As of Sunday, there were 1,088 confirmed cases in the country, with another 66 probable cases, which have resulted in 731 deaths, according to World Health Organisation (WHO) figures, making it the second-worst outbreak in history. Another 172 confirmed cases were been confirmed in the last three weeks up to April 2, with outbreaks hitting 42 percent of health areas in the Congo. Problems have been exacerbated by a lack of trust in public health workers, with two treatment centres run by MSF the subject of arson attacks recently, prompting the organisation to suspend its operations in Butembo and Katwa.
A lack of understanding of the nature of the illness is partially to blame, with some residents preferring to put their trust in the power of prayer rather than life-saving vaccinations.
An MSF spokeswoman said: “People are still dying from Ebola in their communities rather than seeking healthcare in Ebola treatment centres – a clear sign that they do not trust the response.
“In recent weeks up to half of deaths have happened in the community.”
It was vital to ensure the patients and community were included in planning, she stressed.
She explained: “We need to adapt our approach and give choices back to patients, involving them actively.
“People in this region have been suffering for many years from a general lack of healthcare and from insecurity and violence, and Ebola is not necessarily their priority.
“We need to think of tackling Ebola as part of the overall provision of healthcare.
“The use of coercion has created animosity towards the Ebola response.
“The police are involved in surveillance, contact tracing and various other activities.
“This outbreak is happening in a conflict zone and we do not question the role that the police and other security forces can play in protecting those involved in the response.
“But their current role in the response itself is counterproductive for gaining the trust of the population and containing the epidemic.”
Speaking last week, a WHO spokesman said: “The recent shift of emphasis in the response strategy to promoting greater engagement and ownership by affected communities is beginning to produce results.
“While community reluctance and mistrust remain present in certain areas around Butembo and Katwa, other areas saw a notable decrease in resistance to the presence of response workers.
“Diligent efforts at engaging with community committees through direct dialogue resulted in the reopening of the ETC in Katwa, bringing the total number of operational facilities providing care up to six ETCs in Beni, Butembo, Goma, Komanda, Mangina, and six transit centres in Beni, Bunia, Katwa, Kayna, Bwanasura, and Oicha.
“A more proactive approach to investigating and resolving incidents in the communities is also being undertaken to minimise the risk of misunderstandings and to mitigate potential sources of mistrust between local residents and healthcare providers.”
Ebola is a haemorrhagic fever with a high risk of death, killing between 25 and 90 percent of those infected, with an average of about 50 percent.