Anxious healthcare workers in the Democratic Republic of the Congo have said they are underprotected and undertrained in the face of a rapidly spreading Ebola outbreak of a rare type of the virus in one of the world’s most remote and vulnerable places.
“It’s truly sad and painful because we’ve already been through a security crisis, and now Ebola is here too,” said Justin Ndasi, a resident of Bunia, the site of the first known death that was announced last week after what experts call a worrying delay in detecting the virus.
The response unfolds in a region long threatened by armed groups that have kept a large part of the population on the run and control a major city where Ebola cases have been confirmed, complicating health workers’ catch-up efforts to trace the outbreak.
The World Health Organisation, which noted a low risk globally, has said “patient zero” still has not been found.
In Bunia, where tonnes of health supplies have been airlifted, residents said masks have become harder to find and some disinfectants that previously sold for 2,500 Congolese francs (less than £1) now cost up to 10,000 francs (more than £3).
And burials have begun. At a treatment centre in Rwampara, healthcare workers in protective gear handled the bodies of suspected Ebola victims in silence.
Families who tend to wash loved ones’ bodies themselves watched helplessly as workers disinfected them and placed them into coffins for secure burial sites.
The disease struck suddenly, they said, describing a rapid deterioration after symptoms were mistaken for illnesses such as malaria.
“He told me his heart was hurting, and I thought it was his stomach,” said Botwine Swanze, who lost her son.
“Then he started crying because of the pain in his stomach.
“After that, he started vomiting. Then he started bleeding and vomiting a lot.”
The Ebola virus is highly contagious and spreads in the human population through contact with bodily fluids such as vomit, blood or semen.
Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding.
The WHO has declared the Ebola outbreak a public health emergency of international concern, and expressed worry over its “scale and speed”.
Its head in DR of Congo says the outbreak would last at least two months.
The rare type of Ebola, known as the Bundibugyo virus, spread undetected for weeks following the first known death while authorities tested for another, more common Ebola virus and came up negative.
Investigations continued into where and when the outbreak started, but “given the scale, we are thinking that it has started probably a couple of months ago”, said Anais Legand, a technical officer in the WHO emergencies programme.
So far, 51 cases have been confirmed in DR of Congo’s northern provinces of Ituri and North Kivu, as well as two cases in Uganda, WHO director-general Tedros Adhanom Ghebreyesus said on Wednesday.
Beyond that, there are 139 suspected deaths and almost 600 suspected cases.
But “the scale of the epidemic is much larger”, he said.
This is Congo’s 17th Ebola outbreak, and the WHO has said its health ministry has experienced staff and capacity to respond.
Most outbreaks were of the more common Ebola, however.
Dr. Vasee Moorthy, a special adviser in the office of the WHO chief scientist, said a vaccine to address Bundibugyo would not be available for at least six to nine months.
He cited two candidates: A version of the Ervebo vaccine for the Ebola virus that would be specifically designed for the Bundibugyo virus, and another shot based on a vaccine developed by Oxford University.
DR of Congo already faced “immense pressure from conflict, displacement and a collapsing health system”, said Dr Lievin Bangali, senior health coordinator for the International Rescue Committee in the country, adding that years of underfunding have weakened the response.
The outbreak highlights the effects of the Trump administration’s deep cuts in foreign aid.
US secretary of state Marco Rubio has said the administration would “lean into” Ebola response efforts, with a priority on funding 50 emergency clinics in affected areas.
The US pledged to contribute 23 million dollars.
Schools and churches remained open in Bunia. Some residents wore masks and at health centres, anxiety grew.
A Doctors Without Borders team identified suspected cases over the weekend at the city’s Salama hospital but found no available isolation ward in the area, Trish Newport, an emergency programme manager, said on social media.
“Every health facility they called said, ‘We’re full of suspect cases. We don’t have any space’. This gives you a vision of how crazy it is right now,” she said.
In Mongbwalu, where the body of the first known death was taken, the nearby border with Uganda remains open and gold mining continues, said Cherubin Kuku Ndilawa, a civil society leader, highlighting the difficulty of containing the virus.
“There’s no panic. People continue with their normal lives, but they’re also starting to spread the word,” said Mr Ndilawa, and noted a lack of public handwashing stations.
It was very different at Mongbwalu General Hospital, where Dr Didier Pay said it was treating around 30 Ebola patients, and a student from the local medical technology institute died on Wednesday.
“The patients are scattered here and there in rather unusual conditions,” Dr Richard Lokudu, the hospital’s medical director, told the AP.
“We hope for the proper triage and isolation facilities to be installed today, and if that doesn’t happen, we will be completely overwhelmed.”
They are understaffed and not trained to handle suspected cases, he said.
If confirmed cases surge, “we have no protection”.
In the Ebola-affected city of Goma, meanwhile, Rwanda-backed M23 rebels are in control.
“Indeed the situation is complicated there,” Dr Anne Ancia, WHO representative in DR of Congo, has said.
A US national who tested positive in DR of Congo arrived in Berlin on Wednesday and was in a special isolation ward.
A “comprehensive examination” was taking place to determine treatment, German Health Ministry spokesman Martin Elsasser said.
He would not comment on the patient’s condition, whom German authorities and the US CDC have not identified.
The ministry later said it was taking the patient’s wife and three children at the request of US authorities.
It was not clear whether any were infected.
Separately, Christian aid organisation Serge said one of its doctors — identified as American medical missionary Dr Peter Stafford — had been evacuated from DR of Congo after developing symptoms.
