KINSHASA, Democratic Republic of Congo — An Ebola outbreak in eastern Democratic Republic of Congo is spiraling, with health workers struggling to contain the virus as it spreads across a vast and conflict-torn region.
According to the latest government figures, there are more than 1,000 suspected Ebola cases and up to 246 people are suspected to have died from the disease so far. The outbreak is believed to have been spreading for weeks before it was officially declared on May 15.
The epicenter of the outbreak is in Mongbwalu, a poor gold-mining town of 130,000 people, in Ituri province, in eastern Congo.
"The situation is currently very concerning, with active transmission ongoing everywhere around here in Mongbwalu," said Dr. Esther Sterk, a tropical disease specialist with Doctors Without Borders, who is working in the town.
"Every day there are many community deaths and suspected patients arriving at the hospital. This probably is only a small proportion of all cases at the moment," she added.
Deep mistrust among some people in the town is hampering response efforts to the outbreak of the Bundibugyo strain of Ebola virus — for which there is no vaccine.
Angry crowds attacked Mongbwalu's only hospital several times last week, trying to retrieve dead bodies - which can be slow to be buried because of onerous Ebola-related health protocols - for burial. Attackers also burned down one of the patient-isolation tents hastily erected on the hospital grounds, before soldiers dispersed them by firing warning shots.
Dr. Richard Lokudi, the hospital director, said that he and his staff have faced serious resistance from the local community, often from people who don't believe that Ebola is real. This is making tracing contacts of suspected Ebola cases particularly difficult.
"People think it's a mystic illness. Or they don't trust the hospital, they think that hospital personnel are injecting people with the illness," Lokudi said.
"These are false rumors and intoxication that are thwarting measures we have put in place to respond to the virus," he added.
Several health officials interviewed by NPR, who requested anonymity because they are not authorized to speak publicly, said initial resistance from local communities during Ebola epidemics was common. They said they believed that hostility would soon dissipate.
A larger challenge is Ituri province itself, which is deeply poor, and ravaged by decades of brutal militia warfare.
Health responders have to negotiate front lines and militia checkpoints and face a vulnerable population traumatized by conflict. Nearly 1 million people live in dense displacement camps in the province.
World Health Organization Director-General Tedros Adhanom Ghebreyesus described the Ebola outbreak on Wednesday as a "catastrophic collision of disease and conflict." In a social media post Tedros said the disease is outpacing the response.
Tedros is expected to arrive in Congo on Thursday for a short visit.
The crisis is also driving a wave of border and travel restrictions. Both Rwanda and Uganda have closed their borders with Congo.
Uganda has its own, much smaller Ebola outbreak. The country's health ministry has announced seven confirmed cases of the disease in the country.
Canada has announced a 90-day entry ban for residents from Congo, Uganda, and South Sudan. The United States has banned non-citizens who have traveled to those countries from entering.
The White House said on Wednesday the U.S. is establishing a facility in Kenya for Americans who may have been exposed to Ebola, but who are not showing symptoms.
Speaking in Washington on Wednesday, U.S. Secretary of State Marco Rubio said the administration "cannot and will not allow any cases of Ebola to enter the United States."
In Congo, the eastern provinces of North Kivu and South Kivu have also confirmed cases. But the epicenter remains Ituri, which shares a land border with Uganda.
There are hundreds of suspected cases in Ituri's capital Bunia, a city of over 1 million people.
The Congolese government banned most flights in and out of the city last week in an attempt to slow the spread of the virus.
Ituri's military governor, Lt. Gen. Johnny Luboya, has called for urgent medical reinforcements as the Ebola outbreak escalates.
"These financial resources must be made available," he said, stressing that specialist support is needed to contain the outbreak.
International donors have pledged $500 million to the Ebola response, according to the Africa Centers for Disease Control and Prevention. But help on the ground is only just beginning to arrive - after many have already buried their dead.
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