Since authorities identified a new Ebola outbreak in eastern Congo, the effort to contain it has been running into obstacles that health teams and local officials say are driven as much by security and trust as by medicine. On Sunday, Congolese authorities said suspected cases in the east had passed 900, with most of the cases in Ituri Province where the outbreak is centered. The response is unfolding in parallel with a wider crisis of conflict and displacement, and it is being complicated further by attacks on Ebola care sites and by limited supplies for health workers.
Later Sunday night, angry young men stormed a hospital treating Ebola patients in Mongbwalu, a town in Ituri. The hospital’s director, Dr. Richard Lokudu, said the attackers demanded that two bodies of their relatives be handed over, and that medical staff scrambled to evacuate patients as gunfire broke out in the area. It was not immediately known whether anyone was hurt in the melee, and the hospital attack followed arson at two health centers last week, events that authorities and aid groups described as exposing how the outbreak is playing out inside a region already shaken by violence.
The scale of the suspected outbreak is growing, according to the Congolese Ministry of Communication. In an X post on Sunday, the ministry said there were 904 suspected Ebola cases, mostly in Ituri, describing it as a significant jump from previously announced figures of more than 700 suspected cases. The ministry said the total suspected Ebola deaths stood at 119, but in separate figures released for each region, the totals added up to 220; officials were not immediately available to explain the discrepancy.
The outbreak is not confined to one province. Cases have also been reported in North Kivu and South Kivu, where the M23 rebels are in control, and in neighboring Uganda. As a result, the outbreak response is being carried out through a mix of government and rebel-controlled areas, with an array of aid agencies supporting the health work where they can access it.
Aid workers and rights and public health experts described a chronic vulnerability in Ituri and surrounding areas: insecurity limits medical access and reduces the ability of facilities to function during an outbreak. Before the outbreak, Doctors Without Borders said in an assessment that insecurity in Ituri had worsened, prompting doctors and nurses to flee and leaving “overwhelmed health facilities” and, in some parts, “catastrophic conditions.”
They also pointed to displacement pressures in the outbreak’s center. The U.N. humanitarian office said almost a million people have been displaced from their homes by conflict in Ituri, leaving communities dealing with instability and fragile health care systems at the same time Ebola spreads. Gabriela Arenas of the International Federation of Red Cross and Red Crescent Societies said the outbreak is “unfolding in communities already facing insecurity, displacement and fragile health care systems,” and she noted concerns about potential spread to large displacement camps near the city of Bunia, where the first cases were reported.
Beyond security, multiple sources cited funding shortfalls affecting the response. Health experts said international aid cuts last year by the United States and other wealthy countries were devastating for eastern Congo because they reduced capacity to detect and respond to infectious disease outbreaks. Physicians for Human Rights’ Thomas McHale said the cuts “reduced the capacity to detect and respond to infectious disease outbreaks,” and noted Congo has experienced more than a dozen previous Ebola outbreaks.
On the ground, aid groups working the response said they lacked basic protective and burial materials needed for health workers and safe containment. Julienne Lusenge, president of Women’s Solidarity for Inclusive Peace and Development, said her group had limited supplies near Bunia, telling reporters, “We have made requests to different partners, but we have not yet really received anything,” and adding, “We only have hand sanitizer and a few masks for the nurses.” She and others described shortages that included equipment such as face shields and suits, testing kits, and materials used to safely bury victims, whose bodies can be highly contagious.
Doctors and responders also face a difficult social environment, including anger directed at facilities treating suspected cases. Colin Thomas-Jensen, director of impact at the Aurora Humanitarian Initiative, said attacks on Ebola treatment centers may reflect the “built-in skepticism and anger” of people in eastern Congo, rooted in years of violence involving foreign-linked rebel groups and in what some residents see as failures of the government and international peacekeepers to provide protection. He also pointed to strict burial protocols for suspected victims, which authorities are managing in an effort to prevent spread during traditional funerals.
As part of those efforts, authorities in northeastern Congo have banned funeral wakes and gatherings of more than 50 people, and armed soldiers and police are guarding some burials carried out by aid workers. Physicians for Human Rights described the situation as converging crises, warning in remarks attributed to the group that the region is facing “a devastating set of emergencies” that authorities now must address simultaneously. With armed groups still active across parts of the outbreak zone and health infrastructure under strain, containing a rare type of Ebola—described in reporting as the Bundibugyo strain—has become tightly linked to whether responders can secure both access to communities and acceptance of the public health steps needed to slow transmission.