Ebola-hit DRC faces ‘perfect storm’ as uptick in violence halts WHO operation

A “perfect storm” of active conflict and traumatized communities in Ebola-affected areas of eastern Democratic Republic of the Congo (DRC) could enable the deadly disease to spread, but there are “no plans” to pull UN workers out of the country despite concerns for their security, the World Health Organization (WHO) said on Tuesday.

“We are now extremely concerned, that several factors may be coming together over the next weeks to months to create a potential perfect storm,” said Dr Peter Salama, WHO Deputy Director-General for Emergency Preparedness and Response. “A perfect storm of active conflict, limiting our ability to access civilians, distress by segments of the community, already traumatized by decades of conflict and of murder.”

The senior WHO official’s comments follow a spate of attacks, including one that killed at least 21 civilians on Saturday in the city of Beni, where WHO’s Ebola-response teams are based.

Several factors may be coming together over the next weeks to months to create a potential perfect storm – Dr. Peter Salama, WHO

“We’ve seen attacks now on August 24, September 3, 9, 11, 16, 21 and most recently and most dramatically September 22 in the city itself of Beni,” he said. He said that Beni was the base for the agency’s base for the “entire operation.”

Apart from the worrying targeting of civilians, Dr. Salama expressed concern that in the aftermath of the latest attack, outraged communities had declared Beni a “ville morte” so that mourners can grieve, effectively suspending UN operations.

“We’ve heard this morning, that that ‘ville morte’, which was yesterday, has now been extended right through to Friday of this week,” he said, “which basically means for the UN family, including WHO, a lockdown in Beni. Our operations are in effect suspended.”

The development meant that on Monday, WHO staff were able to reach only 20 per cent of the contacts they wanted to, in and around Beni, Dr Salama said.

Butembo could also declare a “ville morte” in coming days in sympathy with the people of Beni, he said, potentially increasing the chances of the situation deteriorating rapidly.

“If we do see unsafe burials that can’t be responded to and symptomatic people that can’t be accessed, we can see this situation deteriorating very quickly,” Dr. Salama said.

In addition to many people’s fear of Ebola, the WHO senior official explained that the situation was being further complicated by local politicians who “exploited and manipulated” them prior to upcoming elections.

Social media reaction to the outbreak was also adding to a “range of conspiracy theories”, Dr Salama said, adding that people have been “actively fleeing” health-workers, including in places where there have been a large number of cases in recent weeks.

In the nearly two months since the outbreak was declared, there have been 150 confirmed and probable cases of the disease, and 100 people have died, as of 23 September. Ebola’s symptoms include high fever and vomiting, which make it difficult to treat, because it resembles many other illnesses in its early stages.

Speaking to journalists at the UN in Geneva, Dr Salama noted that the international response to the major public health threat had been excellent and that donors have responded “very quickly and generously” to this latest outbreak, which is DRC’s tenth since the 1970s.

This progress risks being undone by the uptick in violence in the Kivus region, which is home to more than 100 armed groups, he said, before noting that neighbouring countries now also face an increased risk of the disease spreading.

‘There are no plans for WHO or UN staff to pull out’

“We call on the international community to continue to fund the response,” he said, “both in North Kivu, but also, and this is increasingly important, in the neighbouring provinces of the Kivus and Ituri, and in surrounding countries.”

One of the armed groups in DRC which pose a threat to civilians and the international response to Ebola, the ADF – Allied Democratic Forces – has sufficient military capacity to ambush blue helmets from the UN’a Stabilization Mission in DRC (MONUSCO) and government forces – the FARDC.

“The ADF in particular has enormous capabilities,” Dr Salama said. “They’ve been able to overrun entire FARDC-bases in and around Beni, they’ve been able to ambush (UN) forces.”

Asked whether the increasing violence may force WHO to leave the area, Dr Salama said that there were “no plans” to do so and that only a “very significant presence” of the UN and its partners could stop the disease.

“There are no plans for WHO or UN staff to pull out,” he added. “You know the UN philosophy is to stay and deliver under all circumstances unless we become direct targets of violence.”

“I don’t believe…we can stop Ebola without a very significant presence of UN and partners, despite the fact that the Ministry of Health has exerted great leadership and is doing an extremely good job in this response,” he added.