Vaccinations in North Kivu and Ituri set to continue as fears grow over impact of armed groups on disease spread

Efforts to fight the continuing Ebola outbreak in the Democratic Republic of Congo were set to resume on Wednesday after a 48-hour suspension following a attack by militia in which 21 people were killed.

At least 10 people have died so far from the recent outbreak of the disease, and 150 people are known to have been infected. The decision to resume the effort to vaccinate thousands of people in the provinces of North Kivu and Ituri will go some way to reassure worried health officials.

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The World Health Organisation (WHO) said on Tuesday that the outbreak could worsen rapidly because of the attacks by armed groups, as well as because of community resistance and the broad geographic spread of the disease.

The outbreak has occurred in one of the most violent parts of DRC, a base for dozens of armed groups that contest government authority and exploit mineral resources in the region.

The militia attack on Saturday took pace on the outskirts of the city of Beni. In a second incident, in the town of Oïcha, about 12 miles north of Beni, armed men burned houses, killed one man and kidnapped 14 children and one woman on Monday night, according to two local officials.

Both attacks have been blamed on a group known as the Allied Democratic Forces (ADF), which has a history of targeting civilians and is considered one of the most active and violent of the armed groups operating in the region.

The insecurity in the region and a mobile population has made vaccination campaigns – like the one that helped overcome an Ebola outbreak that killed 33 people in the DRC’s north-west this year – less effective. Insecurity is likely to intensify as tensions rise with the approach of elections later this year, observers said.

“We are now extremely concerned that several factors may be coming together over the next weeks and months to create a potential perfect storm,” Peter Salama, the World Health Organisation’s emergencies chief, told a news conference in Geneva.

Although the weekly number of new cases has fallen from about 40 to about 10 in the past few weeks, and more than 11,700 people have been vaccinated, significant obstacles remained, Salama said.

Nyonyi Masumbuko Bwanakawa, the mayor of Beni, said vaccination of people had resumed. “All stakeholders including civil society leaders have agreed to resume the work on Wednesday because suspending it can be dangerous to those infected ... everybody understands the severity of the epidemic.”

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The Congolese army has launched new operations against the ADF to try to ensure the campaign against Ebola can continue safely. A military spokesman said the militia attacked on Saturday at about 6:30pm and clashed with the army for nearly six hours. The militia’s long-term aim appeared to be to establish a base close to Beni. After the attack Beni declared a “ville morte”, a period of mourning, until at least Friday.

On Monday 80% of Ebola contacts (people at risk of developing the disease and so requiring monitoring) and three suspected cases in and around Beni, could not be reached for disease monitoring, officials said.

The town of Oïcha, which is almost entirely surrounded by territory held by the ADF, has two confirmed cases of the virus and one probable case.

Pockets of “reluctance, refusal and resistance” to accept vaccination were generating many of the new cases, Salama said. Some people were fleeing into the forest to escape Ebola follow-up treatment and checks, sometimes moving hundreds of miles.

Uganda, to the east, is now facing an imminent threat, and social media posts were conflating Ebola with criticism of the DRC government and the UN and a range of conspiracy theories, a development that could put health workers at risk.

The DRC, whose heavily forested interior makes it a natural home for Ebola, is at the forefront of a global campaign to combat the disease. The biggest recorded outbreak of Ebola killed an estimated 11,300 people across Guinea, Liberia and Sierra Leone, from 2014 to 2016. The disease was first seen near the northern Ebola river in DRC in the 1970s. It has twice reached Kinshasa but, on both occasions, was contained.