BUNIA, DR Congo, May 22 (Xinhua) -- In the crowded corridors of the Bunia central hospital in Ituri Province, the epicenter of the latest Ebola outbreak in the Democratic Republic of the Congo (DRC), the disease is more than a medical emergency -- it has become a test of trust.
Families wait anxiously for news of suspected Ebola patients, trading rumors about the disease, the dead, and those tasked with conducting safe burials. Health workers navigate between wards under mounting pressure in an already overstretched and constrained facility.
Against this backdrop, the latest Ebola outbreak, declared on May 15, has expanded beyond its initial epicenter in Ituri to North Kivu and South Kivu provinces, while neighboring Uganda has also reported confirmed imported cases.
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said Friday that the situation in the DRC was "deeply worrisome," noting 82 confirmed cases and seven deaths.
However, the scale is believed to be significantly larger, with nearly 750 suspected cases and 177 suspected deaths, he said in social media posts, adding that "these numbers are changing as surveillance efforts and laboratory testing improve, but violence and insecurity are impeding the response."
At the Bunia central hospital, now functioning as a makeshift Ebola treatment center, doctors said 56 suspected cases are being treated, pushing a facility already operating beyond its capacity.
Pressure is evident not only in patient numbers but also in the tension surrounding every step of the response: isolation, testing, contact tracing, and safe burials.
Relatives of a young man who died of Ebola refused to allow the Red Cross to conduct his burial. They insisted on burying him themselves, citing cultural traditions and family honor. Some still doubted the cause of death.
"We have already negotiated with the family. We understand their pain, but these measures are vital," said Alphonse Leo, a Red Cross team leader at the site. "An unsafe burial could put dozens of people in danger."
Luc Malembe, a local opinion leader in Bunia, said the standoff reflected deeper communication failures.
"What happened here today at the Bunia hospital is the result of weak communication around this virus," he said, calling for stronger public sensitization to prevent rumors from filling the vacuum.
RUMORS AND RESISTANCE
Community resistance has emerged as one of the most significant obstacles to containing the outbreak.
DRC Health Minister Roger Kamba said earlier this week that alerts were delayed in some areas because residents initially believed the illness was "mystical."
Jean-Jacques Muyembe, head of the National Institute of Biomedical Research and one of the world's leading Ebola experts who discovered the virus in the 1970s, told Xinhua that distrust of outsiders could weaken the response.
"When people see that instructions and measures are announced by people from their own area, they believe them. If it is someone from Kinshasa, they doubt," Muyembe said, stressing that building trust is the priority.
In Rwampara, Ituri's worst-hit health zone, mistrust turned violent on Thursday.
Residents set fire to an Ebola treatment site after demanding the return of the body of a community member who had died after being admitted to the center. Police and local authorities said the crowd gathered at the gates shortly after the death was announced, accusing health workers of withholding the body under Ebola safety protocols.
Jean-Claude Mukendi, a senior police officer who intervened with his team, said two quarantine tents with eight beds were burned.
"We found damage at the site," he said, adding that a body scheduled for burial was also caught in the blaze.
The attack forced patients and suspected cases to flee the facility, raising fears that individuals under observation may have disappeared into surrounding neighborhoods.
Mbata Kura Zamindo, chief of the Rwampara groupement, appealed for their return. "We are going to buy megaphones and go through all the neighborhoods of Rwampara to ask those who fled to come back," he said. "The site is now secure."
Local health sources said Rwampara remains the epicenter of the outbreak, with around 50 suspected cases admitted and two to four deaths reported daily.
CONFLICT SHADOWS RESPONSE
Beyond the health emergency, insecurity remains one of the biggest challenges facing humanitarian workers and residents.
In Goma, the capital of North Kivu Province, which is under the control of the March 23 Movement (M23) rebel group, residents expressed doubts about whether the Ebola response could function effectively amid the ongoing conflict.
"We are afraid that the war will make things even more complicated," said Zawadi Clarisse, a trader in central Goma. "Many doctors specializing in Ebola response are no longer here because of the current situation. Hospitals do not function as they did before. How will this work under such conditions?"
A staff member of a local health organization, who requested anonymity, said Ebola has always triggered fear and resistance in North Kivu, but the current political situation could further weaken the response.
"Many people will hesitate even to go to health centers," she said. "Authorities will have difficulty tracing contacts and properly sensitizing the population."
The concern is particularly acute in Mongwalu, a mining town in Ituri Province, where several cases have been detected amid repeated violence by armed groups. Humanitarian sources warned that insecurity could hinder contact tracing, the deployment of medical teams, and community awareness campaigns.
The broader conflict between government forces and the M23 has also strained logistics across eastern DRC. Goma's international airport remains closed to humanitarian flights, raising concerns over the timely delivery of medical supplies, laboratory equipment, and specialized personnel.
On Thursday, the M23, which controls South Kivu's capital, Bukavu, confirmed an Ebola case. It said the patient, a 28-year-old man who had traveled from Kisangani, the capital of Tshopo Province, died before his diagnosis was confirmed.
Tshopo has not officially reported any cases, but Kisangani is one of the country's busiest transport hubs, heightening concerns that the virus may have spread undetected before being identified.
This Ebola outbreak is caused by the Bundibugyo strain, a rarer Ebola variant first detected in Uganda in 2007. Unlike the Zaire strain responsible for previous DRC outbreaks, the Bundibugyo strain has no approved vaccine or specific treatment. Candidate vaccines are under discussion, but WHO officials say doses remain months away at best.
Anais Legand, a WHO technical officer on viral hemorrhagic fevers, said Wednesday that while preparations for possible trials continue, the priority is to establish safe and optimized treatment centers, create patient referral pathways, and ensure that every suspected case is detected and treated early. ■
