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When the recent Ebola outbreak erupted in the Democratic Republic of Congo more than eight months ago, rumors and mistrust spread as quickly as the disease.
Today, the epidemic has become the second deadliest since the onset of the disease in 1976. Some 970 people have died and more than 1,400 cases have been confirmed since the month of April. August. On Sunday alone, a record 27 cases were confirmed in a single day.
The convergence of several factors has made the last epidemic more difficult to control than most, potentially spreading to the main city of Goma or neighboring countries.
The Ebola zone in Beni and Butembo and the surrounding area, in North Kivu province, is an opposition stronghold where historical grievances only escalated when the government postponed the elections until the end of the year. last year. The region has also been in conflict for decades, fueled by more than 100 militant groups fighting for control or fighting government forces, a violence that has spread to Ebola treatment centers. A Cameroonian Ebola doctor was killed in a Butembo center last month.
But the issue of mistrust is also at stake. Many are angry that the Ebola virus has generated profits for some, while other urgent needs have been ignored. Others do not believe the disease is real or think the government is using it to kill them. Some with symptoms have stayed away from the treatment centers, lest it worsen them.
In the middle of the race to contain the epidemic, social media such as Facebook and WhatsApp have provided a platform for all types of messages – true or not.
"We're watching social media because that's where most rumors are spreading," Health Ministry spokeswoman Jessica Ilunga told The New Humanitarian. "We use this monitoring to adapt our messaging in the field and on local radio. We are working on setting up a special team just to monitor and create social media content. "
Deadly lies
A study published in The Lancet in March found that people had been bombarded with misinformation. A sample of 961 adults between September 1 and 16 of last year in the cities of Beni and Butembo, about 86 percent, said they had learned that the Ebola virus did not exist. About one in four, or 230 people, said she did not believe it existed. Similarly, about 86% had heard that the disease was being used to destabilize the region, while more than one in three thought it was true.
A Facebook page, "Veranda Mutsanga in Revolution", now has 230,000 members. It is both a source of information – many users ridicule others for doubting the existence of the disease or offer advice on staying safe – while other users subscribe to multiple theories of conspiracy.
"There is no Ebola virus," said a user. "It's a lie of the government."
Facebook has been regularly criticized for allowing false information to spread.
Recently, anti-vaccination Facebook pages have raised fears that the measles vaccine will lead to autism, causing thousands of parents to leave their children unvaccinated – a trend at the origin of an outbreak cases of measles. In March, Facebook announced that it would close the pages after significant public pressure.
In countries like Congo, people are even more likely to rely on Facebook for information because Internet.org makes the platform, with other features selected, free for subscribers of its telecom partners via its program. Free Basics. Facebook canceled Free Basics in Myanmar after pushing users to the platform and allowed the rapid spread of false information about Rohingya Muslims.
Asked to explain what she was doing to fight the spread of false information on Ebola, Facebook told TNH: "We are working hard to strengthen our efforts to better understand the spread of misinformation in the DRC. the Ebola crisis and continue to work with partners in the field to better understand the problems and to solve them more effectively – our work in this area and the investigations are continuing. "
A politicized disease
The World Health Organization confirmed the outbreak of Ebola in August, a few months before Congo was about to go to the polls for decisive elections.
In December, Joseph Kabila, then President of the Republic, announced that he would postpone the vote in the Northeast to prevent the spread of the disease. At the time of the vote in North Kivu on March 31, President Felix Tshisekedi had already been sworn in and had agreed to form a coalition with Kabila. The result was challenged by the loss of opposition candidate, Martin Fayulu, who accused Kabila of having an agreement with Tshisekedi.
The delay in the vote sparked rumors that the Kabila government was behind the outbreak – either infecting the opposition's viruses or exaggerating its spread to undermine its opponents during the polls.
At least five Ebola treatment centers have been attacked since the outbreak.
After the assassination of the Cameroonian doctor on April 19, attackers armed with machetes attempted to burn another treatment center a few hours later. The Ministry of Health said that the attackers left notes indicating that their motives were political or related to their disbelief in the virus.
Two treatment centers managed by Médecins Sans Frontières, as well as the Ministry of Health, were also attacked three days apart in February, forcing health workers to suspend their operations. "The Ebola virus was considered a political ploy," said MSF spokesman Francesco Segoni.
According to officials, the suspension of operations following such attacks has only made the control of the disease even more difficult.
"Now the money comes in, but it's only for Ebola."
Anger is also fueled by a perceived double standard. Considerable efforts have been made to contain the Ebola epidemic – and large sums of money spent in the region – but why not for more common diseases such as tuberculosis or cholera, or to provide more general assistance? ?
"Now the money comes in, but it's only for Ebola," said Kimberly Bennett, head of advocacy activities at the Norwegian Refugee Council.
Local hospitals and clinics, familiar to local communities, have long been underfunded. For example, the fact that well-funded Ebola treatment centers suddenly appeared – accompanied by massive deployments of vehicles and staff – fueled even more suspicion.
"We must take into account the vast needs of the region, regardless of how the disease develops," said Pascal Hundt, head of crisis management at the International Committee of the Red Cross.
Lessons learned?
The Alliance for International Medical Action (ALIMA) has tried to draw lessons from its work during the 2013-2016 epidemic in West Africa, which has killed more than 11,000 people.
They set up their two treatment centers in the towns of Katwa and Butembo rather than in the suburbs to help reduce the stigma of people seeking treatment. They also organized transparent isolation booths so that family and community members could travel without risk of infection while remaining aware of the type of treatment patients were receiving.
"We wanted to make sure families could see what was going on once a patient was at the clinic," said Augustin Augier, general manager of ALIMA.
Such efforts have not made ALIMA immune to mistrust and violence. After the attack on a Butembo treatment center, the NGO had to withdraw from Katwa as a precaution against further attacks. After consulting the community, ALIMA has since resumed its work.
However, although the West African epidemic has made great progress in learning how to regain contact, vaccinating infected people and treating patients better and more humanely, as ALIMA does, winning the information war has proved much more difficult in North Kivu.
In addition to Facebook, groups have exploded on platforms such as WhatsApp and other discussion boards by mistrusting the Ebola response – and worse – by urging people who think they are suffering from the disease. illness to stay away from treatment centers.
"These communities had never seen this type of mass mobilization before," Segoni concluded. "And they wonder why now?"
(PHOTO ABOVE: Families visit the quarantine area of the Beni Ebola treatment center.)
ve / pd / ag
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