分类： health

In the gold-mining town of Mongbwalu, located in the eastern Democratic Republic of the Congo’s Ituri province, a devastating Ebola outbreak of the rare Bundibugyo strain has spread unchecked for weeks, overwhelming local healthcare workers who already face systemic challenges that threaten both their work and their lives. At the heart of the response is Mongbwalu General Referral Hospital, where medical director Dr. Richard Lokudu has spent every working hour treating a steady stream of infected patients — even responding to suspected case alerts in the dead of night — yet he has received almost no compensation for his frontline work.

This outbreak, which health authorities trace back to Mongbwalu’s bustling mining sector, caught regional officials completely off guard after spreading silently through communities for more than a month before detection. Today, it has become one of the deadliest Ebola events the country has faced in recent years, with Congolese health officials confirming 452 total cases and 82 deaths as of reporting. A single day this week saw 71 new infections, a marker that officials say confirms widespread active transmission across local communities.

Mongbwalu’s unique economic and living conditions have created the perfect environment for Ebola, which spreads through close contact with infected bodily fluids including blood, sweat, feces, and vomit, to multiply rapidly. Thousands of migrant gold miners flock to the town to work in dangerous, cramped pit and cave mines, then reside in overcrowded informal camps with limited access to clean water, sanitation, or basic health guidance. Compounding this risk is widespread community skepticism about the virus, with many residents distrusting medical authorities and avoiding care — a trend that has already cost the lives of multiple frontline health and response workers who were exposed while trying to contain the spread.

For the workers on the ground, the daily struggle extends far beyond the risk of infection. Many have gone months without pay or promised hazard allowances, even as they sacrifice all personal time to respond to the crisis. “During the first week, we did not even have time to go home and eat. The second week was the same. We only eat once a day, what amounts to breakfast in the evening,” explained Alice Bamuhinga, a nurse at the Mongbwalu hospital. Dr. Lokudu echoes the frustration of his colleagues, noting that frontline teams deserve fair compensation and regular pay for the risks they take. “It is one thing to be far away and hear statistics being reported, but what is happening on the ground is enormous. People are sacrificing their rest and comfort for this cause. There should be recognition that they deserve compensation,” he said. To date, the Congolese government has not responded to requests for comment on the delayed payments.

The outbreak is also being fought with almost no dedicated resources, years of underinvestment in the country’s public health system have left regional facilities ill-equipped to handle a large-scale infectious disease event. Unlike more common Ebola strains, the Bundibugyo variant has no approved vaccines or targeted treatments, leaving clinicians only able to manage patients’ symptoms as they wait for outcomes. When the outbreak was first officially confirmed by the Congolese Ministry of Health on May 15, local hospitals had no ability to test for the specific strain — a gap that allowed the virus to gain a critical foothold, according to World Health Organization Director-General Tedros Adhanom Ghebreyesus. International aid groups have scrambled to deploy support to the region, but critical supplies including personal protective equipment, masks, gloves, boots, and symptom-managing medications were in acute short supply in the critical early weeks of the response.

“There has been an erosion of the health system. There has not been investment in the health system, and this has been going on for years,” said Heather Kerr, country director for the International Rescue Committee in Congo.

Even as the outbreak worsens, frontline workers continue to navigate barriers that extend beyond resource gaps. Ongoing conflict between the Congolese government, the Rwanda-backed M23 rebel group, and Islamist militant factions has restricted movement into affected communities, leaving many response teams unable to reach remote areas to investigate new case alerts. “Despite the alerts we receive and the teams we have on site, we lack the means to travel into the field. As a result, there are alerts we are unable to investigate,” Dr. Lokudu explained.

For many local residents, the outbreak has already brought irreversible loss. Asero Jeanne, a 52-year-old Mongbwalu resident, lost two of her five children to Ebola within two weeks after community misinformation led her family to avoid hospital care at first. Neighbors told the family anyone who sought treatment at the hospital would die immediately, and the family initially mistook her daughter’s symptoms for malaria. After three weeks of shifting between home care and delayed hospital treatment, her daughter died, followed days later by her son. Jeanne ultimately contracted the virus herself but survived, one of at least five confirmed recoveries reported by the Congolese government. “I saw about 20 people die. I watched them being taken to the morgue, yet God is allowing me to leave here alive. I thank the doctors,” she said.

