Medical teams frequently complain about the dangerous conditions in the violent rural areas of the Democratic Republic of the Congo (DRC). An alarming report published by Doctors Without Borders on Thursday said the effort to contain the Ebola outbreak in the Congo is “failing” due to community distrust and factional violence, including over 30 attacks on Ebola treatment centers over the past seven months.

Doctors Without Borders, commonly known by the acronym MSF for the French version of its name, said on Thursday it has temporarily shut down two treatment facilities near the epicenter of the Ebola outbreak because unknown attackers set them on fire. Dozens of other security incidents were reported last month. Over a hundred different armed groups are active in the area.

“The existing atmosphere can only be described as toxic. It shows how the response has failed to listen and act on the needs of those most affected,” warned MSF President Joanne Liu.

Liu said the problem is exacerbated by heavy-handed DRC government tactics that amount to dragging reluctant villagers into medical centers for involuntary treatment.

“Using police to force people into complying with health measures is not only unethical, it’s totally counterproductive,” she said.

MSF’s latest update on the Congo outbreak stated that over 40 percent of the new cases of Ebola detected this year were people who contracted the disease and died without leaving their communities to seek medical treatment. Furthermore, 43 percent of new patients over the past three weeks had no known connections to previous Ebola cases, making it difficult to track the spread of the disease.

“We have a striking contradiction,” said Liu. “On the one hand, we have a rapid and large outbreak response with new medical tools such as vaccines and treatments that show promising outcomes when people come early. On the other hand, people with Ebola are dying in their communities, and do not trust the Ebola response enough to come forward.”

Liu described aspects of the DRC’s forceful Ebola response that would seem terrifying to villagers: fleets of vehicles arriving to pick up a sick individual, people instructed to wash their hands but not given soap, dead bodies sprayed with chlorine and unceremoniously buried in plastic bags while their possessions are burned to keep Ebola from spreading.

The New York Times on Thursday contributed the story of a family that dressed up a young woman who died of Ebola, painted her face with makeup, propped her up in the seat of a car, and attempted to drive her through disease-control checkpoints so she could be buried next to her husband, a fellow Ebola victim. The effort was unsuccessful but demonstrated both a lack of understanding about how Ebola works and a lack of trust in the authorities, especially what rural Congolese see as a lack of respect for their burial traditions.

MSF said one of the latest discouraging wrinkles in the Ebola crisis came when the DRC suspended elections, leading skeptics of the government to suspect the Ebola outbreak is nothing but a political ploy.

DRC officials countered by insisting military personnel deployed to the outbreak area are not “involved in Ebola response activities” and have not been instructed to “enforce sanitary measures.”

MSF physicians say they have more success getting villagers to accept vaccinations when government troops are not present, but unfortunately their lives could be at risk from armed insurgents if they do not travel with military protection.

The number of Ebola cases reported in the Congo now numbers over 900 with 569 fatalities.