Anger and suspicion as Ebola spreads through eastern DR Congo

{"text":[[{"start":10,"text":"A week after the Democratic Republic of Congo declared an outbreak of Ebola, and many weeks after the virus began its silent march through the east of the country, the military governor of Ituri province issued a long list of dos and don’ts. "}],[{"start":23.75,"text":"Johnny Luboya Nkashama told people this month they must maintain a minimum distance of two metres, wash their hands regularly and thoroughly cook meat. Among proscribed activities, the governor said, were transporting corpses on motorbikes or on public transport, the attendance of funeral wakes, which are known to be spreader events, and participation in local football matches."}],[{"start":47.15,"text":"Funerals must be conducted according to strict protocols, Nkashama said. That meant avoiding the common practice of bathing or touching bodies that remain highly infectious after death. People must submit themselves to temperature checks at designated checkpoints."}],[{"start":62.599999999999994,"text":"In practice, the list of measures is often unenforceable in a poor and volatile province where trust in the government is low, traditions strong and pharmacy shelves empty. "}],[{"start":null,"text":"

"}],[{"start":null,"text":""}],[{"start":73.55,"text":"Many citizens have little faith in a military administration imposed in 2021 from far-off Kinshasa, the capital, some 2,000 kilometres away. Encouraged by rumours on social media, some people do not believe Ebola exists at all, or regard it as a plot by outsiders to control the population and the province’s resources of gold, coffee and timber. "}],[{"start":97.19999999999999,"text":"Hospitals and isolation facilities have been burned, with crowds demanding the return of loved ones who have died on wards. The whereabouts of several Ebola patients is unknown after they escaped facilities under attack. Flights in and out of Bunia, the province’s teeming capital of nearly 1mn people, have been suspended. "}],[{"start":118.69999999999999,"text":"“People are aware of the disease, yet disinformation reaches every corner,” said Noella, a student in Bunia, who withheld her surname because of the atmosphere of suspicion. "}],[{"start":129.75,"text":"Julienne Lusenge, president of Sofepadi, a coalition of 40 women’s organisations working in eastern Congo, said: “Some local residents continue to claim that it is a ‘game played by the authorities’. Others say that this illness has mystical origins . . . These beliefs hinder the response and complicate awareness campaigns.”"}],[{"start":null,"text":""}],[{"start":149.75,"text":"Meanwhile, the outbreak, already the third worst in the history of Ebola, a haemorrhagic fever discovered in DR Congo in 1976, has been gaining ground at an alarming rate. More than 220 people are suspected to have died from the disease with more than 900 further suspected cases."}],[{"start":168.95,"text":"The current outbreak is spreading faster than the last big one in eastern DR Congo in 2018, which over two years killed 2,229 people of 3,481 infected, according to the World Health Organization. "}],[{"start":183.75,"text":"Almost as worrying as the escalating numbers is the geographic spread, with deaths recorded in at least three provinces as well as in neighbouring Uganda. DR Congo borders on nine countries, a factor that led the WHO to declare the outbreak one of international concern. Uganda on Wednesday closed its border with DR Congo, joining Rwanda, which did so last week."}],[{"start":208,"text":"Because the outbreak is of the less common Bundibugyo strain, there is no approved vaccine or medical treatment. The virus kills roughly 40 per cent of those it infects. "}],[{"start":null,"text":""}],[{"start":218.85,"text":"Ebola has found fertile ground in Ituri province on the Ugandan border, the venue for what Tedros Adhanom Ghebreyesus, the head of the WHO, called a “catastrophic collision of disease and conflict”. "}],[{"start":231,"text":"Tedros travelled to Bunia on Wednesday after declaring that the virus was forcing cash-strapped medical authorities to play “catchup”. The WHO and the Africa Centres for Disease Control and Prevention are jointly asking for $314mn to help combat the outbreak. "}],[{"start":249.1,"text":"Because of activity from armed groups and conflict between pastoralists and farmers, there have been huge levels of displacement, vastly complicating efforts to trace contacts and to contain the outbreak in one place. "}],[{"start":263.05,"text":"Colin Thomas-Jensen, director of impact at the Aurora Humanitarian Initiative and a former senior official at the now-defunct US Agency for International Development, said authorities had taken longer than normal to detect the outbreak. That was partly because of the abrupt end to early-warning systems when USAID was closed down and other western governments slashed aid budgets, he said."}],[{"start":287.05,"text":"Lusenge, the president of Sofepadi, said: “There are severe shortages of medications, masks, and logistical resources. This is evident in empty pharmacy shelves, soaring mask prices, and doctors forced to treat patients without adequate protection.”"}],[{"start":null,"text":""}],[{"start":302.85,"text":"Many African health experts argue that the way to tackle the outbreak is through detection, track and trace and quarantine, not by waiting for a vaccine or medical cure."}],[{"start":312.8,"text":"“Test, test, test and contain. That is what we need right now,” said Ayoade Alakija, chair of FIND, a global diagnostics alliance. "}],[{"start":323.65000000000003,"text":"Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention, said the urgent need was for diagnostic tests. Most of the kits in Ituri can’t detect the Bundibugyo strain and the numbers being tested are wholly inadequate, health officials on the ground said. "}],[{"start":340.70000000000005,"text":"Still, vaccine researchers at the University of Oxford are working urgently to develop a jab. Scientists are collaborating with partners including the manufacturer Serum Institute of India, said Teresa Lambe, the Calleva head of vaccine immunology at the Oxford Vaccine Group. "}],[{"start":358.35,"text":"“We’re ultimately preparing for clinical trials if they become necessary,” Lambe said, “but hoping that they won’t be.”"}],[{"start":365.40000000000003,"text":"Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations, said that the 2018 outbreak took almost two years to control, despite being identified earlier and an effective vaccine being quickly deployed."}],[{"start":380.40000000000003,"text":"Therapeutics and jabs needed to be developed “very, very rapidly,” this time, Hatchett said. “Given the challenges of working in this area, it’s hard to fathom how this outbreak could be brought under control . . . without those tools.”"}],[{"start":393.3,"text":"Cartography by Steven Bernard"}],[{"start":402.70000000000005,"text":""}]],"url":"https://audio.ftcn.net.cn/album/a_1779954782_6159.mp3"}