Attack on civilians threatens Ebola response in DRC

The fight against the Ebola outbreak in the Democratic Republic of Congo is at a "critical juncture" after attacks on civilians forced the suspension of control activities, a senior World Health Organization official has warned.

Some 21 people, including 17 civilians, were killed in an attack by rebel forces in the city of Beni, where WHO has based its operations, leading to the declaration of a "Ville Morte", or period of mourning, lasting until Friday. 

This is the seventh and most deadly attack in the area since the outbreak was first declared in August. The disease is spreading in the Nord-Kivu and Ituri provinces of DRC - the most insecure areas of the country where at least two rebel groups are active. 

Peter Salama, WHO's deputy director-general for emergency preparedness and response, told a press conference that the city was in lockdown.

"WHO's operations are in effect suspended," he said. "More than 80 staff in Beni have been confined to the emergency operation centre. Yesterday we were only able to reach 20 per cent of the contacts of confirmed and probable cases in and around Beni. So 80 per cent of people were unable to be followed up or traced."

So far there have been 150 cases of the disease, including 100 deaths, since the latest outbreak was declared in August. 

Dr Salama said that there had been a "paradigm shift"  in the control of the outbreak with the deployment of the Ebola vaccine and experimental therapies. The vaccine has so far been administered to around 11,700 contacts of people with the disease, the largest Ebola vaccination campaign in history.

Health workers are also for the first time using experimental therapies to treat patients, although it is too early to say what effect these are having. 

But responders are also facing pockets of resistance among a community that had a "natural fear of this terrifying disease", said Dr Salama.

"People are refusing follow up and actively fleeing from responders into the forest," he said.

There has also been a case of the disease in a town on Lake Albert, 200 kilometres from Beni, and near the border with Uganda. This town is completely surrounded by a third rebel group, said Dr Salama. The outbreak also poses a threat to the neighbouring countries of Rwanda, South Sudan and Burundi.

He said that local politicians were exploiting and manipulating the community's distrust of the disease ahead of elections due to take place in December.

"The resistance, driven by natural fear of this terrifying disease, is starting to be exploited by local politicians. We're very concerned in the run up to elections in December that exploitation of that natural fear will gather momentum and make it difficult to root out the last cases of the disease," he said.

He added that responders were facing a "perfect storm": an active conflict zone which hampers WHO's ability to reach civilians, distrust by sections of the community exploited by politicians and a "high threat pathogen".

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