With the number of cases of Ebola now surpassing 3,000 in eastern Democratic Republic of Congo (DRC), it is by far the country's largest-ever Ebola outbreak. It is also the second-biggest Ebola epidemic ever recorded, after the one in West Africa between 2014 and 2016. But this outbreak in DRC is not only notable because of its size, but because it is the first Ebola crisis in an active conflict zone.
Eastern DRC has been devastated by decades of violence. Successive conflicts have resulted in the deaths of over five million people, and have displaced a further four million. There are still dozens of armed groups operating in the area. Since June this year, a new spate of violence in Ituri province – one of the two main areas affected by Ebola – has displaced a further 300,000 people.
Tackling Ebola in a conflict zone is proving difficult, complex and dangerous. Ebola is also hampering development and peacebuilding activities. Fear and mistrust of outsiders have resulted in treatment centres being burnt down, and in the first half of 2019, there were 174 attacks against Ebola workers. Low levels of trust in the government are fuelling suspicion that the disease has been exaggerated, or artificially created as a money-making scheme. The decision to suspend voting in last year’s elections in Ebola affected areas fuelled this suspicion. With one million people displaced in the region, many people are staying with friends or relatives, creating the kind of cramped living conditions that help the transmission of Ebola. Humanitarian responders are having to negotiate with local politicians, community leaders and armed groups to gain access to often very remote areas.
Despite some of these challenges being new, there is still much we can learn from what happened in West Africa about how to prevent further violence erupting during a crisis. In 2014, Ebola swept through Liberia, Sierra Leone and Guinea and was responsible for the deaths of 11,000 people. The epidemic destroyed relationships between and within communities, creating an atmosphere of fear and suspicion, as well as further eroding trust in local authorities, health workers and security officials. Conciliation Resources worked with communities across the Mano River Region and we learnt how to lower the chances of violent conflict during an outbreak.
Firstly, clear information about Ebola and how it spreads not only reduces the number of cases but can prevent violence. Rumours can spread quickly, especially in remote areas, and fuel tension and division. Even more so than in West Africa, social media is being used to share misinformation about the outbreak in DRC. For example, although the risk of catching Ebola from a survivor is low, poor communication and rumours within West Africa portrayed survivors as high risk and they were often banished from their communities. Conciliation Resources facilitated information-sharing events for over 6,000 people to counter these myths and share the real risks around Ebola.
Secondly, communities affected by Ebola need to be included in planning the solutions or interventions might add to the tensions. In West Africa, responses to control the crisis such as quarantines and trade restrictions had a severe economic impact on individuals and communities and further heightened levels of unrest. Conciliation Resource worked with 18 District Platforms for Dialogue (DPDs) to ensure the voices of those impacted were heard. These networks, which are comprised of trusted and respected community members, held dialogue sessions to discuss their communities’ concerns and potential solutions. During the crisis, over 13,00 people attended these meetings including health workers, government officials, and Ebola survivors and victims.
Finally, support for Ebola-affected communities in DRC must not end once the health crisis is declared over. Conciliation Resource and the DPDs continued to support the return and social acceptance of 250 survivors, families of victims and frontline health workers who all faced immense amounts of ostracisation during the outbreak. Organisations working in DRC with those affected by Ebola must also plan how they can remain working with communities after the outbreak.
The challenges of containing Ebola in a conflict zone are diverse and complex. But the lessons we have learnt from our experience of working with communities battling Ebola in West Africa can support peacebuilding efforts in eastern DRC and can inform humanitarian responses as they attempt to halt the spread of the disease.