Health workers at the center of Congo’s Ebola outbreak are walking off the job over delayed pay, and the machinery of response is already wobbling. In Ituri province, the hardest hit of the three provinces in eastern Congo affected by the outbreak, front-line workers told The Associated Press they haven’t been paid wages and bonuses since the outbreak was declared on May 15. They say they’re working with limited gear, being treated unfairly by authorities and response teams, and carrying the burden while the system drags its feet.
"Since the Ebola virus disease outbreak was declared, we’ve been demanding payment for our work," Dr. Biensi Kano, a member of the epidemiological surveillance committee in Ituri’s capital, Bunia, told The Associated Press. That demand sits at the center of the story. People doing the dangerous work are asking for the basics, and the institutions running the response are still failing to deliver them.
Who Pays for the Breakdown
The latest government data shows 1,708 recorded cases, including 580 deaths, and health authorities said the first month of this Ebola outbreak was already the worst on record. That’s the human cost of a response strained by delay, insecurity, and the usual top-down promises that don’t reach the people doing the work.
The strike comes as enrollment begins for clinical trials for the treatment of the Bundibugyo virus responsible for the outbreak. Even as the trial process gets underway, the people expected to hold the line say they’re being left unpaid and under-equipped.
The World Health Organization representative in Congo, Dr. Anne Ancia, said Tuesday that the virus continues to spread, fueled by population movements and insecurity, while some treatment centers are at near-full capacity. The official language is clinical. The reality is crowded centers, movement, and a response that can’t outrun the conditions around it.
Kano said the non-payment of benefits "exposes us and our families to significant socio-economic difficulties and seriously undermines our living conditions." That’s the hierarchy in plain view: risk and labor at the bottom, delay and explanation at the top.
What the Workers Did
In an official notice to national and provincial authorities over the weekend, front-line workers in Ituri threatened to strike if wages were not paid in 24 hours. By Tuesday, some had already stopped working, although no official strike has been declared. Some workers also organized a protest Monday outside the Rwampara Ebola treatment center, where they set tires alight and caused a brief panic before police intervened to restore order.
The workers include safety and security teams, people who do community outreach, and those burying patients who died from Ebola. They’re not abstract functionaries. They’re the people carrying the outbreak response into villages, homes, and burial sites, often with little protection and less respect.
Dr. Ben Bakule, a community investigator, said he narrowly escaped death in late May when a group of angry young men attacked him and his colleagues while they were tracing contacts of a confirmed Ebola case in the village of Tutu, in Djugu territory. He said, "We spend money on transport to get to work. We thought we’d be rewarded. At the moment, nothing is going right because we’re not being paid. We don’t deserve this sort of treatment." He added, "We might have to give up our jobs. These are risks we’re taking. We risk dying for nothing. This government wants this epidemic to continue."
Promises From Above, Delay Below
When he visited the mining town of Mongbwalu last month, Congo’s Minister of Health Roger Kamba assured response teams that the government was prioritizing their working conditions. "All doctors, all nurses and all staff working on the response will be fully supported. We have the money for that," Kamba said at the time.
Front-line workers say the reality is different. Dr. Ghislain Maneba, an epidemiologist and community investigator in the Rwampara health zone, said, "We are doing everything we can to make the public understand how dangerous this disease is. I came here to save people’s lives, but this is how I am being thanked. We are working day and night without being paid."
Akilimali Pierre, incident manager at Congo’s National Institute of Public Health, said the closure of Bunia airport is hampering the implementation of the response, particularly the flow of funds, and that this may account for the delay in payment. That’s the official explanation: the airport is closed, the money gets stuck, and the workers wait.
Congo’s government did not immediately respond to a request for comment about the situation. Officials in Ituri said they’ve met with the workers and their concerns are being addressed. Meanwhile, residents in Ituri are already living with the economic hardship caused by measures meant to slow the outbreak.
Bunia resident Anifa Kito said she fears response efforts may falter and make daily life even harder. "I would ask the authorities to resolve this situation before things get any worse," she said, standing in front of her tomato stall. That’s the whole arrangement in one frame: a public health emergency, unpaid labor, police restoring order, and ordinary people left to absorb the shock.