The Ministry of Health for the Democratic Republic of the Congo (DRC) said on Sunday that over 1,000 cases of Ebola have now been confirmed, with 254 deaths.
At least 30 of those fatalities occurred in a single camp for internally displaced persons (IDPs) in the northeastern Congo, increasing fears that Ebola will run wild in crowded and unsanitary refugee camps.
The good news from the DRC Ministry of Health was that 100 people have recovered from Ebola infections – an encouraging recovery rate for the deadly disease amid conditions of poverty, insurgent conflict, and public distrust of health officials. The ministry said at least 365 patients were currently receiving treatment in hospitals and isolation wards.
The worst of the bad news came from the Kigonze refugee camp near Bunia, capital of Ituri province, which is the epicenter of the Ebola Bundibugyo outbreak.
The Kingonze camp has about 15,000 residents, and according to administrators, many of them have refused to be tested for Ebola. At least 30 people have died since the beginning of May after exhibiting symptoms consistent with Ebola, and given the resistance to testing, officials simply have no idea how many people are infected.
“People didn’t just die like this before,” said camp spokesperson Desire Grodya Bapi.
Reuters quoted eyewitnesses who saw corpses covered in sheets at the camp, including pregnant women and children, while teams wearing hazmat suits labored to disinfect bodies for burial.
The families of many of the dead refused to cooperate with Ebola protocols for burial, a sadly familiar trend in the Congo that has helped Ebola spread by bringing unprotected people into contact with infected bodies.
“Our team tried to persuade people to accept doctors to inspect the bodies. They completely refused,” said Justin Zanamuzi, director of the Catholic aid group Caritas.
A camp resident who has already lost two children told Reuters that the situation in the Kigonze camp is even worse than it looks.
“These are conditions that no human being should have to live in. If you look around, people are dying one after another,” he said.
Another refugee camp called Kpangba confirmed its first two Ebola-related deaths last week. The victims were a 60-year-old woman and her daughter. The mother broke out of quarantine several days before her death, and her contacts could not be traced during that time.
The eastern Congo is dotted with refugee camps because a wide variety of insurgent and jihadi groups have been fighting the government, and each other, for years. Humanitarian aid groups say it is simply impossible for them to reach some villages because the insurgents have cut off travel and communications.
UNHCR, the United Nations refugee agency, said on Friday there are at least 2 million IDPs in the eastern DRC, with about 320,000 living in refugee camps. UNHCR warned that thousands of people have fled the most dangerous conflict zones during the outbreak, potentially spreading Ebola to new areas.
The World Health Organization (W.H.O.) said on Friday that another growing area of concern is the risk posed to medical personnel. At least 75 medics in the DRC have contracted Ebola since the official beginning of the outbreak in May, and 17 of them have died.
“It is a really high price that the system, the healthcare system, is paying, because we don’t have enough of healthcare workers in DRC,” W.H.O. emergency director Marie Roseline Belizaire told reporters.
Balizaire said W.H.O. is offering “psychological support to some medics who were too scared to treat patients, having watched many of their colleagues fall ill.” The DRC was already grievously short of doctors, with one of the lowest proportions of medical workers to population in the world.
On Saturday, Belizaire said the local and international response to the outbreak has improved, but remains insufficient.
“On a scale of zero to ten, compared with where this response needs to be, I would say we are at about three or four,” she said.
“The outbreak is evolving rapidly,” she added, urging “all partners” to “step up their efforts on the ground in order to keep pace with the evolution of this epidemic.”
Part of that “evolution” is a demographic shift in the victims, who originally skewed young and male. Epidemiologists remain uncertain exactly when the outbreak began, but initial transmission appears to have been among itinerant men working in the numerous mines that dot Ituri province. The latest waves of Ebola patients, on the other hand, tend to be women and children.
“In outbreaks of infectious diseases, women are generally the most affected. They are the ones who care for family members, their husbands, their parents and their children,” Belizaire said.
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