(LONDON) — Doctors and public health workers at the epicenter of the Ebola outbreak in eastern Democratic Republic of Congo (DRC) told ABC News that the deadly virus is still spreading at an alarming rate.
“The outbreak is completely out of control,” said Dr. Richard Kojan in an interview from the city of Bunia in Ituri province, which is the hardest hit.
Kojan, who has been involved in fighting previous Ebola outbreaks in central and western Africa and is president of the Alliance for International Medical Action, said deep mistrust within some local communities is hampering efforts to contain the virus.
Another clinician, Dr. Richard Lokudi, who is the director of the main hospital in Mongbwalu, the hardest hit area, told ABC News that the disease was spreading “at an exponential speed.”
Dr. Lokudi said seven symptomatic patients suspected of having Ebola had recently “escaped” from Mongbwalu Hospital.
This was creating “chains and chains of contamination,” Dr. Lokudi said, adding that this was making the virus “difficult to fight.”
According to the World Health Organization, more than 1,000 suspected cases of a rare strain of Ebola, known as Bundibugyo, have been identified in the eastern DRC and more than 230 suspected deaths from the virus have been recorded.
There is currently no vaccine for the Bundibugyo strain. Seven confirmed cases have also been identified in neighboring Uganda, the WHO said.
Last week, the World Health Organization declared the outbreak a public health emergency of international concern.
Jeremy Konyndyk, who worked as a senior official at USAID under Presidents Barack Obama and Joe Biden and is now president of Refugees International, said that the outbreak had already reached an “explosive” level of transmission.
Konyndyk, who is based in Maryland, described the situation in central Africa as “about as urgent as any Ebola response has ever been” and said the 1,000 suspected cases were “almost certainly the tip of the iceberg” and “perhaps even an undercount by a factor of two or three.”
Health officials believe the Bundibugyo strain of Ebola had been circulating, undetected, in the Ituri province for up to three months before it was officially identified. The unusual strain was harder to identify via testing.
However, levels of mistrust within local communities toward measures to contain the virus, as well as skepticism that the virus even exists, are now hampering efforts to stem the outbreak, health officials say.
Kojan said there is currently a lack of laboratory testing capacity in the region, which is needed for accurate diagnosis and effective contact tracing.
The lack of lab capacity means symptomatic patients suspected of having the virus can wait for days for test results, increasing the risk of them leaving isolation prematurely, Kojan said.
“People don’t trust that, you know, Ebola is a reality,” he said.
The Congolese clinician said he was on “the front line” without access to a laboratory, meaning he was struggling to build trust with patients.
New cases every day
Both Both Dr. Lokudi and Dr. Kojan said their healthcare facilities were receiving new suspected cases of Ebola every day.
Amidst the high levels of mistrust, there has also been growing anger towards strict healthcare procedures, which are necessary to safely bury the dead and stop the virus from spreading.
The two Congolese doctors confirmed reports that on two occasions, isolation tents and healthcare facilities had been set on fire by angry crowds in recent days.
In an exchange of messages with ABC News on Tuesday, Lokudi said the police and military were now protecting his hospital, but he said angry groups of youths had still been gathering nearby.
He said that in some cases, amid “resistance” from local populations, officials were unable to safely access remote areas of Ituri province to investigate suspected deaths from the virus.
Lokudi described the situation as “really concerning,” saying that if teams do not go to such areas, then family members face a high risk of catching the virus if they themselves bury their loved ones.
Ebola is transmitted via bodily fluids, so treating sick patients and handling the deceased should only be done by healthcare teams in protective suits. Ideally, a victim’s home should also be sprayed down with disinfectant.
In the remote rural communities affected, these vital protective measures can run contrary to local burial practices and reports suggest this, mixed with a level of misunderstanding, has been the source of many people’s anger.
Kojan described a lack of masks and protective clothing as another “really big problem,” and both doctors said more adequately trained healthcare professionals were needed on the ground to raise awareness and implement barriers to stop the spread of the virus.
Cuts to U.S. programs created difficulties
Konyndyk said significant cuts to U.S, humanitarian aid in the DRC had made things harder.
“We’re kind of fighting this one with several hands tied behind our back,” Konyndyk told ABC News.
“When we have fought Ebola in the past on this scale, it has been a combination of the Ministry of Health, WHO, USAID, CDC,” he said.
“USAID is fully gone, CDC is badly weakened. WHO has been badly weakened, the U.S., of course, withdrew from WHO and cut off all funding,” Konyndyk added.
The former USAID official said in an interview that they were “almost certain” that if USAID were still in place, this outbreak would have been caught earlier.
Konyndyk said he believed earlier reports of “an unknown viral hemorrhagic fever outbreak” in the region “would have been brought to the attention of the U.S. mission” in the DRC.
“I’ve talked with some of the members who worked on that team, who were forced out of the government, who would say things like, look, I would be on the phone every week with health leaders in this part of the country,” Konyndyk told ABC News.
“I think the U.S. visibility on that diminished badly and that contributed certainly to the US being slow to wake up to this, but also to the world being slow to wake up to it,” the humanitarian leader said.
A White House official in response said the claim that cuts to U.S. aid have affected the response to the Ebola outbreak in the DRC was “ridiculous.”
“You could just as easily say people died because England didn’t give enough money or Canada didn’t give more or China didn’t. Why not blame the other countries who don’t do any foreign aid?” the official added.
The Trump administration has argued that its “America First Foreign Assistance programs” are intertwined with broader foreign policy goals and the national interest.
“The United States has saved more lives, and continues to save more lives, than any other country in the world, and we’re going to continue to do it,” the White House official said in a statement. “We’re not going to continue to pour billions of dollars out the door of American taxpayer funds for programs that don’t work and in some cases were flat-out corrupt.”
Back in the affected area of the DRC, both doctors interviewed by ABC said they had messages for the US and the world.
International support is needed urgently “on all levels,” according to Lokudi.
Kojan said he is appealing to the world to realize that this is about people’s “humanity.”
“People are really scared. It’s our humanity … so my message is, you know, we need attention.”
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