In response to the growing crisis, Tedros announced a $518 million international response plan Friday to contain the outbreak, noting that “containing Ebola depends on political commitment, sustained financing, and the trust and engagement of communities.” For frontline workers like Dr. Lokudu, however, the immediate need remains clear: fair pay, adequate resources, and the support required to stop an outbreak that is currently spreading faster than their existing capacity to treat it.

Along the Uganda-Democratic Republic of Congo frontier at the Mpondwe border post, piles of perishable goods and lines of idling trucks tell the story of a public health measure that has brought cross-border trade to a near-standstill, leaving hundreds of traders and daily laborers facing crippling losses.

Two weeks after Congolese authorities declared an Ebola outbreak in the eastern province of Ituri, Uganda implemented a full closure of its western border on May 28, a proactive step driven by rising alarm over cross-border transmission of the rare, untreatable Bundibugyo Ebola variant now spreading through eastern Congo. While narrow exceptions are carved out for emergency response, humanitarian aid, security operations, and cargo, local authorities in Kasese district – Uganda’s frontier district bordering the outbreak zone – have ramped up enforcement in recent days as virus transmission in Congo continues to outpace containment efforts.

The new, stricter controls have left long convoys of cargo trucks stacked on both sides of the border, with perishable shipments at risk of rotting before they can clear inspection. For Leah Masika, a Ugandan trader, her 50-bag consignment of plantain destined for markets around Kampala is already leaking water, and will spoil within hours if the trucks do not move. “Our things are here rotting,” she told the Associated Press, adding that she cannot absorb the estimated $2,200 loss, and has no plans to order more goods from Congo until the outbreak is fully contained. “We are begging them to help us and open (the border). We will not go back to Congo.”

Traders across the crossing say they understand the need for public health safeguards, but argue the current delays are excessive. Sylvia Asiimwe, a clearing agent at Mpondwe, notes that a queue of trucks stretching more than a mile along the Ugandan side includes seven carriers hauling Chinese-imported fish bound for Beni and Butembo – cities in North Kivu province, hundreds of kilometers from the Ituri outbreak epicenter. “The fish is going to spoil,” she said. “So much money.”

The economic pain extends far beyond large-scale cargo traders. Mpondwe is Uganda’s busiest hub for informal cross-border trade, which the Uganda Bureau of Statistics valued at an estimated $131 million in 2023. For generations, the border has bound communities together: the Bakonzo people on the Ugandan side share deep family and cultural ties with the Banande on the Congolese side, and trade has long been the backbone of the local economy. Today, storefronts along the border route sit shuttered, and casual laborers who once made their living loading and unloading cargo pass the time idling on stools.

Ismail Mumbere, a roadside snack vendor who depends on border traffic for customers, summed up the widespread despair: “The situation is bad. A lot of people earn from here, in many businesses. But now the government has told us there is Ebola. Ebola has wasted our work.”

Public health officials defend the harsh restrictions, noting the unique danger posed by this specific Ebola outbreak. The variant spreading in eastern Congo is the rare Bundibugyo strain, which no existing licensed vaccines or treatments are effective against. Uganda has already recorded 15 confirmed Ebola cases, all linked to the Congolese outbreak, after infected Congolese nationals traveled to Kampala for treatment before the outbreak was publicly declared on May 15. Investigators believe the virus was circulating undetected for days or even weeks before that declaration, putting neighboring Uganda at extreme risk.

Arafat Bwambale, a surveillance officer for Kasese district, explained that the tightened cargo controls are designed to limit unregulated human movement across the border, which stretches hundreds of miles and is crisscrossed by dozens of unmonitored footpaths outside formal crossing posts. Officials are currently working to block more than 24 informal footpaths to stop unauthorized crossings from Congo. “With movement of cargo, and maybe trucks, is mobility of people, and we want to reduce that,” he said.

Uganda has a long, traumatic history with Ebola outbreaks dating back to 2000, when an outbreak killed more than 200 people. The virus, first discovered in 1976 in simultaneous outbreaks in what was then Zaire and present-day South Sudan, spreads through close contact with the bodily fluids of infected people or deceased victims. For this outbreak, local health authorities have prepared extensively: the nearest referral hospital in Kasese maintains a fully staffed isolation center and a local lab that can return Ebola test results within six hours. To date, 41 samples taken from suspected cases in the Kasese area have tested negative.

