Oxfam has declared that the 'first line of defence' against a deadly strain of Ebola has collapsed in the Democratic Republic of Congo (DRC). The country is facing its largest-ever outbreak of the virus, with nearly 781 people infected and 181 dead. However, Oxfam warns the true toll is likely much higher as contact tracing and water infrastructure are at breaking point.
Water crisis in Ituri province
Only one in five health centres in the northeastern province of Ituri, the worst-affected region, has access to enough clean water. In Mongbwalo, a town of 140,000 people, only 20% have access to clean water, and a quarter have access to working hygiene facilities. Manel Rebordosa, Oxfam's field response coordinator, said this forces families to use water contaminated with chemicals from local mines.
'Water – the absolute first line of defence in any public health emergency is simply not available,' he said. 'Miners working in the surrounding areas have no toilets and handwashing stations. Then they return home to communities already battling the virus. Clean water costs $2 (£1.50) for 20 litres. For most families here, that is far beyond what they can afford.'
Community impact
Tibakanya Mireille, a mother of five in Ituri, said she is 'worried' her child has become infected with Ebola. 'Here, two houses have been quarantined, and one family lost several relatives after caring for a sick relative, which caused others to be sick,' she said. 'The disease has already killed several people in our community of Shari, in Bunia.'
Largest Bundibugyo outbreak on record
The strain behind this outbreak, known as Bundibugyo, is rare and has no vaccine or treatment. The US Centers for Disease Control and Prevention (CDC) confirmed this is the largest Bundibugyo outbreak on record. In North Kivu province, Ebola cases are being identified after patients have died, unaware they had the illness. Contact tracing coverage is just 43%.
Oxfam fieldwork found only 0.2 doctors per 1,000 people, and some 70 health facilities have been destroyed by conflict. Years-long violence has displaced millions, including in Ituri, complicating contact tracing efforts.
Challenges in containment
Aid workers built isolation tents and disinfection stations near hospitals, only for locals to burn them down when officials refused to hand over bodies over infection fears. People can become infected through contact with bodily fluids of an infected, sick, or dead person. Locals now see hospitals as 'death traps' and turn to traditional health methods, hampering containment.
Rebordosa also cited US involvement: 'One month into the 2018 outbreak, healthcare workers achieved contact tracing rates where nearly eight in 10 known contacts were successfully monitored. Today, following the withdrawal of US funding for disease surveillance and severe funding shortfalls, contact tracing is reaching fewer than half of the contacts. That gap is not just a statistic; it is a painful reality that allows the virus to spread undetected through communities.'
Ebola overview
Ebola is caused by a group of related viruses called orthoebolaviruses. Infections have dry symptoms (fever, aches, fatigue) and wet symptoms (diarrhoea, vomiting, bleeding). As initial symptoms resemble the common cold, many cases go undiagnosed.
The US withdrew from the World Health Organization in January after closing the US Agency for International Development.
Hope on the horizon
About 25 people have recovered, the Africa CDC reported. Dr Katherine O'Reilly, medical director at International SOS, said an 'experimental' Bundibugyo vaccine is in development by the Oxford Vaccine Group using COVID vaccine technology. Researchers are developing the ChADOx1BDBV candidate vaccine, aiming for an accelerated schedule while adhering to scientific, ethical, and regulatory standards.
