BUNIA, Congo (AP) — In a camp for 10,000 displaced people in Bunia, there is one handwashing station and one infrared thermometer to fight the Ebola epidemic, a grim snapshot of how people at the bottom are left to improvise while disease and displacement pile up around them. Camp leaders say residents are told to wash their hands before eating, with soap for the lucky ones who have it. For everyone else, the instruction is to use oatmeal or sand.
Who Pays for the Breakdown
Francine Leve Janguzi, a resident of the so-called ISP camp, described the conditions from inside the tarpaulin maze. “My fear is that we are here with nothing to protect ourselves. We have no protection, no water or soap, and we live near garbage,” she said as she opened an empty tap. Janguzi, who said, “I’ve been here for eight and a half years. Now we’re hearing about Ebola,” added, “Look at the state of where we’re sleeping. We don’t have any help whatsoever. We don’t have soap or water, yet we’re told to wash our hands regularly and be clean.”
Supplies are being rushed to Ituri province as aid groups and healthcare workers try to stem an outbreak of the infectious disease that has been declared a global health emergency. Front-line responders are worried the disease could spread to the large displacement camps near Bunia, where thousands of people are packed into limited space without access to basic hygiene. The emergency response is arriving after the fact, into conditions already shaped by neglect, crowding and scarcity.
Heather Kerr, Congo director with the International Rescue Committee, said, “Eastern DRC’s years of conflict and displacement have left health systems on their knees, and that makes containing this outbreak all the harder.” Gabriela Arenas, a regional coordinator at the International Federation of Red Cross and Red Crescent Societies, said the outbreak is “unfolding in communities already facing insecurity, displacement and fragile healthcare systems.”
Displacement as the Background Noise
Almost a million people have been displaced from their homes by conflict in Ituri, according to the U.N. The majority of residents of the ISP camp, which takes its name from its proximity to the Higher Pedagogical Institute, or Institut Superieur Pedagogique in French, were forced to leave their villages in the Djugu territory after attacks by CODECO, one of several armed groups operating in the region. The camp is not an exception to the crisis; it is one of its products.
There is no vaccine or treatment for the rare Bundibugyo type of Ebola, which has been spreading undetected for weeks in eastern Congo. Standard tests struggle to detect the Bundibugyo. Over 1,000 suspected cases and at least 220 deaths had already been recorded as of Tuesday, including seven confirmed cases in Uganda. But the World Health Organization and aid groups on the ground say the outbreak is much larger.
Ebola is a highly contagious virus and can be contracted from bodily fluids such as vomit, blood or semen. The disease it causes is rare but severe and often fatal. Symptoms include fever, headache, muscle pain, weakness, diarrhea, vomiting, stomach pain and unexplained bleeding or bruising.
What the Armed Groups Leave Behind
Eastern Congo has for years seen attacks by dozens of separate rebel and militant groups, some with links to foreign countries or the extremist Islamic State group. The Rwanda-backed M23 rebels are in control of parts of the region. While the Congolese government still largely controls the northeastern Ituri Province, the epicenter of the Ebola outbreak, that control is tenuous. The Allied Democratic Forces, a Ugandan Islamist group linked to IS, is one of the dominant rebel groups there and responsible for violent attacks against civilian targets.
Before the outbreak, humanitarian group Doctors Without Borders said in an assessment that the insecurity in Ituri had worsened recently, causing doctors and nurses to flee and leaving overwhelmed health facilities and, in some parts, “catastrophic conditions.” That is the terrain into which the Ebola response is being pushed: a landscape where medical care is already hollowed out and the people most exposed are the ones with the least protection.
Gérard Maki, a community leader in the camp, said the disease is very frightening. “I’ve learned that there’s no cure, which is why it scares me. ... Our government should also do everything possible to find a solution to this disease,” he said. His words land in a place where the state’s presence is thin, the camps are overcrowded, and the basic tools of hygiene are missing.
Pronczuk reported from Dakar, Senegal. Associated Press writer Jean-Yves Kamale contributed to this report from Kinshasa.