The World Health Organization says success in ending the Ebola epidemic in eastern Democratic Republic of Congo hinges upon improving security in North Kivu and Ituri provinces. The region has been engulfed in conflict for many years, and many locals do not trust outsiders, even the ones trying to stop the spread of the deadly virus.

The U.N. health agency reports security incidents in eastern DRC have increased dramatically in the past few months. So far this year, it reports 174 attacks by armed groups in North Kivu on health care facilities, workers and patients. These include five deaths and 51 injuries.

In mid-April, Cameroonian Dr. Richard Mouzoko was shot and killed while working in a hospital in Butembo, North Kivu. This incident was seen as a big setback to the Ebola operation.

This past Saturday, villagers killed a health worker in the health sector of Mabalako.

WHO Regional Director for Africa, Matshidiso Moeti, says health workers are being intimidated and threatened by armed men and live in fear, not knowing when the next violent attack may occur.

She says this insecurity is leading to a lack of access and driving the increase in cases.

“When the response cannot reach people,” she said, “they do not get the chance to be vaccinated or to receive life-saving treatment if they do fall ill.

“The technical means to stop this Ebola outbreak are available,” she added. “But without access or a secure operating environment, they cannot be deployed optimally and effectively enough. …This is why the response is one of the most complex health emergencies the world has faced.”

The latest WHO figures show 1,920 Ebola cases in the region, including 1,281 deaths. A new structure for coordinating and strengthening the Ebola response was presented at the World Health Assembly this week.

WHO Executive Director of Health Emergencies Michael Ryan says key partners will have to scale up their operations and take charge of crucial aspects of the new strategy.

“We believe the work on security, the work on non-humanitarian interventions and the work on sustainable financing are the things that need to happen to provide the environment in which public health operations can continue to progress and be successful,” he said.

However, he warns if there are further large-scale security incidents than all bets are off. He says the likely impact of this ongoing instability will have on the Ebola emergency operation is unpredictable, but worrisome.
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