The World Health Organization, which has classified the current outbreak as a Public Health Emergency of International Concern (PHEIC), has openly discouraged widespread border closures, though it acknowledges neighboring countries face extremely high risk of imported cases. Even so, Ugandan officials are expected to impose even stricter, more systematic rules for cargo and truck movement in the coming days, after a meeting of the local Ebola task force.

For the traders and workers who depend on the Mpondwe border for their livelihoods, the prospect of tighter restrictions only deepens their uncertainty. With perishable goods already rotting in idling trucks, many face financial ruin if the border remains closed for weeks more while authorities work to contain the outbreak across the frontier.

The ongoing Ebola outbreak in Central Africa currently centered in the Democratic Republic of the Congo could surge to as many as 20,000 cases or more, a new analysis from U.S. Centers for Disease Control and Prevention (CDC) has warned. The final size of the epidemic will depend entirely on how rapidly response teams can identify and isolate infected people to slow chains of transmission, health officials confirmed Friday.

The CDC released projections from multiple computer-generated scenarios, which forecast a wide range of possible case counts spanning from 10,000 to more than 20,000 total infections. If the worst-case projection holds, the outbreak would come close to matching the deadliest Ebola epidemic in recorded history: the 2014–2016 West Africa outbreak that killed more than 11,000 people and infected over 28,000.

Speaking at a press briefing for reporters, CDC Ebola response incident manager Dr. Satish Pillai emphasized that aggressive public health intervention is the only way to avoid large-scale spread. “Without strong public health interventions, the modeling work suggests an outbreak of that scale is possible,” Pillai said.

Jennifer Nuzzo, director of Brown University’s Pandemic Center, noted that the new projections confirm long-held concerns among infectious disease experts. “This modeling affirms what we have worried about since the beginning: This outbreak is following a dangerous trajectory if more is not done to stop the spread of Ebola,” she said. However, she also cautioned against overreliance on the exact numerical forecasts, noting that outbreak projections are notoriously difficult to get right with limited real-time data. “I wouldn’t read too much into the specific numbers. It’s really hard to make an accurate projection when you have limited data,” Nuzzo added.

As of Friday, the Africa Centres for Disease Control and Prevention has recorded roughly 400 confirmed Ebola cases and 63 confirmed deaths from the current outbreak. Experts widely agree that the actual caseload is higher, as many infections have likely gone undiagnosed and unreported in conflict-impacted regions.

The current outbreak is driven by the Bundibugyo Ebola virus, a strain for which no approved targeted treatments or specific vaccines exist currently. The virus spreads through direct contact with infected bodily fluids including blood, vomit, and semen, and the disease has a high mortality rate. The World Health Organization designated the outbreak a Public Health Emergency of International Concern, the agency’s highest alert level, in May 2024. Retrospective analysis suggests community transmission may have begun as early as February, but initial testing incorrectly targeted a different Ebola strain, delaying a coordinated response.

Response efforts have been severely hampered by ongoing armed instability in eastern DRC. The region is facing active conflict between the Congolese government and Rwanda-backed M23 rebel forces, alongside attacks from the Allied Democratic Force, a group affiliated with the Islamic State. Widespread violence has forced hundreds of thousands of people to flee their homes, disrupting public health outreach and contact tracing efforts.

Despite the alarming projections for the outbreak in Central Africa, both Nuzzo and the CDC have assessed that the risk of large-scale community spread of Ebola in the United States remains very low. “I don’t think it’s a scenario that it’s going to come here and spread broadly,” Nuzzo told reporters earlier this week, a conclusion the CDC echoed in its Friday publication.

The low U.S. risk stems in part from new travel restrictions implemented by the U.S. government: entry is banned for non-U.S. citizens and non-green card holders who have traveled to the DRC, Uganda, or South Sudan in the 21 days prior to their attempted entry. U.S. passport holders returning from those three countries are required to undergo mandatory health screening and enter through one of four designated U.S. airports to monitor for potential symptoms.

The CDC’s latest modeling framework tested a range of variables to generate its projections, including undiagnosed past infections and variation in how quickly response teams can isolate new cases. Under a scenario where roughly 50 people had died by late May and only 20% of infected people were successfully isolated before spreading the virus, most simulations forecast at least 20,000 cases and 4,000 deaths over a three-month period. Pillai noted that the actual current rate of successful isolation is believed to fall on the lower end of the range modeled by the agency.

