Attempts to end the second worst Ebola outbreak on record are hampered by “political games” and distrust of outsiders in two Democratic Republic of Congo towns, a senior World Health Organisation (WHO) official said.
The epidemic moved through north-eastern Congo, killing 1,117 people since mid-2018. A rapid international response with an effective vaccine managed to stop the spread in a string of towns, including Beni, Kyondo, Komanda, Tchomia, Mabalako, Mandima and Kayna, WHO emergencies chief Mike Ryan said.
In two towns, Butembo and Katwa, there is persistent infection and reinfection, he told an audience at Geneva’s Graduate Institute.
“They see Kinshasa being as far away as New York. Anyone further than five miles down the road, or maybe sometimes 500 metres, is an outsider,” he said.
“They are distrusting of outside influence. And getting this community on board has been a challenge with missteps made along the way.”
Ryan added there were “myriad” Mai-Mai militia groups, with at least 21 around Butembo and Katwa alone, some leaning towards criminal activity and many manipulated by political causes.
“There is political gaming going on in this part of the world – government, opposition and others – and this needs to stop,” Ryan said.
Community engagement strategy involves healthworkers visiting a village in advance of vaccination, but by the time they go back the next day, youth groups or others are often there to intercept them.
“It’s not the family who are rejecting, it’s other community elements organised to respond to ‘outsiders’, be they government or NGOs or others and that causes flashpoints with the teams.”
Ryan said the problem was different from attacks on health facilities by armed insurgents, who used “heavy arms fire, rocket-propelled grenades and other stuff”, which horrified local inhabitants.
To try to improve access for healthworkers there had been discussions with Congo’s president and opposition leaders, as well as the bishop of Butembo, imams and tribal chiefs who wield political influence. A truly “all society approach” was needed, “or the situation will get worse”, Ryan said.