As rare Ebola virus spreads in Congo, residents say ‘nobody knows whether they are safe’

Bagamba Araali says the mood in his city can be distilled down to two words: “Fear and anxiety.”

Araali is a resident of Bunia, Ituri province, Congo, the site of the first known death connected with an Ebola outbreak that the World Health Organization (WHO) has declared a public health emergency of international concern.

As health officials scramble to respond to a virus that has spread undetected for weeks, or possibly months, Araali says he can’t stop thinking about all the people he’s had contact with before he knew there was anything to worry about. 

“Nobody knows whether they are safe,” Araali, a research associate at the language advocacy group SIL International, told As It Happens host Nil Köksal. 

“Nobody is 100 per cent sure if they did not get in touch with someone who is sick.”

Why it spread undetected

Ebola is highly contagious and spreads through contact with bodily fluids. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding.

Currently spreading in Congo is a rare type of Ebola virus called Bundibugyo. It spread undetected for weeks following the first known death as authorities tested for a different, more common Ebola virus and came up negative.

WHO says a Bundibugyo-specific vaccine may not be available for at least six to nine months.

So far, 51 cases have been confirmed in Congo’s northern provinces of Ituri and North Kivu, and two cases in Uganda, WHO Director-General Tedros Adhanom Ghebreyesus said Wednesday. 

There are 139 suspected deaths and almost 600 suspected cases.

It’s not yet clear when and where the outbreak began, but given the scale of it, WHO officials suspect it may have been spreading for months before the first confirmed death. 

But to people in Congo, the outbreak feels very sudden.

At a treatment center in Rwampara, resident Botwine Swanze says her son’s condition deteriorated rapidly before he died. 

“He told me his heart was hurting, and I thought it was his stomach,” Swanze said. 

“Then he started crying because of the pain in his stomach. After that, he started vomiting. Then he started bleeding and vomiting a lot.”

At Mongbwalu General Hospital in Ituri province, Dr. Richard Lokudu says about 30 Ebola patients are “scattered here and there.”

“We hope for the proper triage and isolation facilities to be installed today, and if that doesn’t happen, we will be completely overwhelmed,” said Lokudu, the hospital’s medical director. 

The hospital is understaffed, he says, and its people are not trained to handle suspected cases. 

If confirmed cases surge, he says, he and his colleagues “have no protection.”

Congo is home to some of the world’s most vulnerable people. The country’s already strapped health-care system took a major hit last year when U.S. President Doanld Trump’s administration slashed foreign aid. 

The UN estimates 70 per cent of the country’s humanitarian aid came from the United States. 

U.S. Secretary of State Marco Rubio has said the administration will contribute $23 million to combatting the outbreak and set a priority on funding 50 emergency clinics in affected areas.

Fear and stigma

Conflict is another barrier to treatment as armed groups keep large segments of the population constantly on the move, making the virus difficult to trace. The United Nations Refugee agency estimates that 1.6 million people in Congo have been internally displaced. 

In the Ebola-affected city of Goma, meanwhile, Rwanda-backed M23 rebels are in control. 

“The situation is complicated there,” said Dr. Anne Ancia, WHO representative in Congo. 

Another impediment to getting the virus under control, says Araali, is fear.

“A lot of people are afraid because they are not 100 per cent sure if they have Ebola, so they are afraid, in fact, of being taken to the centre,” he said. “They think maybe I’m going to catch it over there.”

He says international news coverage of the outbreak treats Ebola victims as statistics or “objects.”

“We feel somehow a bit guilty and ashamed, too — guilty that something that has started in our town, in our region, could, you know, could put the entire world in risk,” he said. “We also feel ashamed that we are kind of stigmatized for something we don’t know how it came out.”

This shame, he says, keeps people from seeking treatment.

“What we need now is just compassion and encouragement rather than just presenting the news in the way that stigmatizes the area,” he said.

‘The waiting game’

Despite the anxiety, in some ways, life continues as usual in Congo. 

In the town of Mongbwalu, where the body of the first known death was taken, the nearby border with Uganda remains open and gold mining continues.

Schools and churches remain open in Bunia. Some residents wear masks.

Araali says there are billboards in the city with messages about the outbreak, encouraging people to wash their hands and telling them what symptoms to look out for. Community radio stations are spreading those messages, too.

Whether it will work, he says, remains to be seen. 

He says he’s hopeful that the world will step up over the next few weeks, and Congo will get the medical personnel, equipment and funding it needs. 

“We know a lot more people are going to die. It will get worse before it gets better,” he said. “That’s just the waiting game.”