If response teams can scale up isolation efforts to reach 50% or 70% of infected people quickly, the CDC projects total cases would drop to roughly 10,000. At the same time, officials warned that if the true death toll from late May was higher than currently confirmed, final case counts could end up even higher than the worst current projections.

It is not the first time the CDC has released high-profile Ebola outbreak modeling: during the 2014 West Africa epidemic, the agency projected a worst-case scenario of up to 1.4 million infections if no interventions were implemented, a forecast that ended up being more than 50 times higher than the actual final caseload. That experience has shaped the agency’s current approach to framing projections as possible scenarios rather than definitive predictions, officials noted.

The Associated Press’ health and science coverage receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation, with the AP retaining full editorial control over all content.

Ebola, a deadly viral pathogen that transmits through direct contact with infected bodily fluids, requires medical personnel to utilize full personal protective equipment when caring for confirmed patients to prevent accidental exposure. The latest Ebola outbreak statistics from the eastern Democratic Republic of Congo (DRC) have sparked initial cautious optimism, after a dramatic downward revision of reported case counts – but public health leaders stress the reduction does not signal the outbreak itself has become less severe.

Previously, DRC authorities had reported more than 1,000 suspected cases and nearly 250 suspected deaths linked to the current outbreak. The updated count, however, narrows those figures to roughly 380 confirmed cases and 60 confirmed deaths within DRC borders, with an additional 15 confirmed cases and one fatality recorded in neighboring Uganda. The key shift behind the revised numbers is a transition from counting suspected cases to only confirmed cases: expanded laboratory testing has allowed officials to rule out thousands of patients who presented with Ebola-like fever but were actually suffering from other endemic illnesses, most commonly malaria, which is widespread across DRC.

Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), noted that the outbreak gained a significant foothold before coordinated response efforts began, but that intervention teams are now closing the gap in containment. Even with progress in data collection, however, major barriers to stopping the outbreak remain.

One of the most pressing challenges is incomplete contact tracing, a core strategy for stopping Ebola chains of transmission. Currently, only around 45% of people who have had direct contact with confirmed Ebola patients are being actively monitored for symptoms. WHO guidelines require at least 90% of contacts to be traced to bring an outbreak under control. The low follow-up rate is partially tied to the outbreak’s location: the epicenter lies in a conflict-affected region of eastern DRC, where ongoing violence disrupts public health work.

Community mistrust is another major obstacle. Earlier this week, an Ebola burial response team was attacked in South Kivu province, forcing workers to abandon a coffin and raising grave concerns about further uncontrolled transmission. Traditional funeral practices in the region often involve close contact with deceased bodies, including washing and touching, and large public gatherings – two factors that dramatically increase Ebola infection risk, since the virus spreads through bodily fluid contact. Dr. Tedros emphasized that building trust with local communities is a non-negotiable critical step to getting the outbreak under control.

The current outbreak is concentrated across three eastern DRC provinces, a territory roughly the size of the United Kingdom, with large swathes of rural, remote terrain that is difficult for response teams to access. Compounding this, the region is one of the most politically volatile in Africa, with multiple active armed groups operating across the area that disrupt aid work.

Speaking to the BBC’s *Today* program, Dr. Tedros highlighted a broader global health priority: earlier this year, he urged foreign ministers planning to increase defense spending not to overlook the threat of “invisible enemies” like infectious disease, noting the COVID-19 pandemic claimed roughly 20 million lives – far more than any recent armed conflict. He also reassured the global public that the risk of a worldwide Ebola pandemic is low, since unlike the respiratory coronavirus that caused COVID-19, Ebola is not transmitted through airborne particles.

WHO’s current risk assessment classifies the outbreak as very high risk within DRC (which has now faced 17 separate Ebola outbreaks since the virus was first discovered there 50 years ago), high risk across the central African region, and low risk globally. In line with this low global assessment, British officials announced earlier this week they will not implement mandatory temperature screenings for flights arriving from affected regions at UK airports, citing the proven limited effectiveness of such measures. During the 2014 West African Ebola outbreak, more than 12,000 passengers were screened across five major UK airports, but screenings failed to detect the country’s only confirmed case – that of nurse Pauline Cafferkey, who entered the UK undetected before being diagnosed.

In the eastern Congolese city of Bunia, epicenter of an unexpected and fast-moving outbreak of the rare Bundibugyo Ebola variant, a quiet public health battle is being waged on the airwaves. This outbreak caught local communities completely off guard, spreading undetected for weeks before authorities issued an official alert, and deep-seated misinformation and public skepticism have hindered containment efforts from the start.

