Renewed Violence Fuels Deadlier Ebola Outbreak in Eastern Congo’s North Kivu

(Bloomberg) -- Ebola is gaining momentum in another part of the Democratic Republic of Congo, where escalating violence is hampering efforts to find patients and contain the virus.

More than 25,000 people have fled fighting into the northeastern city of Beni, while attacks by armed groups have killed at least 60 civilians since July 12, according to the United Nations. Several humanitarian organizations have suspended movements in parts of the area, disrupting the Ebola response.

Worsening insecurity, limited treatment capacity and weak community surveillance are making it harder to identify infections before they spread. Ebola cases more than doubled to 275 in North Kivu this month, outpacing the increase in Ituri, the outbreak’s epicenter, while 63% of confirmed patients in North Kivu have died, compared with 42% in Ituri.

Communities are hiding suspected cases, according to Alice Ribes, the International Rescue Committee’s Ebola response team lead. Surveillance is “very, very low,” she said, with responders lacking the staff, motorcycles and fuel needed to actively search for cases.

“If we don’t act now, what’s going to happen in Grand Nord Kivu is going to be the same as in Ituri,” Ribes said, referring to the province’s northern area, near Ituri.

The National Institute of Public Health revised the outbreak’s cumulative death toll upward by 236 Thursday after reconciling provincial and national databases in Ituri and North Kivu. The increase primarily reflected harmonization of epidemiological records rather than deaths occurring during the previous 24 hours, it said. At the same time, the report recorded 62 newly confirmed deaths over the latest reporting period.

Insecurity, Displacement

More than 260 armed groups operate across North Kivu and Ituri, fueling chronic insecurity and repeated displacement, according to a UN report released in June. 

The latest phase of unrest began in late 2021, when the Rwandan-backed M23 rebel group resumed its offensive against Congolese government forces, reigniting a conflict rooted in the aftermath of the Rwandan genocide in 1994. More than 8 million people have been displaced across Congo during decades of fighting.

Renewed violence along the Ituri-North Kivu border has forced more people from their homes in Ebola-affected areas, the UN Office for the Coordination of Humanitarian Affairs said Thursday. Thirty people were reportedly killed Wednesday in attacks on villages in Mambasa territory, while six humanitarian organizations suspended movements in parts of neighboring Beni territory, disrupting the outbreak response.

“Insecurity continues to impact humanitarian operations in the eastern parts of North Kivu province,” UN Spokesperson Stéphane Dujarric said Wednesday. “This includes our efforts to respond to the ongoing Ebola outbreak, which is only getting worse.”

The violence is compounding the outbreak in two ways, IRC’s Ribes said. Some people avoid seeking care because they fear Ebola treatment or mistrust authorities. Others want treatment but can’t safely reach health facilities, while humanitarian teams face growing difficulty reaching affected communities.

“That’s the worst recipe for a catastrophe,” she said in an interview from the Congolese capital, Kinshasa.

Beni and Butembo, a city 55 kilometers (34 miles) to the south, endured the world’s second-largest Ebola epidemic just six years ago. Yet that experience hasn’t translated into a more effective response, Ribes said. 

Years of conflict, displacement, food insecurity and repeated crises have instead left many communities exhausted and increasingly mistrustful of health authorities.

Rather than avoiding crowds, people in Beni continue to attend weddings, parties and other large gatherings, while handwashing stations and temperature checks are scarce, she said.

“Life is going on as if nothing was happening,” she said. “It’s terrible.”

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