In the past two weeks, Doctors Without Borders (MSF) has been forced to suspend treatment activities in some regions of the Democratic Republic of the Congo after two devastating, fiery attacks on ebola treatment centers in the war-torn cities of Katwa and Butembo.
But instead of condemning the attackers in a press conference on Thursday, MSF president Joanne Liu slammed the international ebola response for alienating the local population and fueling mistrust.
“The existing atmosphere can only be described as toxic,” Liu, who just returned from a visit to the DRC, told reporters in Geneva. “It shows how the response has failed to listen and act on the needs of those most affected.”
Since the ebola outbreak began in August, more than 900 people have been infected and approximately 569 have died, Liu said. It’s the second-largest outbreak in the disease’s history; a 2014 outbreak in West Africa claimed more than 11,000 lives. Indicators suggest that the Congo’s ebola outbreak is “not under control,” Liu added solemnly, claiming that the disease “still has the upper hand.”
While the disease has been contained in some parts of the country, it continues to rage in Katwa and Butembo. Liu said that in the past month alone, there have been at least 30 attacks on medical responders in the DRC. Parts of the nation are active war zones with multiple sparring militias.
Responders claim that another major problem, is active resistance from communities skeptical of international medical outreach.
Liu said that’s the wrong way to think about it. “It would be all too easy to place the blame on the communities themselves, or say that they’re not complying with the public health measures,” she said. “But the problem is not the community.”
“What is it that the local villager sees of the response?” she added. “There’s fleets of cars, driving too fast, arriving to take away a sick person. They see vast amounts of money pouring in, but they don’t see where it ends up. They hear the constant advice to wash their hands, but nothing about the lack of soap and water. They see their relatives sprayed with chlorine and wrapped in plastic bags, and buried without ceremony.”
And many locals view ebola as a contrived political scheme—a belief only deepened by the government’s controversial decision to use the outbreak as a reason to ban citizens in some opposition strongholds from heading to the polls for the country’s national elections this December.
“People told me: ‘Ebola robbed me of my basic democratic rights,’” Liu said, arguing that as a result, using government police to force the population to comply with health measures “is not only unethical, it’s totally counterproductive.”
Instead, Liu proposed that ebola responders, including her own organization, should provide community-based care for patients who don’t want to go to treatment centers, train family members to care safely for their infected loved ones—and, crucially, treat patients as “humans” instead of “biothreats.”
“The effectiveness of the ebola response will rest on whether or not it is viewed as legitimate and trustworthy,” she said. “Today, what reason does the population have to trust us?”