Faith, fear and trust: Inside DR Congo’s fight against Ebola
Faith, Fear and Trust: Inside DR Congo’s Fight Against Ebola
Faith fear and trust - In the remote hills of eastern Democratic Republic of the Congo (DRC), a medical team arrived last week to assist in the burial of a man who succumbed to Ebola. Their mission, however, was met with suspicion. Locals warned that armed rebels would be summoned if the workers stayed, and the team was forced to retreat. The family, unaided, performed the ritual themselves, risking further transmission of the virus to the surrounding population.
Outbreak Escalates Amid Cultural Resistance
The incident underscores a critical barrier to controlling the latest Ebola crisis. As of 3 June, the epidemic has infected 381 individuals and claimed 64 lives, with cases spreading rapidly in the DRC’s eastern provinces. Dr. Marie Roseline Belizaire, WHO’s Emergency Preparedness and Response Director for Africa, highlights how deeply rooted beliefs—such as the idea that Ebola is caused by witchcraft—complicate public health efforts. “The virus is not the only challenge,” she explained. “Sometimes, the hardest part is sitting with families who refuse to accept scientific explanations.”
“We are not trying to overcome their culture,” she said. “We’re trying to involve the science in their own belief.”
Despite the technical advances in detection and response, community resistance remains a persistent hurdle. In some areas, mistrust of health workers leads to delays in reporting symptoms or accepting quarantine measures. “People see illness as a spiritual issue,” Dr. Belizaire noted. “They may attribute deaths to curses or poisoned food rather than a virus.” This perspective has historically fueled outbreaks, with communities sometimes retaliating against health teams perceived as threats.
Regional Spread and Cross-Border Concerns
The outbreak, driven by the Bundibugyo strain—a variant for which no vaccine or treatment exists—has now reached Uganda. Cases linked to the DRC have been confirmed in the neighboring country, raising fears of a wider regional crisis. Dr. Belizaire, speaking from Bunia in Ituri province, emphasized the urgency of containment. “The disease’s ability to cross borders is a major concern,” she said. “Mobility allows it to spread faster than ever before.”
One Congolese national, who had traveled through the United Arab Emirates, is believed to have brought the virus to Uganda. This highlights the global interconnectedness of outbreaks and the need for international collaboration. “When there is an epidemic, and people move freely, the risk multiplies,” she warned. “But through mechanisms like WHO’s International Health Regulations, we can share information quickly and act collectively.”
Testing Capacity and Rapid Response
Recent weeks have seen significant progress in the DRC’s response efforts. At the outbreak’s onset, laboratories could handle about 40 tests per day. Today, that capacity has surged to 800 tests daily, enabling swift identification of suspected cases. “We process almost every sample on the same day,” Dr. Belizaire said. “Results are now available within 24 to 48 hours, which is a game-changer for early intervention.”
This acceleration in testing has allowed health authorities to isolate infected individuals more efficiently. Community alerts are now investigated in the field, with those exhibiting outbreak-specific symptoms promptly tested. “We’ve streamlined the process,” she added. “This means suspected cases are cleared from the system faster than before.”
Building Trust Through Cultural Collaboration
Trust-building has become a cornerstone of the response strategy. Many communities in affected areas have endured years of conflict and instability, fostering skepticism toward external organizations. To address this, health workers adopt a dual approach: respecting local traditions while integrating scientific methods. “We don’t dismiss their beliefs,” Dr. Belizaire said. “Instead, we ask them to recognize both the spiritual and medical causes of illness.”
“We don’t stop them going to traditional healers,” she said. “We ask [the healers], if you see someone with those symptoms, refer it also to us.”
Traditional healers, once seen as obstacles, are now being enlisted as allies. By collaborating with these local practitioners, WHO teams aim to bridge the gap between scientific medicine and cultural practices. “It’s about coexistence, not confrontation,” she said. “If a family believes in witchcraft, we simply ask them to also believe in the disease’s reality.” This approach has helped reduce resistance and improve community engagement.
Challenges and Encouraging Signs
While progress is evident, challenges persist. Contact tracing rates—once around 25%—have risen to 45%, but this is still far below the 90 to 95% needed for effective containment. “We still have a lot of work to do,” Dr. Belizaire acknowledged. “The regional nature of the outbreak means we must remain vigilant.”
Yet there are hopeful signs. Seven individuals, including six healthcare workers, have recovered from Ebola. Their survival is attributed to early treatment and intensive supportive care, such as rehydration therapy and symptom management. “They recovered because they sought help promptly,” she said. “This shows that timely intervention can make a difference.”
“Misinformation is almost as dangerous as the virus itself, and spreads just as fast.”
WHO Director-General Tedros Adhanom Ghebreyesus, who recently visited the outbreak’s epicenter, has stressed the importance of combating false narratives. “When people believe in myths, it can delay action and worsen the spread,” he said. “Our role is to provide accurate information while respecting cultural contexts.”
The DRC’s battle against Ebola is a microcosm of broader public health challenges. It requires not only medical expertise but also an understanding of local beliefs and the ability to adapt strategies to cultural realities. As Dr. Belizaire put it, “We are not just fighting a virus—we are fighting the perceptions that shape how people respond to it.” The road ahead remains difficult, but with improved testing, community partnerships, and rapid information sharing, there is reason to remain optimistic about containing the outbreak.