Misinformation and difficult access hamper Ebola response in eastern DRC

More than 9,000 confirmed cases and over 4,300 deaths have been recorded in the latest Ebola epidemic in the Democratic Republic of the Congo, five months after authorities officially confirmed it. The outbreak, the country’s 17th, continues to spread across eastern provinces, with Ituri at its epicentre and cases reported in North Kivu and Haut-Uélé.

“The epidemic has spread across an area larger than Switzerland,” says Pierre-Oliver Ngadjole, a doctor and nutritionist with the Swiss aid organisation Medair. The scale complicates efforts to reach patients and contain transmission across rainforest communities and mining camps. Ngadjole says the high death toll is driven chiefly by delays in treatment: people often reach hospitals only after becoming seriously ill. For response teams, that makes distance, transport and public trust central to stopping the outbreak.

Some patients travel for days and cross several rivers to reach a treatment centre. Poor roads and limited transport turn medical care into an arduous journey, especially during the rainy season. “The roads are in a terrible state. During the rainy season, not even motorbikes can get through,” Ngadjole says.

Families facing those barriers may turn to home remedies, losing time that can be critical to survival. At the Katwa Ebola treatment centre in Butembo, more than 70 of the 252 patients admitted have died. Ngadjole says patients commonly arrive too late for treatment, making access a defining factor in the death toll.

The outbreak is also concentrated among people whose work and family lives bring them into close contact with others. Those aged 15 to 49 are the hardest hit, a pattern Ngadjole links to employment in mining camps. Young children are also quickly infected within their families.

Rumours that no vaccine or cure existed for the current strain weakened people’s willingness to seek care. The epidemic is caused by the Bundibugyo strain, for which no approved vaccine is currently available. But Ngadjole says early intensive care, including intravenous fluids containing electrolytes, can substantially improve a patient’s chances of survival. Hospital isolation also helps break transmission chains.

Misinformation has compounded the physical barriers to treatment. In a region where reaching a hospital can take days, a belief that care cannot help may further delay a decision to travel. The security situation adds another risk: people with Ebola fear attacks by armed militias on the way to hospital. Some religious communities urge patients to pray rather than seek medical care.

Medair is involving survivors to build trust and counter rumours through first-hand accounts. “We let survivors tell their stories,” Ngadjole says. Their testimony offers communities a direct account of treatment and recovery as aid teams work to encourage earlier care.

A Swiss aid organisation is working to contain the epidemic in a region larger than Switzerland. Medair is an international emergency relief organisation based in the canton of Vaud. It provides medical and infrastructure support in crisis zones, and the Swiss Agency for Development and Cooperation is among the organisations supporting its work in Switzerland.

Founded in 1989 by two medical doctors and other volunteers, Medair employs more than 1,500 people worldwide. Its reported annual operating income is about $91.6 million (CHF 75.6 million). In eastern DRC, the immediate challenge described by Ngadjole is to get patients to treatment sooner, despite poor roads, long journeys, rumours and security fears.

The response also depends on protecting aid workers and communicating in ways communities trust. Medair’s use of survivors’ accounts is one effort to encourage people to seek care. In a vast outbreak zone, access and confidence shape whether treatment can begin in time.