BACKGROUND-Democratic Republic of Congo President Felix Tshisekedi has stated that he wants the Ebola virus outbreak contained within 3 months.  Health experts estimate this will take twice as long.  Statistics from the DRCongo National Health Ministry put the Ebola count at 800 deaths from 1200 confirmed cases.  (AP)

ANALYSIS-DRCongo President Tshisekedi request to contain the virus within the 3 month time frame will be difficult to accomplish due to multiple complex challenges and the inability of security forces to counter rebel attacks or provide regional stability.

Complex Challenges-Key Points

  • The existing atmosphere can only be described as toxic
  • People sickened by Ebola are from a volatile area near the border with Rwanda and Uganda, where rebel groups and bouts of community resistance complicate efforts to contain the outbreak
  • The security situation is impacting the response
  • Years of deadly rebel attacks and instability have made residents wary of both outsiders and the government
  • Populations are wary of outside help after years of rebel attacks (AP)
  • There is a lack of trust in authorities in Congo because of insecurity and conflict (AP)
  • It is challenging to control this type of outbreak without community involvement in rapid detection (WHO)
  • 80 percent of Ebola cases are untraceable-officials cannot accurately track the spread of the virus (Doctors Without Borders)
  • Infection rates continue to be a problem
    68 healthcare workers have been infected to date-indicating poor infection control practices
    Noscomial (Hospital Acquired) infections are upward trending due to poor practices and infection control
  • Medical activities have been suspended by Medecins Sans Frontières after 2 facillities were burned down and 1 nurse killed
  • MSF was insisting on security before it returned to its damaged facilities


Community Trust Issues That Need to be Overcome for a Better Response Include,

  • 30 attacks and incidents against the Ebola response in the past month alone
  • Lack of trust-patients not seeking help- 40% of deaths outside medical centers
  • Surveillance not effective- 35% of new cases are not linked to existing cases
  • Security services-deployment is confused and hurting efforts- their role has never been to enforce sanitary measures
  • Burial practices are poorly understood and offensive to relatives & community-Bodies wrapped in plastic and sprayed with chlorine, buried without ceremony, possessions burned

Failure to overcome grassroots problems surrounding, security, trust, burial practices, surveillance, detection, and infection control will continue to disrupt containment efforts for Ebola in DRCongo.



  • Controlling the difficult and dangerous Ebola outbreak in the Democratic Republic of the Congo may take another year or more
  • It would be a mistake not to plan for a more prolonged outbreak, given the evident complexity of stopping transmission of the virus in north eastern DRC
  • We cannot underestimate this outbreak
  • We need a long-term strategy (CDC)


De Faakto intelligence assessment on 12 October 2018, noted the security situation would directly impact the response of authorities and the procedures required to counter the Ebola Virus. Inadequate infection control continues to be a challenge. Key mitigation strategies include, improved security, surveillance, screening and infection control.
Without implementation of these strategies and quality assurance the risk of transmission to other immediate regions remains high.


About Ebola

  • Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans
  • The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission
  • The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks
  • The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests. The 2014–2016 outbreak in West Africa involved major urban areas as well as rural ones
  • Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials and social mobilisation
  • Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development (WHO)

Associated Press-Via WFTV 9 ABC


WSAU News VIA Reuters

The Associated Press