What is worse than the Ebola virus? Fight him in a war zone

PARIS – Even for the Democratic Republic of Congo devastated by the civil war, where more than 120 rebel groups are fighting for control, the Beni guerrillas have been fierce.

One of the largest 'armies', the Allied Democratic Forces, which originally formed an Islamist movement in neighboring Uganda, but which now has no clear agenda, attacked not only a local Congolese army garrison and US peacekeepers, but civilians.

Twenty-one people – including 17 civilians – have died.

It was the seventh attack in August and September, six in total before this one on September 22nd. The inhabitants declared "dead city"(Literally," dead city ") closing the city of more than 40,000 inhabitants for a day. Then another one. Then another one. For a while at least, the violence has decreased.

But during this confinement, death entered by another door. It was Ebola.

The week after the two and a half days dead city there were 15 new confirmed and probable cases in Beni, an increase of 50% over the week before confinement.

Beni is in North Kivu province, where an Ebola outbreak began last summer at less than 20 kilometers from the city of Mangina. North Kivu is a major communication route in the African Great Lakes region, adjacent to Uganda, Rwanda and Burundi. Thousands of people cross the border every day at checkpoints.

Meanwhile, guerrilla organizations do not recognize any boundaries and respond to no one.

Since August 1, when the first case of Ebola was recorded, the Congolese government, the World Health Organization, Médecins Sans Frontières and others have tried to contain the disease.

According to the latest WHO figures, there would have been 188 confirmed and probable cases as of Wednesday this week. 118 are dead. Although the death rate is high, this latest epidemic is far from the scale of the epidemic that ravaged Guinea, Liberia and Sierra Leone in 2014, which killed more than 11,000 people.

But Ebola has been in motion, and more so because of the chaotic war zone.

Peter Salama, World Health Organization Emergency Preparedness Officer, told reporters late last month that the situation looked like a "perfect storm" in the middle of "red zones" where fighters limit access for civilians. Mistrust prevails among people "already traumatized by decades of conflict and murder … motivated by fear of a terrifying disease, but also exploited and manipulated by local politicians before the elections". The DRC must vote for a new president on December 23rd.

The Director General of the World Health Organization, Tedros Adhanom Ghebreyesus, told the UN Security Council last week that the outbreak had reached a "critical point".

"This epidemic is occurring in the context of much larger humanitarian needs, in a country whose population has suffered tremendously for decades," said Ghebreyesus.

Although violence was generally not directed against health workers fighting the epidemic, on September 24, the same day Salama described the perfect hurricane in North Kivu, three volunteers of the Red Cross were shot dead by members of the local community of Beni. They had tried to bury the victims of Ebola safely in order to limit the risk of infection from other people.

More about fighting Ebola:

Ebola spreads by contact with body fluids. One of the first priorities after diagnosing the disease in people is to separate them from the general population. More than 15,500 doses of experimental vaccine have been administered in North Kivu, but this does not begin to contain the problem. All kinds of medical logistics have to be put in place, from isolation rooms to laboratory tests for the virus.

Operations often take place in areas where the infrastructure is very small. At the beginning of the epidemic, in Mangina, communications on the Internet were so irregular that much of the work had to be done on WhatsApp. However, one of the most important tasks is to locate anyone who may have come in contact with an infected person and monitor the symptoms closely.

"Finding suspicious cases and their contacts is a kind of detective work," says Tarik Jašarević, a spokesman for WHO recently returned from North Kivu to Geneva headquarters. "It involves talking to people, helping them remember who they met and where they were. This is how we find people susceptible to contracting the disease. "

It was one of the things that could not be done in Beni during dead city.

"We certainly think that the upsurge of cases in Beni that we are seeing in recent days is related to the fact that we have not been able to follow the contacts," said the chief of the intervention of 39, WHO emergency, Salama, at the Daily Beast, during a phone interview. Wednesday.

And there is a new twist, born of fear and Congolese politics. "We are currently seeing a link between insecurity and the response to the Ebola response," Salama said.

"This epidemic is occurring in the context of much larger humanitarian needs, in a country whose population has suffered enormously for several decades."

– Tedros Adhanom Ghebreyesus, Director General of the World Health Organization

Chaos and unrest in Congo mean that the response has been messy. Civilians argue that if the government and the international community can not protect them, why bother?

Ebola teams are working with the Congolese government and the international community. The United Nations Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) has some 20,000 people on the ground in the DRC, including more than 15,000 soldiers.

But they did not prove effective for the May-May guerrillas, a catch-all term for the small factions in the North Kivu region. And they certainly do not seem to compete with the Allied Democratic Forces (ADF), which struck Beni last month just 600 meters from the WHO operations center for the entire region.

Salama had previously warned that the ADF "has enormous capabilities: they have been able to invade the entire FARDC [Congolese government army] bases in and around Beni. They were able to ambush the MONUSCO forces, especially on the road from Beni to Mavivi, and they were able to reach … in the very center of the city of Beni itself. "

"It's very dark, this group," Salama told The Daily Beast. "We know that they have links with Islamist groups. But we know very little about them.

The tenth Ebola outbreak in the Democratic Republic of the Congo may still be halted and hope for a vaccine is growing. But the disease of war challenges treatment.