Congolese health officials formally declared the outbreak on May 15. As of this week, official records count 363 confirmed cases and at least 62 deaths, but public health experts warn these numbers almost certainly understate the true scale of the epidemic. Initial testing protocols focused on more common Ebola strains, creating critical weeks of delay that allowed the virus to expand far beyond its original three health zones to 24 zones across the region.

Many local residents have dismissed official warnings of the outbreak as an invented “Western conspiracy,” spreading unfounded rumors that the crisis is exaggerated by opportunistic actors seeking financial gain. For 52-year-old Bunia resident Samson Gerson, a father of seven, this mistrust runs so deep that he says he would refuse any future Ebola vaccine, preferring to risk death over accepting what he sees as a dangerous, profit-driven hoax. Even basic facts about the outbreak are questioned by locals like Chantal Francine, who notes that most residents have only seen secondhand edited images of Ebola fatalities on mobile phones, leaving them skeptical of reported death tolls.

This widespread resistance to public health guidance has already had dangerous consequences. Since the outbreak was declared, local communities have carried out at least three separate attacks on Ebola treatment centers, demanding the release of deceased patients’ bodies. During these attacks, multiple suspected Ebola patients fled the facilities, and health workers have been unable to trace their whereabouts, creating new, unmonitored transmission risks. Health officials confirm that misinformation and fear discourage residents from following safety protocols or seeking timely medical care, directly allowing the virus to spread faster.

Public health analysts trace this deep mistrust to a combination of longstanding skepticism of the national healthcare system and limited engagement from local government officials in outbreak response. “What is key is to involve the local actors at all levels. If we try to impose what we think is right to the community, we are running towards failure,” explained Basile Rambaud, emergency programs director for Mercy Corps in Congo. “If people do not trust the response, they end up delaying to seek care, rejecting protective measures, or avoiding working with health teams, giving the virus more time to spread.”

Compounding the crisis further is the context of ongoing violent conflict in the region. Eastern Congo remains destabilized by clashes between government forces and the Rwanda-backed M23 rebel group, plus frequent attacks by the Allied Democratic Force, an extremist group affiliated with the Islamic State that killed 16 people in Beni territory, North Kivu, just this week. Widespread population displacement from these conflicts has disrupted public health work and created more opportunities for the virus to spread across communities. There is also no approved vaccine or specific treatment for the rare Bundibugyo Ebola strain, adding an extra layer of danger and uncertainty to the response.

Against this backdrop, one local journalist has stepped forward to fill the information gap. Vérité Johnson, editorial secretary at Bunia’s Radio Télévision Mont Bleu, launched a daily radio program specifically designed to counter false rumors and deliver accurate, accessible information about the outbreak to local residents.

The 45-minute show, which airs every morning at 10 a.m., has quickly become a critical lifeline for communities. It regularly features public health specialists who share the latest outbreak updates, explain safety protocols, and answer listener questions directly. Listeners can call in live to ask about their concerns, and short educational jingles about Ebola safety are played throughout the broadcast day to reinforce key messages. For many residents who were unaware of the outbreak’s facts or deeply skeptical of official information, the program has helped shift perspectives.

Congo has now faced 17 separate Ebola outbreaks since the virus was first identified in the country in 1976, so community resistance to public health measures during emergencies is a well-documented challenge. Johnson acknowledges that significant public resistance remains, but says the local media’s role in disseminating facts remains indispensable.

“Everyone is free to think what they want, but the information remains the same. The epidemic is here,” Johnson said, confirming that the station will continue running the program as long as the outbreak persists. The WHO Director-General Tedros Adhanom Ghebreyesus has also warned that response efforts are still falling behind despite recent improvements in testing, underscoring the urgent need for trusted, local information campaigns like Johnson’s to turn the tide of the outbreak.

In the heart of eastern Congo’s Ituri province, where one of the most rapidly expanding Ebola outbreaks in recorded history is unfolding, 28-year-old Aline Kasiwa makes an unwavering, dangerous choice every single day. For a week, she has cared for her ailing mother—feeding her, helping her drink, washing her clothes—all while acutely aware that every interaction puts her at risk of contracting the deadly Bundibugyo Ebola virus, a strain with no approved vaccine or targeted treatment. Too terrified to bring her mother to a local hospital, where she has heard even medical staff are dying from the disease, Kasiwa says she has no other option: “She is the only family I have left. I cannot abandon her.” With nothing but a low-cost cloth face mask to shield herself, Kasiwa embodies a stark, underreported reality of this crisis: women across eastern Congo are disproportionately exposed to Ebola, forced into frontline caregiving roles that leave them far more vulnerable to infection than their male counterparts.

