The Ebola Clinics They Came to Burn

During the 2018-2019 Ebola outbreak in eastern Democratic Republic of Congo, rumors that treatment centers were harvesting organs or that the virus was a political invention spread through communities and on messaging apps. The false claims fueled attacks that burned clinics, drove out aid groups and, health bodies said, gave the epidemic new force.

The outbreak was declared on Aug. 1, 2018, in the North Kivu and Ituri provinces of eastern Democratic Republic of Congo, a region scarred by years of armed conflict. It would become the second-largest Ebola epidemic on record. But from early on, responders found themselves fighting two things at once: the virus, and a current of rumor and distrust that circulated through communities and on platforms such as Facebook and WhatsApp, according to an analysis by the Council on Foreign Relations.

The claims took several forms. Some held that Ebola did not exist and had been invented for political or financial gain; others alleged that foreign health workers in protective suits were harvesting organs or deliberately spreading the disease. The Council on Foreign Relations reported that such messaging “informed attacks that armed factions have launched against Ebola treatment centers in the DRC as symbols of foreign meddling.”

Belief in the rumors was measured, and widespread

The distrust was not anecdotal. A population-based survey of 961 residents of Beni and Butembo, published in The Lancet Infectious Diseases, found that 25.5 percent of respondents did not believe Ebola was real and 45.9 percent thought the outbreak had been fabricated to destabilize the region or for financial gain. Respondents who doubted the virus’s existence were markedly less likely to seek formal health care or accept a vaccine, the study reported.

The findings were reported by Al Jazeera, which quoted one of the study’s authors, Patrick Vinck of Harvard University: “It’s been three years now that we saw a declining level of trust in those actors, and the Ebola crisis comes on top of that and accelerates the distrust.” The exclusion of people in Ebola-affected areas from the December 2018 presidential vote, the outlet noted, had further fed conspiracy theories that the disease was a political tool.

The clinics that came under fire

The suspicion turned violent. On Feb. 24, 2019, assailants attacked an Ebola treatment center run by Médecins Sans Frontières in Katwa, throwing stones and setting parts of the structure ablaze, destroying wards and equipment. Days later, on Feb. 27, a second MSF-supported center in nearby Butembo was set alight. MSF suspended its medical activities at both sites. “We are extremely saddened by these attacks on our medical facilities,” Hugues Robert, an MSF emergency desk manager, said in a statement.

MSF’s international president at the time, Joanne Liu, said the response had grown “toxic,” describing a climate of deepening community mistrust and suspicion that “Ebola is a political ploy.” She warned that coercive measures during burials, contact tracing and patient admissions were “counterproductive to controlling the epidemic,” according to Al Jazeera. By March 7, 2019, the outbreak had killed at least 569 people. A DRC health ministry spokesperson, Jessica Ilunga, dismissed some of MSF’s criticisms of the security response as a “gross exaggeration.”

A response repeatedly forced to halt

The attacks continued through the year. In May 2019, the World Health Organization reported that since January there had been 42 attacks on health facilities in which 85 health workers had been wounded or killed. On Nov. 28, 2019, coordinated overnight attacks on response bases at Biakato Mines and Mangina killed four workers and injured five others, the World Health Organization said.

“We are heartbroken that people have died in the line of duty as they worked to save others,” the WHO director-general, Tedros Adhanom Ghebreyesus, said, warning that “Ebola was retreating. These attacks will give it force again.” The WHO regional director for Africa, Matshidiso Moeti, added: “These constant attacks must stop.” Each closure and evacuation, health officials said, opened a window for the virus to spread untraced — the practical cost of a rumor that had outrun the response.