some churches, pastors have told their congregations the outbreak is fake, that prayer alone will protect them.

The response is hampered by the region's collapse. Nearly a million people have been displaced by armed conflicts over mineral resources. Medical facilities are starved of supplies. In the provincial capital of Bunia, AP reporters found emergency treatment centers sitting empty. In the nearby town of Bambu, doctors were using expired masks while treating suspected Ebola patients. Julienne Lusenge, who runs a local aid group, said her small hospital near Bunia has only hand sanitizer and a few masks for nurses. "We need much more than that," she said. The International Rescue Committee had to stop surveillance activities in three of five areas in Ituri over the past year because of funding cuts.

The disease has also appeared in two provinces to the south—North Kivu and South Kivu—where the Rwanda-backed M23 rebel group controls key cities including Goma and Bukavu. The rebels reported two cases and said Friday they were forming a crisis team. But Congo's Foreign Minister Thérèse Kayikwamba Wagner noted that M23 is "thoroughly ill equipped" to fight the disease, and that the government and rebels are not communicating about the outbreak. Getting aid from Bunia to Mongbwalu requires aid groups to brace for potential attacks from armed groups.

Misinformation spreads as easily as the virus in a region exhausted by years of conflict. Lusenge said rumors take hold quickly when people have lived through such hardship. Some communities believe the outbreak is a hoax. Others resist treatment because medical policy has clashed with burial customs. The anger is real, and it is dangerous. In Mongbwalu, coffin makers are working around the clock. Christian Djakisa, who manages a coffin workshop in Bunia, said demand has soared since the outbreak began. "We're here every hour making coffins," he said.

The international response is mobilizing. The United Nations released sixty million dollars from its Central Emergency Response Fund on Friday. The United States pledged twenty-three million dollars and said it would fund the establishment of up to fifty Ebola treatment clinics in the affected regions. But Gabriela Arenas from the International Federation of Red Cross and Red Crescent Societies warned that "the outbreak can still be contained but the window for action is narrow." The race, as Congo's Foreign Minister put it, is against the clock.