UN agencies on ground expected to run out of funds within weeks
On Aug. 12 in the Mutiri neighborhood, on the outskirts of the city of Butembo, a half-dozen young men and women dispatched to arrange the safe burial of a 25-year-old Ebola victim arrived at the family’s home wearing government hazmat suits, dumped the body inside and whistled and sang to protest their lack of pay, according to a video verified by CARE International staff. Family members then opened a white body bag and touched the corpse with bare hands.
In a separate incident witnessed by CARE International staff, locals retrieved a coffin from a burial team and opened it. Three men removed the deceased from a body bag, which they tossed aside, and returned the corpse to the coffin before a crowd gathered around singing a dirge in a local Swahili dialect. Government health workers were not visible in that footage.
“The response teams are not being paid, and now they are handing over dead bodies to the community, which already believes that Ebola is not real,” said Noela Ndoole, a CARE International worker who witnessed several such incidents in North Kivu province. “We are risking losing many more people to Ebola.”
The outbreak is Congo’s deadliest on record. The WHO has warned the death toll is likely to exceed the 2014-2016 West African epidemic that killed 11,000 people across Guinea, Liberia and Sierra Leone. Roughly 6,600 cases have been registered since the outbreak was declared four months ago. The current epidemic is driven by the rare Bundibugyo strain of Ebola, for which there is no approved vaccine. It took nearly twice as long for the West African epidemic to reach a comparable caseload, according to the WHO.
UN agencies coordinating the response will likely run out of funds in the coming weeks, Harneis, the UN Senior Ebola Coordinator stationed in Ituri province where the outbreak started, told a press briefing last month. “We’re unable to bring in the amount of money that is required to pay the workers, which has led to great unhappiness amongst front-line workers,” Harneis said. “Every delay in funding and implementation makes this epidemic more deadly, more difficult to stop and more expensive. So we need that international support immediately.”
The United States has extended roughly $80 million to the Congolese government to support safe burials and boost capacity in Ebola treatment centers, the U.N. has said. Other donors, including the European Union, have promised $400 million more, according to the Africa Centres for Disease Control and Prevention. The U.S. has pledged more than a half-billion dollars in total to Congo, Uganda and South Sudan to counter the outbreak. But the region’s creaking banking system has hampered efforts to deliver the cash to front-line workers.
About 160 healthcare workers have contracted the virus and 43 have died, Harneis said. Workers at Congo’s Ebola treatment centers have gone on strike over unpaid wages. Safe-burial team members have not received their Ebola-response allowances for weeks, according to the WHO and local aid officials.
The cultural and political terrain compounds the response. Touching the dead to usher them into the afterlife is traditional practice in many eastern DRC communities, and many residents do not believe Ebola exists. Locals have chased health teams sent to enforce no-contact burial rules. The national government in Kinshasa sits roughly 1,900 miles from the epicenter, and deep suspicion of foreign health workers and the central government runs through the region.
The epicenter sits in a remote area that health experts and the WHO say is plagued by Islamic State insurgents and a variety of other militant groups. Some patients are in areas of eastern Congo controlled by the M23 rebel group, who impose their own Ebola-prevention measures, including strict enforcement of safe burial practices. Government personnel cannot reach those areas.
Mistrust and disinformation about the disease have fueled repeated attacks on health workers. Last month, a mob chased a convoy of Red Cross vehicles shortly after it crossed into Ituri from neighboring Uganda. The crowd, some armed with machetes, beat the responders and seriously injured one, and vandalized two ambulances, according to the International Red Cross and Red Crescent Movement. Eleven violent attacks over the past three months have destroyed ambulances and other emergency equipment, the organization said, and a dozen Red Cross volunteers were injured in attacks while trying to impose burial safety rules. The Red Cross has pulled workers out of some viral hot spots in response.
The Congolese Ministry of Public Health did not respond to requests for comment.