The rare Ebola outbreak is one danger. Attacks on healthcare workers are another

BUNIA, Congo– Every time Vanny Birungi, a Red Cross volunteer in eastern Congo, goes out to raise awareness about the latest Ebola outbreak as suspected cases approach 1,000, she faces a double threat.

One of them is the rare Bundibugyo type of Ebola, which has no vaccine or treatment. The other is the anger and suspicion of residents who threw stones and verbal violence at her in Bunia, a town at the heart of the epidemic.

“We keep telling them the disease exists. Some accept it, some don’t,” Birungi told The Associated Press on Monday as she and her colleagues spoke to groups of people in a working-class neighborhood under the blazing sun.

Aid workers are particularly at risk in this volatile region where residents like Birungi have long been threatened by armed groups who have killed thousands and displaced many more in recent years.

Trust is hard to find among the traumatized population who are wary of outsiders, even those desperately trying to contain the fast-spreading outbreak that experts say was discovered weeks later. Surveillance of these diseases has been weakened by cuts in U.S. and other aid.

“These people should stop bothering us. They just want to get rich. Let’s not forget that Ebola is a white man’s invention,” said Pierre Basola, a 56-year-old Bunia resident, who added: “Stop talking to me anyway.”

On three occasions in the past week, health facilities have been attacked. Angry young men stormed a hospital treating Ebola patients on Sunday, forcing medical staff to evacuate them as gunshots rang out.

On Saturday, a group of residents set fire to a tent for suspected and confirmed Ebola cases run by Doctors Without Borders in Mongbwalu, and more than a dozen people suspected of carrying the virus fled. On Thursday, a center in Rwampara was set on fire after relatives were barred from retrieving the body of a man suspected of having Ebola.

Anger is amplified as virus prevention practices prevent relatives from handling bodies during final rites following an illness that some have described as sudden and dramatic, with vomiting and bleeding.

The Ebola virus is spread through close contact with the bodily fluids of sick or deceased patients, such as sweat, blood, feces or vomit. Experts say health care workers and family members who care for patients are most at risk.

“Trust is almost as important as the health response, because if you feel this massive distrust in communities, they won’t go to health centers,” said Heather Kerr, country director of the International Rescue Committee in Congo.

Armed conflict in the region poses another challenge. Traveling from Bunia, the capital of Ituri province, to Mongbwalu puts humanitarian groups at risk of attack in a region more than 1,000 kilometers (620 miles) from Congo’s capital, Kinshasa.

At the same time, the outbreak now has more than 900 suspected cases and more than 220 suspected deaths, World Health Organization Director-General Tedros Adhanom Ghebreyesus said on Monday.

“We are currently playing catch-up in the face of an epidemic that is evolving very quickly,” he said.

Mado Nditamba, a 70-year-old Bunia resident, said she saw students fleeing aid workers.

“The last time Ebola appeared, the scale was not comparable to what we are experiencing today,” Nditamba said. “But today this epidemic is worse. We go to doctors in hospitals, but they die too. That’s what worries us. We don’t know what to do and we leave everything to God.”

Congo has experienced 17 Ebola outbreaks and the WHO says the country is equipped to respond. But the first tests in this outbreak were done for a more common type of Ebola, wasting valuable time. Experts are still trying to determine when this outbreak began.

There are few places to test this type of Bundibugyo in a region where clinics can run on generators and a major airport serving as a humanitarian hub has been in rebel hands for more than a year.

Health workers on the ground told the AP they were underprepared and underprotected. Today, an unknown number of responders have been infected and some have died.

A Congolese doctor was reported dead Sunday in Rwampara, Rubens Dhedgia, coordinator of the region’s Ebola response, told the AP. In neighboring Uganda, where a much smaller number of cases began spreading after the Congolese traveled, at least three health workers have been infected.

Perhaps most worryingly, the International Federation of Red Cross and Red Crescent Societies says three volunteers died in Mongbwalu after what it believes handled bodies on March 27 during work unrelated to Ebola.

If confirmed, it would significantly delay the timeline of the outbreak since the first confirmed death in late April in Bunia.

Even as at least one funeral home manager dusted off coffins for sale along a road in Bunia, experts reported a lack of trust among some area residents who don’t believe in the virus.

Action Aid, another international humanitarian group responding, said a high level of skepticism and lack of understanding persisted, citing residents interviewed in mid-May in Ituri province, just after the outbreak was announced.

“The only way forward, when it comes to this particular virus, is community engagement,” said Yakubu Mohammed Saani, Action Aid Congo country director.

How this will be improved, and quickly, is still unclear. At the same time, the WHO and the Africa Centers for Disease Control and Prevention estimate that the outbreak is larger than the cases reported so far.

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Adetayo reported from Abuja, Nigeria. Associated Press writer Jean-Yves Kamale in Kinshasa, Congo, contributed.