Dr. Furaha Elisabeth, director of Bunia’s Karibuni Wa Maman gynecology and obstetrics clinic, explains that social norms in the region place almost all informal care work on women’s shoulders. “It’s the woman who gives them a bath, it’s the woman who feeds them, and it’s the woman who’s there to wash the dirty clothes and everything else,” she says. Beyond at-home care, women also traditionally lead burial preparation for deceased family members—a practice that carries extremely high Ebola transmission risk, given the virus spreads through contact with infected bodily fluids.

History bears out the lopsided risk of this crisis. Data from past Ebola outbreaks consistently shows women suffer higher infection and death rates than men. During the 1970s first recorded Ebola outbreak, 56% of deaths were women, according to UN Women. In the 2018–2020 Congo outbreak—the deadliest the country has ever experienced—women and girls made up roughly two-thirds of all confirmed cases. Sofia Calltorp, UN Women’s chief of humanitarian action, says the same pattern is already emerging in the current outbreak. “Ebola transmission follows social realities,” she notes. “The virus spreads along the lines of care-giving, domestic labor, front-line health work and burial practices.”

Compounding this inequality is a catastrophic shortage of critical personal protective equipment (PPE) that leaves both professional health workers and family caregivers defenseless. Staff at Karibuni Wa Maman clinic, which screens symptomatic patients before referring them to larger treatment centers, say they have received no full PPE since the outbreak began, despite repeated appeals to national health authorities. The clinic is run by local aid group Women’s Solidarity for Inclusive Peace and Development, whose president Julienne Lusenge says the only supplies the organization has secured from international and state partners are a small amount of hand sanitizer and a handful of masks for clinical staff. This gap puts even informal caregivers at extreme risk, Lusenge adds: most women caring for sick relatives at home do not even know their loved one may have Ebola, let alone have access to gear to protect themselves. “During previous outbreaks, many women died because they were the ones nursing sick family members,” she says.

Pregnant women face a particularly devastating, impossible dilemma. Many avoid seeking routine prenatal care at local clinics out of fear of contracting Ebola, leaving them and their unborn children without life-saving monitoring. Anny Ekyambo, a 32-year-old Bunia resident five months pregnant, says she shares this fear with most other pregnant women in her community. “I know that there are steps we must follow with the doctors to monitor the pregnancy and the baby, but we have no choice because this epidemic frightens us,” she explains. UN Women points out that pregnant women already face higher exposure due to their regular need for health services, and Lusenge warns that avoiding care will have dire secondary consequences: “We risk seeing a rise in prenatal and postnatal mortality, for both mothers and children.”

As of this week, Congolese authorities have confirmed 344 cases of Ebola, including 60 deaths, with dozens more suspected cases yet to be tested. Neighboring Uganda has recorded 15 confirmed cases and one death. The outbreak was identified weeks later than it should have been, because the rare Bundibugyo strain was not included in initial testing protocols. Even with incremental improvements in response coordination and new aid arrivals in recent days, medical charity Doctors Without Borders says the virus is still spreading faster than intervention teams can contain it. “Nobody knows the true scale and severity of this outbreak,” said Dr. Alan Gonzalez, the organization’s deputy director of operations.

Multiple overlapping challenges have hampered the international and state response to the crisis. Ituri province, where the outbreak is centered, is located more than 1,000 kilometers from Congo’s capital Kinshasa, with crumbling road networks and chronically underfunded, underequipped health facilities. Ongoing violent conflict has further blocked access: the Islamic State-allied Allied Democratic Forces rebel group operates in the region, while the Rwanda-backed M23 rebel militia controls key urban centers in neighboring North Kivu and South Kivu, where additional cases have been confirmed. Decades of conflict have also left local communities deeply wary of outside authorities and medical workers, pushing more people to rely on at-home care from family members rather than seek official treatment—once again shifting the risk onto women.

This coverage is supported by the Gates Foundation as part of AP News’ global health and development reporting in Africa, with the AP retaining full editorial control over all content.