During this time when the world is focused on the Coronavirus pandemic, other viral diseases still persist in many parts of the world, including the Democratic Republic of the Congo. On Friday April 10, a new Ebola case was reported in Beni, a city in the DRC, after the country had nearly defeated the 19-month outbreak, the biggest Ebola outbreak since the West African epidemic in 2014. Ebola is a very dangerous virus which has been found to kill about 50% of those who are infected. However, the numbers in the Congo indicate that there is about a 65% mortality rate for those infected in the country (3,456 people were infected and 2,276 have died) because of difficulty in controlling the epidemic. According to the World Health Organization’s regional director for Africa, the outbreak has been so persistent in the Congo because of insecurity. This insecurity comes from mistrust of civilians towards healthcare workers and the government, which stems from a history of political instability in the country.(Dahir, 2020) After gaining independence from Belgian colonization in 1960, the country has been subject to authoritarian leader Joseph Mobutu, civil war resulting in Joseph Kabila taking over, protesting when he was reelected, and then more violence when he delayed elections from 2016 to 2018. While this civil unrest is obvious, critics may argue that the 2018 election, won by opposition candidate Felix Tshisekedi, may be showing a shift towards stability; however, the 2018 elections were cancelled in Beni and Butebo because of the Ebola outbreak and in Yumbi because of excessive violence. (“Africa :: Congo, Democratic Republic of the Congo”) Violent protesting broke out in the areas in response to this political decision, which only served to put the Ebola eradication processes and the nation’s healthcare system more at risk and proved that political instability is still very much ingrained in the country. This Ebola outbreak and the fact that nearly two years later it is still prominent in the DRC proves that political instability does not just affect the political system in a country, but has resounding impacts, especially on the healthcare field.
The Ebola epidemic is being fought by regional Congolese healthcare workers, national officials, and international aid programs like the Red Cross. Despite these efforts, the epidemic has been hard to control because of intergovernmental instability and resulting mistrust of community members towards healthcare centers and workers. (Dahir, 2020) The intergovernmental disagreement primarily consisted of opposing views from Dr. Ilunga, the Congo’s former health minister, and Dr. Muyembe who was the director-general of the country’s National Institute for Biomedical research. Dr. Muyembe acted as a whistleblower who exposed Dr. Ilunga for refusing the use a second Ebola vaccine, not coordinating with the army or government, putting national officials up in excessively luxurious hotels which regional healthcare workers were unpaid, and not providing rapid tests which put the healthy population at higher risk of the disease before patients were officially diagnosed. (McNeil Jr., 2019) This intergovernmental mistrust only strengthened mistrust civilians had towards the healthcare workers. In a 2019 study of social resistance and its effect on Ebola transmission and persistence, researchers found resistance to EVD response measures. 12% of respondents believed the virus was not real, 72% were “dissatisfied with or mistrustful of the EVD response”, 9% “sympathized with perpetrators of overt hostility” and 15% expressed that they had not followed proper protection protocols, including “hiding from the health authorities, touching the body, or refusing the welcome an official burial team”. The data suggests mistrust which the study concluded may be fueled by “deep political and historical roots in this area besieged by chronic violence and neglected by the outside world”, unsurprising with the background of political violence and confusing disagreement between the nation’s medical officials. (Claude et al., 2019) While the study only emphasized mistrust which resulted in dangerous but nonviolent disposal practices, healthcare workers, burial teams, and treatment centers in the area have been at risk of attack from local protesters. These workers and treatment centers have been threatened by mourners and protestors with weapons ranging from machetes and sticks to setting fires to brandishing guns and grenades. (Goldstein and O’Reilly, 2019) In some cases this has led healthcare workers to have to evacuate the areas, leaving communities without any resources to fight the Ebola outbreak. In others, it has led to a transition in strategy to include measures to win community support including building wells and treatment centers closer to communities and using new technologies like isolation cubes which allow family members and healthcare workers to help patients without PEE and without risk of infection. (Dahir, 2020) Though the outbreak is much closer to eradication now than in the last two years, it has shown that health care crises have just as much capability of inciting violence and instability as events like elections and political transitions, which more commonly lead to violence. Moreover, the case of the Congo shows how a health care crisis only increases political instability in countries where political weakness and mistrust in the government is already rampant due to a history of colonization, violence, and political instability.
While the Ebola epidemic is finally becoming more controlled in the country, political violence remains widespread and now, the Coronavirus pandemic has reached the nation as well. For one of the poorest countries, this makes Coronavirus even more dangerous, since treatment efforts depend on national and international aid which may be slowing during this time of international economic downturn. (Elliott, 2020) Perhaps the Ebola efforts have taught healthcare workers how to deal with virus outbreaks and will make Coronavirus control and prevention more efficient, or perhaps it will only serve to increase political instability and will result in an even more dangerous outbreak than the Ebola epidemic being fought. It will be interesting to see how the Congo uses their experience with Ebola in order to combat the Coronavirus and how these two back-to-back health crises will affect an already weak political system, either making it stronger or possibly inciting even more violence in the country.
“Africa :: Congo, Democratic Republic of the Congo.” Central Intelligence Agency The World Factbook, 6 Apr. 2020, https://www.cia.gov/library/publications/the-world-factbook/geos/cg.html.
Claude, Kasereka Masumbuko, et al. “Social Resistance Drives Persistent Transmission of Ebola Virus Disease in Eastern Democratic Republic of Congo: A Mixed-Methods Study.” PLOS ONE, vol. 14, no. 9, Public Library of Science, Sept. 2019, p. e0223104. PLoS Journals, doi:10.1371/journal.pone.0223104.
Dahir, Abdi Latif. “Congo Was Close to Defeating Ebola. Then One More Case Emerged.” The New York Times, 11 Apr. 2020. NYTimes.com, https://www.nytimes.com/2020/04/11/world/africa/congo-ebola-coronavirus.html.
Elliott, Larry. “Blindsided: How Coronavirus Felled the Global Economy in 100 Days.” The Guardian, 9 Apr. 2020. www.theguardian.com, https://www.theguardian.com/world/2020/apr/09/blindsided-how-coronavirus-felled-the-global-economy-in-100-days.
Goldstein, Joseph, and Finbarr O’Reilly. “Fighting Ebola When Mourners Fight the Responders.” The New York Times, 19 May 2019. NYTimes.com, https://www.nytimes.com/2019/05/19/world/africa/ebola-outbreak-congo.html.
McNeil Jr., Donald G. “In Congo, a New Plan to Fight Ebola Follows a Government Power Struggle.” The New York Times, 26 July 2019. NYTimes.com, https://www.nytimes.com/2019/07/26/health/ebola-africa.html.
World Health Organization. “Ebola Virus Disease- Democratic Republic of the Congo.” World Health Organization, World Health Organization, 9 Apr. 2020, http://www.who.int/csr/don/09-April-2020-ebola-drc/en/.