Christian Adams
In 1976 a village along the Ebola River witnessed the first recorded outbreak of the deadly virus named after the now infamous river in the Democratic Republic of Congo, formerly Zaire. Ebola is a fatal hemorrhagic fever that engulfs the body and manifests in symptoms of diarrhea, muscle pain, and, most notably, bleeding from the eyes, ears, and rectum. The virus is transmissible through physical contact with bodily fluids. What began as a public health crisis is now embedded within a conflict involving nearly 100 armed militia groups fighting for territory and resources, making it exceptionally challenging for public health officials to combat the virus.
The conflict stems from three intertwining components: corruption, weak government, and a surfeit of natural resources. According to the Council on Foreign Relations, the DRC has an estimated $24 trillion in untapped natural resources. In the Second Congo War (1998- 2003), government-backed forces fought rebel groups at the cost of an estimated 3 million civilian casualties. An agreement was made in 2003 to end the fighting, but fractious rebel groups grew stronger and persisted. These groups still terrorize citizens in Eastern Congo, where Ebola proliferates the most.
Civil unrest and unstable government has also exacerbated hysteria from the virus and made it all the more difficult to contain. The Democratic Republic of Congo delayed their elections in December 2018 due to difficulties with technical infrastructure and the Ebola virus, and as a result, the government took unprecedented measures by cutting vital communication systems. This included internet, cell phone services, and one of the country’s most popular radio stations, Radio France Internationale. The incumbent government led by Joseph Kabila refused to investigate the accusations of voter suppression and refused to give up power. A pot stirring with corruption, political violence, and conflict has since prolonged the public health disaster. With the United States unwilling to send its experts into the region, the second largest recorded Ebola outbreak in history now falls in the hands of an unstable democracy.
The most recent outbreak of the virus is localized in the North Kivu region, including the major city of Beni, with a population of over 230,000. To date, the 2018 Kivu outbreak has reporte over 600 cases and a whopping 60% mortality rate in comparison to the 50% mortality rate of the 2014 West African Ebola outbreak. Could the abnormally high mortality rate be attributed to the lack of a peaceful democratic transfer of power? Experts say yes. According to the BBC, an Ebola assessment center in Butembo was attacked by protestors furious with Joseph Kabila’s corruption: “Some people inside the Ebola assessment centre fled after it was attacked… of the 21 who fled the centre, 17 had tested negative for Ebola once and were doing a second test while four others were doing a test for the first time.”
With critical infrastructure like the Ebola health clinic in Butembo destroyed, the ability to contain the virus is an uphill battle. Vox has reported that it is impossible to link newly diagnosed cases with known cases—this means there are many carrying and transmitting the virus that have gone unidentified by public health officials. Likewise, the political violence has mitigated the impact of humanitarian aid and medical experts to contain the virus. Vox stated: “Due to the ongoing conflict in the region, the US government has decided it’s too dangerous to allow its top Ebola experts to work at the outbreaks epicenter.” The consequences of such a decision are profound—the Democratic Republic of the Congo does not have the resources to solve this crisis, and the longer the United States withholds its assistance, the longer Ebola will spread.
The medical community believes that the most effective means of combating the virus would include a clinical trial that tests various Ebola therapies in the DRC. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases stated: “Combating Ebola requires a comprehensive response that draws on the strengths of all areas of public health. Biomedical research can lead to critical new tools, such as potentially life-saving therapies.” Though biomedical research may save lives, it will be difficult to administer in a war zone. This is what differentiates the outbreak of Ebola in the Democratic Republic of the Congo from cases reported in West Africa in 2014.
As of February, 17th 2019, the World Health Organization reported that there have been 840 cases of Ebola and 537 deaths in the North Kivu region. The World Health Organization reported a number of new vaccinations and preventative activity in neighboring nations. The health care facilities and vaccinations are spreading quickly to other countries like Uganda, where 3,900 workers have recently been vaccinated, South Sudan, where 600 have been vaccinated, and Rwanda, where it is expected that 1,415 workers will receive a vaccination. Preventing Ebola’s spread to other volatile regions is imperative to stop a public health crisis from overlapping with conflict.