Healthcare workers and humanitarian volunteers battling Ebola in the Democratic Republic of Congo are increasingly coming under attack, threatening efforts to contain an outbreak that the United Nations has described as growing at an alarming rate.
More than 260 healthcare workers have reportedly been attacked over the past six months, with eight killed, according to the United Nations Ebola coordinator, Julien Harneis.
Speaking on Friday from Bunia, the capital of Ituri province, Harneis said fear and misinformation were fuelling hostility towards medical teams and the vehicles transporting them.
“Fear translates into angry young men who start throwing stones at their object of fear, the ambulance,” he said.
He described attacks in which ambulances had been burned and health facilities targeted, warning that the violence was particularly troubling because medical personnel were already exposing themselves to significant risks in the fight against the virus.
The dangers have also affected healthcare workers directly. Harneis said about 160 health workers had contracted Ebola themselves, with 43 dying from the disease.
The situation has raised concerns about the ability of responders to reach communities as the epidemic continues to expand.
Red Cross volunteers attacked
The International Red Cross has separately reported a series of attacks against its personnel and equipment in the country.
According to the organisation, 11 incidents involving its volunteers have been recorded, leaving nine volunteers injured. Some ambulances and other equipment have also been damaged or destroyed.
The latest reported incident occurred on Wednesday in Beni, in North Kivu province, where three Red Cross volunteers were assaulted and equipment was destroyed.
A day earlier, two other volunteers were injured in Haut-Uélé while attempting to conduct a burial.
In another incident, a convoy belonging to the Ugandan Red Cross was attacked in Aru, Ituri province, on August 17. Several members were injured, while three ambulances were struck with stones and vandalised.
The Red Cross warned that every attack against its volunteers, vehicles or equipment further complicates efforts to respond to the outbreak.
Misinformation fuels resistance
Aid workers have linked some of the hostility to misinformation and conspiracy theories surrounding Ebola.
Some residents reportedly believe that the outbreak is a hoax, while others have become angry over restrictions governing the burial of relatives who die from the virus.
Traditional burial practices can pose a significant risk of Ebola transmission because the bodies of people who have died from the disease can remain highly infectious. Consequently, specialised teams are often involved in the safe handling and burial of victims.
For families already grieving, however, restrictions on traditional funeral practices can become a source of frustration and suspicion.
Health officials and humanitarian organisations have therefore faced the dual challenge of containing the virus while persuading communities to trust the medical teams attempting to protect them.
Outbreak spreading rapidly
Harneis said the epidemic had killed 2,606 people among 5,458 confirmed cases and warned that its spread was accelerating.
“The epidemic is spreading to an area that is bigger than France, and the outbreak is growing faster and wider than the Ebola response,” he said.
His warning highlights the scale of the challenge confronting health authorities and international organisations working in the affected communities.
The outbreak is unfolding in a region that has endured decades of armed conflict, creating an environment in which insecurity, displacement and weak infrastructure have complicated the delivery of humanitarian assistance.
“All of this is happening in an area that has had three decades of conflict and is generating huge humanitarian needs,” Harneis said.
The combination of insecurity and a rapidly expanding outbreak has placed additional pressure on already stretched medical and humanitarian teams.
Cash crisis threatens response
Beyond direct attacks, aid operations are facing logistical difficulties, including problems with paying the large workforce involved in the Ebola response.
Harneis said tens of thousands of people had been employed to help tackle the outbreak, making reliable payment systems essential to maintaining operations.
However, banking services have been disrupted following the government's suspension of commercial flights that had been used to transport physical cash to banks.
The disruption has created another obstacle for a response already struggling with insecurity, misinformation and the rapid geographical expansion of the epidemic.
Humanitarian organisations say restoring safe access to affected communities and protecting health workers will be crucial to slowing transmission.
For the thousands of medical workers, volunteers and support staff operating in the affected areas, however, the immediate challenge remains reaching vulnerable communities without becoming victims themselves.
The UN and Red Cross have continued to warn that without improved security, community cooperation and functioning logistical systems, efforts to contain the Ebola outbreak risk falling further behind the virus's spread.