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Over 10 months ago cases of ebola sprung up in the Democratic Republic of the Congo (DRC) and ever since officials from both the DRC and the international organizations like the U.N. have scrambled to contain the virus. Recently the outbreak’s death toll topped 1,000 and prompted U.N. Secretary General Antonio Guterres to put “the whole United Nations system” into fighting the outbreak.

Since it all started 10 months ago DRC officials, working in tandem with the U.N., have administered over 100,000 vaccines and administered life saving care to thousands living with the disease. The vaccine is highly effective and could go a long way toward stopping epidemics before they start. However, instability in the DRC has made administering the vaccine en masse difficult. To make matters worse, healthcare workers have fallen victim to a number of armed attacks, leaving a number of doctors dead and those who are left with the constant fear and stress they could be next.

The attacks themselves are seemingly inspired by a combination of economic factors and a deep distrust of the government and by extension international care organizations. The perpetrators of a mid-april attack scrambled to steal as much as possible from the treatment facility and left one doctor dead and two injured in their wake. However other attacks, or incidents of arson and threats of stone throwing, seem easier tied to a general distrust of the government and those on the ground. The area surrounding the attack has been a literal war zone with dozens of armed factions at play for years, so many have been repeatedly abused by those in power.

This anti care-worker violence is deeply rooted in the colonial history of the DRC and specifically the brutal legacy of Leopold II of Belgium (who’s depravity inspired Conrad’s Heart of Darkness.) From the beginning of the Congo Free State in 1865 to 1908 when the Belgian government seized control of the colony due to his brutality, Leopold terrorized the people of the Congo with an inhumanity only matched by events like the genocide of Native American populations and the Holocaust.

Leopold systematically extracted rubber and ivory from the Congo and upper estimates suggest his regime killed over half the population. In the early days Leopold relied on slaves and his ability to play native populations against one another and subject them to draconian agreements which effectively signed over the entire Congo to Belgium. Codifying the transactions in European legal documents the native populations had no real concept of or ability to understand. With his new found property rights, and a European continent quickly turning against slavery in a forceful way, Leopold cut the nation off entirely and double down his efforts to extract the rubber wealth of the Congo.

Those efforts included the forced labor (read, enslavement) of the native populations. Punishment for failure to meet rubber extraction quotas was as severe as having one’s hands chopped off, but random widespread killings and beatings were commonplace as well. Leading one Belgian official to write, “the abject misery and utter abandon is positively indescribable. I was so moved, Your Excellency, by the people’s stories, that I took the liberty of promising them that in the future you will only kill them for crimes they commit.” When it was all said and done, estimates suggest over half the native population died, or somewhere around 10 million people. That is the sort of genocide which obviously has a lasting impact to this day.

It’s no mystery why people in a country ravaged by the most brutal colonialism this planet has ever seen are skeptical of foreign aid workers. And while the U.N. has supposedly put “the whole U.N. system” behind the efforts to end the ebola outbreak, the instability and skepticism of outsiders which inspires attacks like those which leave aid workers dead is deeply rooted in the history of DRC. More specifically the history of outsiders ruthlessly exploiting the country for their own gain.

On the ground aid workers with groups such as the U.N. and WHO are struggling to implement tougher guidelines meant to more effectively administer the vaccine. Of this U.N. Secretary General Antonio Guterres said, “we know the vaccine is saving lives in this outbreak, but we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible.” The biggest challenge therein are the militia attacks and the setbacks they inspire.

NPR reported that post-attack security assessments and recovery puts a noticeable dent in vaccination efforts. Before the first attacks in February, new monthly reported cases of Ebola hovered around 30, in the weeks following the April attack they’ve sat around 80 and have reached as high as 110. And while the U.N.’s recent statements and commitment to providing security on the ground is admirable, the complexity of DRC’s colonial history highlights just how treacherous a tightrope those on the ground are walking.

Attempts to help are met with skepticism and given the history, it’s hard to blame people for looking down on outsiders who are “just there to help.” After all, Leopold II said he was there to help the natives as well. It’s a complicated problem, more resources is helpful, more aid workers is helpful, and more security is probably necessary to keep the whole mission afloat. But it’s not as simple as throwing more people and guns at the problem. In fact, that might just make it worse. But doing nothing is clearly making the ebola outbreak worse. Leaving regulators and international aid workers stuck between a rock and a hard place.

The U.N.’s recent statements are a sign of hope, and hopefully they’re able to thread the needle. Delivering much needed aid to the people of the DRC should and must be a U.N. priority, as must be doing so in a way that doesn’t feed neo-colonial backlash. Only time will tell if that needle can be threaded, but it’s a palpable reminder, history is here, it sticks with us, and tragedies of the past continue to kill people long after they’ve transpired.