Eastern Congo's Ebola Clinics Are Burning, and War Is to Blame

Think about what it means when a mother carries her feverish child to a clinic and finds the building on fire. Think about what it means when a nurse is shot because someone decided she was spreading the disease. This is what Ebola looks like in eastern Congo in 2026. The virus is only part of the killing. The rest comes from a society so exhausted by war that it no longer trusts the people who come to save it.

Between 1 September and 31 October, the Crisis Analysis Team documented 130 incidents linked to the Ebola response. Thirty-one people were hurt. Four were killed. Those are not abstractions. Each number is a family, a neighbourhood, a health worker who went home to a locked door or never went home at all.

Let us be precise about where this is happening. Ituri recorded 62 incidents and North Kivu 54, with Tshopo adding 12. In October, North Kivu overtook Ituri for the first time since monitoring began. The total fell from 81 incidents in September to 49 in October, a drop of 40 percent. Good news, you might think. Read the fine print. The analysts themselves warn that fewer incidents do not mean less danger. The incidents that remain are increasingly aimed at the places where the sick are supposed to be safe.

That is the most damning finding in the report. Attacks on and tensions around Ebola treatment centres, hospitals, health posts and transit centres became the leading category of the period, with 21 incidents. Thirteen buildings were damaged or destroyed, nine of them by fire. In July, these kinds of incidents numbered 18. In August, only 7. They surged again in the two months under review. Communities are not simply resisting the response. They are attacking the places where it lives. At Drodro, Mandima, Mutwanga and Bafwasende, opposition came before the clinics even opened.

Eleven incidents involved families or residents refusing care, transfer or follow-up. Those refusals produced no casualties and no damage, which is exactly why they are dangerous. Every person who hides a symptomatic relative is a person the surveillance system goes blind to. Every ignored follow-up is another chain of transmission nobody is tracking. In an outbreak, silence is a lethal weapon, and it is being fired by people who have been given no reason to believe the system is on their side.

Then there is the question of who holds the guns. Twenty-five incidents implicated an armed actor or a security force, nearly one in five of the total. One response worker was shot dead during an armed raid on a checkpoint at Beni. A resident was killed by police fire during a safe and dignified burial at the same town. A nurse was killed at Bafwasende on the accusation that she was spreading the disease. A local political figure was murdered at Butembo after broadcasting an awareness message. Let that sink in. The people trying to stop a deadly virus are being killed by the people who are supposed to protect them, and by those who fear what the virus means for their lives.

Beni and Butembo are not strangers to violence. They sit in a province where armed groups and state forces have fought for decades, where the Allied Democratic Forces have massacred civilians for years, and where the state has repeatedly failed to deliver basic services. Into this vacuum now steps a rumour that schoolchildren will be vaccinated by force. The word "vaccine" did not appear once in August's monitoring. In October, it sparked 14 of the 16 school disruptions. Parents stormed schools, children were pulled out, stones were thrown. Most of these rumours were attached to no scheduled campaign at all. Someone is profiting from fear, and we should be asking who.

And then comes the part that should shame every African capital. The response is being undermined by unpaid health workers. Allowance arrears are generating internal protests inside the very teams fighting the outbreak. A health system that does not pay its nurses cannot expect nurses to take risks, and it cannot expect the public to trust a uniform that arrives late and leaves empty-handed.

Now the context, because none of this happens in a vacuum. Eastern Congo has been bleeding for thirty years, and the wounds have deepened since 2021 when the M23 rebellion resumed its offensive. M23 controls Goma and Bukavu. The United Nations Group of Experts has repeatedly documented the presence of Rwandan Defence Force units fighting alongside M23, with Rwandan soldiers operating as the core of an offensive that has displaced millions of Congolese. This is not a local rebellion. It is a war of aggression by Kigali, dressed up as a proxy insurgency so Paul Kagame can claim innocence while his soldiers hold Congolese territory. Rwanda markets itself to the world with gorilla tourism and the glossy prestige of hosted summits, while its army helps keep a neighbouring country's health system on its knees. That is sportswashing at its most obscene, and the world keeps buying the brochure.

Every outbreak in eastern Congo now runs through that war. Clinics cannot be built where armed men control the roads. Health workers cannot be paid when budgets are looted or diverted. Communities cannot trust a state that has abandoned them to militias and foreign troops. When a government cannot protect its citizens from bullets, it will not protect them from a virus either.

But the answer is not despair. Africa has already shown us what works. In 2014, Nigeria confronted an Ebola case arriving in Lagos and contained it, through rapid contact tracing, transparent communication from government, and coordination between the state and local health leaders. Senegal, the same year, isolated its single imported case and prevented a wider epidemic through community engagement and disciplined public health work. Neither country was rich. Both had institutions that people believed in, and that belief saved lives.

So here is what must happen. The African Union must publicly name the armed actors attacking health facilities, and the Peace and Security Council must demand that all forces, including Rwandan troops, withdraw from Congolese territory. The United Nations Security Council must extend and enforce sanctions against commanders who order attacks on clinics and against any state that arms or deploys forces inside Congo. Kinshasa must do what it has refused to do for decades: pay its health workers on time, publish its vaccination plans before the rumours arrive, and bring its security forces under civilian oversight so that a police bullet at a burial stops being a normal event. Local leaders must be consulted before clinics are sited, not after they are burned. Families must be mediated with, not overrun. And the private sector and civil society should fund transparent community radio campaigns that tell the truth about what vaccines are and are not.

As for the rest of us, we have a duty to refuse the lazy story. Do not let this become another headline about "tribal violence" or "primitive superstition." These Congolese mothers are not ignorant. They are frightened by a state that has failed them and a war that has taken everything. Demand from your own government and from the African Union that the Ebola response be funded, protected, and held accountable. Demand that the countries arming and backing the war in eastern Congo face consequences. Share this story until those who profit from chaos feel the heat.

Four people died in two months for doing the work of saving lives. How many more will it take before we decide that a clinic should be the safest building in any Congolese town, not the most dangerous? The answer belongs to us. Make it loud.

Based on reporting by RELIEFWEB