We cannot build community trust while bombs are falling
In eastern Democratic Republic of the Congo, two ancient human catastrophes have converged — war and epidemic — each amplifying the other in ways that no single intervention can untangle alone. The World Health Organization's director-general has traveled to the region to bear witness and to call on all warring parties to lay down arms, arguing that without a ceasefire, the nearly 1,000 suspected Ebola cases and 220 deaths cannot be contained, and the virus will continue to follow the displaced and the desperate across borders. It is a reminder that disease does not respect front lines, and that the conditions which make war possible — broken trust, shattered infrastructure, scattered populations — are precisely the conditions that make outbreaks unstoppable.
- Nearly 1,000 suspected Ebola cases and over 220 deaths have emerged in just weeks, with children accounting for roughly a quarter of confirmed fatalities and the outbreak already crossing into Uganda and rebel-held provinces.
- Active combat in Ituri and North Kivu is destroying the very architecture of containment — health facilities are being attacked, isolation tents burned, and patients are fleeing into the bush mid-treatment.
- A doctor in Butembo reported having only two body bags left and buying supplies out of pocket, while international aid cuts have stripped NGOs of soap, protective suits, and basic equipment needed to safely handle the dead.
- Uganda's border closure, though understandable, risks pushing movement through unmonitored crossings, and transit sites in the West Nile region are already operating at more than double capacity.
- WHO's Tedros has issued a direct appeal to all armed factions for a ceasefire, warning that community trust, contact tracing, and safe burials are impossible while fighting continues — and that without them, the virus will keep winning.
The World Health Organization's director-general traveled to the Democratic Republic of the Congo this week to confront what he called a 'catastrophic collision of disease and conflict' — an Ebola outbreak confirmed on May 15 in the northeastern Ituri province that has already produced nearly 1,000 suspected cases and at least 220 deaths. Tedros Adhanom Ghebreyesus issued an urgent plea for an immediate ceasefire, arguing that without it, the virus cannot be contained. Health authorities have confirmed 101 cases and are tracking more than 3,000 possible contacts. Roughly a quarter of confirmed deaths have been children.
The outbreak has spread south into rebel-held territories in North Kivu and South Kivu, where the Rwandan-backed M23 group controls significant ground. Almost 1 million people in Ituri have already been displaced by conflict, and attacks on health facilities have made case tracking and contact tracing nearly impossible. In Butembo, a doctor reported having only two body bags remaining and had recently purchased one with personal funds. Shortages of soap, chlorine, and protective equipment — worsened by international aid cuts — have left responders improvising under impossible conditions.
Cultural burial practices, in which families wash and touch the deceased, have collided fatally with the reality that Ebola victims' remains are highly contagious. That tension turned violent over one weekend when unidentified attackers burned isolation tents at a hospital in Mongbwalu, forcing 18 patients to flee. One suspected patient died hemorrhaging during the escape. Seven more fled the following day.
Uganda closed its border with the DRC for four weeks, though WHO warned the measure risks pushing people through informal crossings where surveillance is impossible. All seven of Uganda's confirmed cases appeared in Kampala — among them a driver, a Congolese woman who had traveled for medical care, and two Ugandan health workers who had treated an Ebola patient. The pattern illustrates how swiftly the disease follows human movement. As Tedros put it, the fighting must stop — or every effort to contain the outbreak will continue to fall short.
The World Health Organization's director-general issued an urgent plea this week for an immediate ceasefire in eastern Democratic Republic of the Congo, where an Ebola outbreak is unfolding amid active armed conflict. Tedros Adhanom Ghebreyesus described the situation as a "catastrophic collision of disease and conflict," with the virus spreading faster than containment efforts can manage. The outbreak, confirmed on May 15 in Ituri province—the DRC's northeastern region bordering South Sudan and Uganda—has already claimed at least 220 suspected lives among nearly 1,000 suspected cases. Tedros announced he would travel to the DRC this week to assess the crisis firsthand.
The numbers tell part of the story. As of Tuesday, health authorities had confirmed 101 cases and were investigating more than 3,000 possible contacts. In neighboring Uganda, seven confirmed cases and one death had been recorded by Sunday. Aid organizations noted a grim detail: roughly a quarter of the confirmed deaths were children. The outbreak has since spread south into rebel-held territories in North Kivu and South Kivu provinces, where the Rwandan-backed M23 group controls significant territory, further complicating any coordinated response.
Uganda responded by closing its border with the DRC on Wednesday, with restrictions set to last four weeks. The measure exempts Ebola response teams, humanitarian workers, security operations, and food and cargo transport. Anyone permitted to enter Uganda from the DRC must undergo mandatory isolation for 21 days. The decision reflects the scale of concern, though it contradicts earlier WHO guidance against border closures—the organization warned such measures push people toward informal crossings, making disease surveillance nearly impossible. UN refugee data showed that transit and reception sites in Uganda's West Nile region were already operating at more than double capacity.
