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By Gabe Joselow and Linda Givetash
People who have contracted the Ebola virus decide to die at home rather than seek treatment. Conspiracy theories fuel distrust of the government and health workers in the Democratic Republic of Congo, according to workers and aid groups.
Nearly 20 new cases of fatal illness are identified every day in two provinces in the north-east of the country. Both areas are strongholds of opposition where political tensions are strong.
Many victims are found outside treatment centers after refusing to seek help, officials said. The epidemic killed more than 700 people and affected more than 1,000 people.
In addition to fighting a deadly virus, health workers must dispel rumors that the disease is being made and that the millions of dollars spent on the response are part of a money-making program called derisively "the Ebola business".
"We have lost the trust of the community," said NBC News, Goma's Tariq Riebl of the International Non-Profit Rescue Committee.
A study conducted in September, less than two months after the start of the epidemic, revealed that 25% of those surveyed in the affected areas did not think that the Ebola virus was real, while 36% thought that the Ebola virus was real. it was made to destabilize the region.
"Everything is a matter of money, we get bonuses for the cases we see, extending the answer helps businesses," said Riebl, citing some of the lies spread among local communities.
Anifa Vahavi is a demographic researcher working in Butembo, one of the most affected areas.
She expressed skepticism about the existence and origins of Ebola, and asked why humanitarian workers took extra precautions when they treated her with regard to malaria or cholera.
Ebola treatment centers established by the central government in collaboration with international aid groups have been suspected. Designed to isolate and treat suspected Ebola cases and staffed with health workers dressed in large "space suits", the centers benefit from increased police and military presence.
Some people in Butembo even believe that "when you go, they inject you with the disease," according to Vahavi, 30, who collects data for a Congolese non-profit organization.
The Ebola outbreak also occurs in a part of the country that regularly experiences violence from armed groups. Health workers are increasingly under threat, leading to further setbacks in emergency response.
The World Health Organization announced Friday that a doctor responsible for the Ebola virus had been killed during an attack on Butembo University Hospital.
A few hours later, attackers armed with machetes attempted to set fire to another treatment center, the deputy mayor said on Saturday.
Two centers run by Médecins sans Frontières, as well as the Ministry of Health, were attacked three days apart in February, forcing health workers to suspend their activities.
After the second attack, Joanne Liu, President of Médecins sans Frontières, described the "great hostility" against the Ebola response, adding that "the use of security forces and police only reinforces the suspicion of those who who believe that the Ebola virus is used as a political tool. "
Deep-rooted opposition to the government in the areas affected by the epidemic means that even the arrival of foreign aid is treated with apprehension.
"The government is considered deeply untrustworthy," said Phil Clark, a political scientist at SOAS University in London.
He described the time and place of the epidemic as an "unfortunate coincidence".
The Ebola virus was confirmed by the World Health Organization on August 1, a few months before the country was about to go to the polls. Former President Joseph Kabila, who was planning to step down after two terms, announced in December that he would defer voting in Ebola-affected communities to prevent the spread of the disease. .
This triggered rumors that the government was behind the outbreak – infecting communities with the virus or exaggerating its spread – to allow Kabila to choose a successor to elections, said Clark.
Health Minister Oly Ilunga Kalenga recently returned from a visit to the affected Butembo region and told NBC News that "mistrust of the community" has even been fueled by election candidates.
"When the epidemic began in August, it was during the election period, so, unfortunately, some local politicians deliberately spread lies to boost their popularity before the elections," he said. .
He is more optimistic now that the elections have taken place, saying the vaccination campaign – which affected more than 100,000 people in the Ebola-affected region – has been effective.
"Things are improving," he added.
Aid agencies have also taken unprecedented steps to address local doubts about the response to Ebola, including changing the way they proceed with the burial of the dead.
Eva Erlach, who runs the regional community engagement program of the International Federation of Red Cross and Red Crescent Societies, said the organization had bought transparent body bags for the first time " in order to show the family that it is actually their loved one who is buried and these are not empty stones or coffins. "
The decision was not random, but was based on a plethora of data collected by IFRC volunteers during home visits with local communities to better understand their concerns. Some 800 volunteers working in eastern Congo collected more than 150,000 comments, which are then stored in a database to share with other organizations in the field.
"Our role is really to make sure that in everything we do, we engage with communities and we understand what our role is and what is being done," said Erlach.
Riebl, of the International Rescue Committee, said the situation still could not be compared to the 2014 outbreak in West Africa, which claimed the lives of more than 11,000 people in six countries in the region, with cases also occurring abroad.
But he still has his concerns. "In the end, if you do not connect with communities, the effectiveness of the treatment system does not matter," said Reibl.
Saphora Smith contributed.
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