As Ebola spreads, it amplifies mistrust

[u/TheContinentAfrica]

Edizon Musavuli, an artist, sends dispatches from eastern Democratic Republic of the Congo, where communities and health authorities are responding to yet another Ebola outbreak – sometimes in sharply conflicting ways.

Butembo, North Kivu: The city was one of several hit by the 2018-2020 outbreak, the second-worst Ebola outbreak on record. It also experienced flare-ups in 2021 and 2022. Health authorities quickly rolled out safety protocols and messages this time, but some residents remain sceptical about the threat. As is the case in other areas, residents who are vigilant about infection prevention sometimes find themselves harshly judged by those who believe the virus doesn’t even exist.

Bunia, Ituri: This provincial capital is the epicentre of the current outbreak – and threat-assessment differences between experts and residents. In some cases, health workers are clashing with relatives of dead Ebola patients who insist on customary burials for their loved ones despite strict official protocols on body disposal.

Goma, North Kivu: This provincial capital is under the martial rule of March 23 Movement rebels, so its residents are caught between the virus and the gun.

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[u/Bakyumu]

This once again is a display of how deeply frustrating the reality of managing public health crises is, not only in Africa but everywhere else.

I get the desire to honor loved ones with customary burials which is culturally understandable, but clashing with health workers and denying the obvious existence of the virus is reckless and actively fuels the outbreak.

Clinging to skepticism over safety protocols only guarantees more preventable deaths. That will ultimately nullify the efforts to contain a devastating disease in an already volatile region.

[u/CMidnight → u/Bakyumu]

I wrote a paper in grad school that analyzed responses of people in eastern Congo and conservative Jews in NY during an Ebola and Measles outbreak respectively about if they would seek vaccination. The responses of vaccine hesitant people for both groups fell into one of two categories: healthcare workers wouldn't do anything for me or healthcare workers are making people sick. It was striking how similar the responses were.

The strongest predictor of vaccine hesitancy: distryst of public institutions.

[u/MusicBooksMovies]

Has the skepticism worsened post-COVID pandemic or has there always been a sceptical part of the population?

[u/Bakyumu → u/MusicBooksMovies]

​I doubt skepticism is the main factor. It seems to be more about a lack of awareness and a strong desire to hold onto traditional rituals that really amplify the issue.

​For instance, not everyone recognizes the early signs of the infection, so they go right in to care for their sick family members. Once those family members pass away, they try to handle the body for burial, which just exposes them further to the virus.

​I think the government needs to be a lot stricter about enforcing the rules, though honestly, I do not trust them either.

[u/OwlComplex48 → u/Bakyumu]

I concur about stricter enforcement of rules. That said, unfortunately in many places where these outbreaks occur, government control is tenuous at best and that combined with lack of education and traditional beliefs is an unfortunate combination.

[u/KeenyKeenz → u/Bakyumu]

I'd say it's still a main factor as a lack of awareness and strong desire to hold onto traditional rituals is skepticism... it's an education thing even before it's about enforcement. And when it all needs to happen at once, things fall over...