The United Nations reported on Wednesday that a measles outbreak in the Democratic Republic of Congo (DRC) has killed at least a hundred children since the beginning of the year, adding to a medical and security crisis that already included Ebola, cholera, and factional violence that makes it difficult for doctors to treat any of the deadly diseases.

The U.N. peacekeeping mission in the DRC documented 7,175 cases of measles in January, 137 of them fatal. Over 80 percent of the fatalities were children under the age of five.

The measles casualties were added to 1,936 recorded cases of cholera since the beginning of 2019.

The Ebola outbreak has claimed 513 lives since August 2018. Children made up 97 of the Ebola fatalities, 65 of them under five years of age. Hemorrhagic fever is running rampant in the DRC, with most of the cases attributable to Ebola exposure.

The rate of new cases in January doubled from 20 per week to 40, a surge attributed by Save the Children’s DRC director Heather Kerr to public mistrust of doctors due to “misinformation” and the deteriorating security condition.

“It is paramount to convince communities that Ebola is an urgent and real concern,” Kerr said on Sunday. “People have disrupted funerals because they didn’t believe the deceased had succumbed to the virus. Aid workers were threatened because it was believed they spread Ebola.”

“We have to scale up our efforts to reach out to the vocal youth and community leaders to build trust and to help us turn this tide. Treating the people who are sick is essential, but stopping Ebola from spreading further is just as important,” she urged.

Kerr noted the DRC is suffering from an “extreme hunger crisis” in addition to violence and disease, with 4.6 million children “acutely malnourished.” Malnutrition is a major factor in the spread of measles and its mortality rate among children.

“The main concerns for many people are safety and making sure they have enough to eat. But Ebola has to be a priority too,” she said.

The U.N. cited poor sanitation, limited medical care, a shortage of clean drinking water, and armed rebel factions terrorizing the population as factors in the spread of all three epidemics.

The Congo Ebola outbreak is the second-worst in history but is mercifully far smaller than the worst, the 2014 epidemic in West Africa that killed over 11,000 people. The DRC outbreak has been contained with the assistance of far more powerful vaccines and more effective containment strategies developed during the West Africa horror, but those medicines and techniques require cooperation from the public.

Doctors fear the DRC outbreak area trembles on the edge of a societal collapse in which Congolese flee the outbreak and conflict zones into surrounding areas where they would become much more difficult to monitor and could infect others.