The core problem, as Tedros articulated it, is that stopping transmission requires humanitarian access—and the fighting makes that impossible. Ongoing clashes are displacing entire populations, pushing exposed contacts into overcrowded camps and destroying the corridors needed to contain the disease. Almost 1 million people in Ituri province have already been displaced by conflict, according to UN figures. Attacks on health facilities have made case tracking and contact tracing nearly impossible. "We cannot build community trust or isolate the sick while bombs are falling," Tedros said, calling on all warring parties to agree to a ceasefire.
On the ground, the situation is deteriorating rapidly. A doctor in Butembo, North Kivu—where six of seven Ebola cases had ended in death—told Reuters the facility had only two body bags remaining. "If there are more deaths I don't know how we will manage," the doctor said, speaking anonymously out of fear for their job. The same physician reported critical shortages of soap, chlorine, and personal protective equipment including boots, body suits, masks, and gloves. International aid cuts to NGOs have worsened the scarcity. The doctor had recently purchased a body bag with personal funds when none were available through official channels.
Cultural practices are colliding dangerously with disease control. Traditionally, families wash and touch the bodies of the deceased before burial. But Ebola victims' remains are highly contagious and have been a major vector for transmission in previous regional outbreaks. This tension erupted into violence. On Saturday and Sunday, unidentified individuals attacked a hospital in Mongbwalu, Ituri, burning isolation tents and forcing 18 Ebola patients to flee. On Sunday, seven more patients fled the facility, and one suspected Ebola patient died hemorrhaging during the escape.
The transient nature of communities in Ituri—drawn by goldmines and migrant work—has also complicated response efforts. Philippe Guiton, the DRC director of World Vision, noted that years of conflict have weakened community systems and left many children malnourished and vulnerable. "For children, the risks are especially acute," he said. The combination of displacement, distrust of authorities, inadequate supplies, and ongoing violence has created conditions where the virus can spread faster than it can be contained.
In Uganda, all seven confirmed cases appeared in Kampala. They included a driver who had transported another case, a Congolese woman who traveled for medical care, a Congolese health worker, and two Ugandan health workers who had treated an Ebola patient. The pattern shows how quickly the disease can cross borders and infect those trying to help. As Tedros prepares to visit the region, the fundamental barrier to containment remains unchanged: the fighting must stop, or the outbreak will continue to outpace every effort to stop it.
Citações Notáveis
Stopping this Ebola transmission depends entirely on humanitarian access. Yet ongoing clashes are driving mass displacement, pushing exposed contacts into overcrowded camps and severing critical containment corridors.— Tedros Adhanom Ghebreyesus, WHO director-general
If there are more deaths I don't know how we will manage. We recently had to secure a body—we had no choice but to use our own money to buy a body bag.— A doctor in Butembo, North Kivu (speaking anonymously)
A Conversa do Hearth Outra perspectiva sobre a história
Why is a ceasefire so central to stopping Ebola? Couldn't you contain it even during conflict?
Not really. Ebola spreads through direct contact with the sick or the dead. When bombs are falling, people flee into camps where they're packed together. When health workers are attacked, they can't reach patients or trace contacts. The virus moves faster than fear of the fighting.
Uganda closed its border anyway. Doesn't that help?
It might slow things down, but the WHO warned it could backfire. People will cross illegally where no one's watching them. You lose the ability to test them, isolate them, track where they've been. A closed border can actually make the disease harder to contain.
The doctor buying body bags with personal money—that's a sign of what, exactly?
Complete system collapse. When frontline workers are improvising with their own money, it means the supply chains have broken, aid has been cut, and no one is coming to help. That's when people start losing faith in the response. That's when they stop cooperating.
Why are families attacking hospitals to get bodies?
Because Ebola is new to many communities there, and burial is sacred. Families don't understand why they can't wash and touch their dead. They see the hospital as taking their loved ones away. So they attack. But those bodies are the most contagious thing in the outbreak.
So the conflict created the conditions for the outbreak to spread, and now the outbreak can't be stopped without ending the conflict.
Exactly. It's not two separate crises. They're feeding each other. Displacement creates crowding. Crowding spreads disease. Disease spreads fear. Fear makes people distrust authorities. Distrust makes them attack health workers. And the fighting never stops.
What happens if the ceasefire doesn't come?
The outbreak spreads across borders. More countries close their boundaries. More people die. And the virus becomes endemic in a region where conflict never really ends anyway.