It seemed like impossibly bad luck for the Democratic Republic of Congo: even as the country’s ninth Ebola outbreak was being smothered in the country’s northwest this summer, the tenth outbreak was starting 1,800 kilometres to the east, near the border with Rwanda and Uganda.
But the DR Congo’s really bad luck is that its Ebola outbreaks are not the real story. Not when millions of Congolese have died by Kalashnikovs, old-fashioned machetes and starvation in the past 20 years, while the rest of the world ignored them.
The DR Congo has learned a lot about Ebola since it was first identified in the country in 1976. In recurring outbreaks, Congolese doctors have gained impressive expertise in spotting and smothering Ebola before it could spread widely. Ebola tended to break out in small, remote communities that were hard to get into but also hard to get out of. Once identified, it could be contained.
When the ninth outbreak occurred last spring, everyone worried because it had been found in small villages in Equateur province, not far from Mbandaka, a city on the Congo River with a million residents. If Ebola cases got onto the river, they could be in Kinshasa (estimated population 11.3 million) in a day or two.
That didn’t happen. Embarrassed by its sluggish response to the West African Ebola disaster in 2014-2016, the World Health Organization had reorganized itself. It swept into the Mbandaka hot zone to aid the Congolese Ministry of Health with impressive resources — including an experimental Ebola vaccine that had looked promising in the late stages of the West African outbreak. Forty-two days after the last confirmed case, DR Congo declared the ninth outbreak over.
World media paid attention to the outbreak, mostly because of the possibility that it might explode into another West African-style disaster. African nations suffer all kinds of epidemics. HIV alone has infected 23.8 million Africans, including 91 per cent of the world’s HIV-positive children. Over a million African adults and children die every year from the disease.
Ebola’s collateral damage
Compared to those numbers, the 11,300 West African Ebola deaths were a rounding error. No one paid attention to that outbreak’s collateral damage: the thousands of deaths from malaria, childbirth and measles that might have been prevented if people hadn’t been terrified of going to hospitals and clinics. It hardly mattered. Such deaths were no threat to the rest of the world.
West Africa, recovering from a couple of ruinous civil wars, was at peace when Ebola hit. So was the DR Congo’s Equateur province. In the eastern provinces of North Kivu and Ituri, however, a violent anarchy has prevailed for 20 years.
North Kivu, bordering on Rwanda and Uganda, has a population of around six million; Ituri, just to the north, has about four million. The region has been the site of what New York Times reporter Jeffrey Gettleman in 2012 called “The World’s Worst War,” a chaos of casual slaughter, starvation and rape that has been going on for years. Even by 2012 it had cost an estimated five million lives since 1996, and it still continues.
This is happening in a nation of 84 million that by rights ought to be one of the richest countries in the world thanks to its estimated $24 trillion in reserves of oil, coltan, cobalt and other mineral wealth. But the Belgians, after robbing it for generations, deserted in 1960 and let it fall into anarchy. Mobutu Sese Seko continued the robbery, and the present president, Joseph Kabila, has overstayed his mandate but promises to leave at the end of the year.
After the Rwandan genocide, many of the “genocidaires” fled into the DR Congo and established themselves as mini-warlords. Various Islamist East African groups did the same, and now some 70 armed groups control much of North Kivu’s border with Rwanda and Uganda. The UN has established MONUSCO, a peacekeeping force of about 20,000, but has not brought much stability to the region. (Just the other day, residents of one Ebola hot-zone town protested because a DR Congo commando unit was being moved elsewhere, leaving the town exposed to local bandits and terrorist groups.)
If this is news to you, you’re not alone. The western media tend to go comatose about the sorrows of central and southern Africa. They can’t find a “narrative” — catastrophes like Rwanda’s genocide, or saints like Nelson Mandela, or strategic issues that might inconvenience western nations. When it’s mentioned at all as a problem for Ebola fighters, it’s just as “conflict” or “insecurity.”
Over five million deaths might not catch our attention, but Ebola’s sheer grossness did: in extreme cases victims will bleed from many orifices, and they shed more virus when they’re dead than when they’re alive. African culture shows respect for the dead by bathing, caressing and kissing them — making every funeral another disastrous spread of the disease. We westerners, by contrast, rarely even see a dead person let alone touch one, so African family feeling strikes us as foolish rather than beautifully humane.
The worst case scenario
This is not to diminish the threat of Ebola. Dr. Peter Salama, WHO’s deputy director-general for emergency preparedness and response, recently said the best-case scenario for the outbreak is a sharp drop-off in Ebola cases by mid-September.
“The worst-case scenario,” he added, “is that we see either cases across borders of Uganda, Rwanda, most concerningly South Sudan, which has very little infrastructure to deal with it, or Burundi, and we see cases in those very difficult to access security areas, [including] that far eastern hinterland close to the DRC-Ugandan border, on the DRC side.”
Despite 20 years of incessant violence, North Kivu and Ituri provinces maintain busy social and economic ties with neighbouring countries. The DRC Ministry of Health recently reported checking 1,739,648 travellers through 36 official entry points since the outbreak was declared on Aug. 1. How many have crossed the Congolese border via footpaths in bandit country is anyone’s guess.
If Ebola does begin to spread, the Ugandans at least may be able to handle it; they have experience gained from their own outbreaks. But the rest of East Africa is effectively defenceless.
Once loose in East Africa’s vast cities, Ebola could soon spread from the Cape to Cairo and beyond. If it does, we can’t blame the Congolese or the bandits. We can blame ourselves, for allowing a vast, rich country to fall into the hands of both domestic and foreign predators.
And even if the DRC and its allies do suppress this outbreak, the underlying anarchy we have tolerated will remain, condemning scores of millions to needless misery and early deaths from much less dramatic deaths than Ebola.