A mobile blood-testing lab. Hand-washing stations on street corners. Motorcycle taxi drivers forbidden from sharing spare helmets. If Ebola is coming, the city of Goma in eastern Congo wants to be ready.

An outbreak suspected of killing 43 people is spreading across the lush farmlands of eastern Congo, where ethnic and military conflicts threaten to hobble containment efforts.

Goma, a lakeside city of 1 million people near the Rwandan border, is more than 350 km (220 miles) south from the epicenter of the outbreak in the town of Mangina in North Kivu province, and no cases have been confirmed there.

But the virus has already spread to neighboring Ituri province, and the number of infected is rising daily. Residents in the busy trading hub are taking no chances.

“It’s not only me who fears the appearance of Ebola. The whole community here is scared,” said shopkeeper Dany Mupenda. “To protect ourselves we stick to the rules of hygiene to avoid being one of the victims of this epidemic.”

UNICEF has set up hand-washing stations around the city, many of whose streets are built on top of the lava rock left from the eruption of the Mount Nyiragongo volcano in 2002.

Health workers check residents’ temperatures in public places and at the entrance to the city. The hospital has set up a mobile lab to test suspected cases.

It is the kind of preparation that has become routine in Congo, which has experienced 10 Ebola outbreaks since the virus was discovered on the Ebola River in 1976, altogether killing some 900 people.

Ebola causes diarrhea, vomiting and hemorrhagic fever and can be spread through bodily fluids. An epidemic between 2013 and 2016 killed more than 11,300 people in West Africa.

Congo, a vast, forested country, has become a staging ground for new treatments, including the first use of vaccines that helped contain an outbreak that was declared over in July, just days before the latest flare-up was discovered.

Goma residents know that medical breakthroughs mean little if simple measures are not taken on the ground. After basketball games, teams have been told not to shake hands, said Fiston Kasongo, a young basketball player.

“What scares me is the speed with which Ebola spreads and the consequences that follow.”

Patrons of Goma’s popular motorcycle taxis have to risk speeding helmetless across town.

“We are told that it can spread through the sweat of heat, and as our helmets are not worn by one customer only, they allowed customers to ride with no helmet to prevent the spread,” said a taxi driver called Wemba.

KEYWORDS Congo, epidemic, ebola, Goma