Mistrust and Ebola: how conflict, displacement and extraction create space for misinformation

Widespread belief in misinformation around Ebola is clearly prevalent. So much so that the Public Prosecutor’s Office of Ituri – one of the hardest hit of DRC’s provinces – indicated in June that individuals found to be spreading misinformation could face charges. A population-based study of the 2018–19 outbreak found 25% of respondents believed the Ebola outbreak was not real, whereas a more recent survey conducted in Ituri puts this at 1 in 3. The same survey relays the testimony of a resident of Lita, Ituri, who says “people can’t bring themselves to believe in this disease. Some call it a satanic disease, while others believe it was invented to make money”. Scepticism is also borne out on social media – one post observed by CIR claims Ebola was created in an American laboratory and ‘does not exist in Congo’, while another claims ‘the WHO wants to kill Congolese people with its vaccines’. 

This mistrust has likewise had clear manifestations on the ground. Within the first two weeks of the outbreak having been officially declared, CIR observed two incidents of resistance to burials being carried out by health workers. A video posted to X on 23 May shows civilians harassing health workers heavily clad in PPE as they attempt to remove a casket from a hearse, reportedly in Kyondo. A second video, posted to X on 30 May, similarly shows PPE-clad health care workers standing around a coffin as they are surrounded by a large crowd, who eventually open the coffin after the health workers step away. This can be partly explained by the perceived incompatibility of safe burial protocols with local funerary customs that require physical contact with the body of the deceased. Efforts are currently underway to adapt safe burial protocols to accommodate these customs.

Mistrust has also manifested as outright violence against responders. CIR geolocated footage posted on 1 June of a health worker being chased by crowds reportedly attending the funeral of an Ebola victim at Nyamurongo cemetery in Bunia, Ituri. This health worker was reportedly one of four working for the Red Cross who were seriously injured after trying to stop attendees from opening the casket. On 9 June, a doctor was reportedly kidnapped and detained in Rwampara, Ituri, while investigating a suspected Ebola case, and on 19 June footage was posted to X showing a woman, allegedly a health worker involved in Ebola response, being beaten in the Mabolio area, south of Beni. These violent responses show that mistrust of health measures and those tasked with their implementation is a serious obstacle, but to better understand the roots of this mistrust we need to zoom out.

Ebola is far from a new disease in DRC – the nation has endured 17 separate outbreaks since 1976. Over this period, the region has been continually wracked by cycles of violence and displacement, driven and exacerbated by outside geopolitical and economic interests, resource exploitation, smuggling, domestic political instability and an enduring colonial legacy. This has generated multiple, overlapping humanitarian crises that have drawn the involvement of numerous international agencies – involvement that has been marred by scandal and corruption. A landmark 2020 New Humanitarian investigation uncovered extensive embezzlement of aid money earmarked for displaced populations under a programme managed by UNICEF and OCHA. In 2021, an independent panel identified 80 alleged cases of abuse during the 2020 Ebola outbreak, including rape and forced abortions, some of which were allegedly perpetrated by WHO personnel. 

Public knowledge of such cases must go some way towards explaining recent online narratives that mention Ebola alongside expressions of mistrust of Western intervention, with one X user claiming on 19 May that “the WHO lies, manipulates, and spreads false information”. The DRC government has also been criticised – CIR has observed claims on X that Ebola is a bioweapon manufactured by the central government. While it is difficult to directly trace these online narratives back to individuals with lived experience of outbreaks in DRC, they do seem at least generally indicative of perceptions on the ground. A video from 13 July reportedly shows civilians preventing a World Food Programme helicopter from delivering medical supplies in Ituri, while trust in national authorities for Ebola response among the population in Butembo and Bunia – both major epicentres of the current outbreak – was as low as 40.5% immediately following the outbreak in 2018, according to one study.

Links between extractive mining practices and the ongoing epidemic provide a case study for examining the logic behind this mistrust. WHO has suggested the current outbreak originated in Mongbwalu, a high-traffic gold mining area in Ituri. Here, a highly mobile labour force, large numbers of internally displaced persons and poor health infrastructure have all likely contributed to the spread – health workers reportedly lost track of two miners identified as Ebola contacts after they moved to another mining site. As the displacement and poverty that result from prolonged conflict insecurity drive more towards precarious, itinerant mining work where risk of transmission is high, the contaminated runoff generated by the mining itself has worsened water insecurity in the area, complicating basic infection prevention measures like handwashing. At the same time, despite earmarking funding for the response, US cuts to WHO, USAID and CDC funding have reportedly hampered response efforts. The same US administration recently secured preferential access to DRC’s extensive mineral resources in a deal with the government. Against this backdrop, it is hardly surprising that international intervention and government diktats are met with scepticism. As noted in The New Humanitarian, the suspicion that lurks behind much Ebola misinformation is that ‘interventions serve interests other than those of the population’.

In the context of persistent insecurity and exploitation, mistrust looks increasingly natural as a response to decades of intervention that has largely failed to halt cycles of violence, instability and poverty. Attacks on health workers, disrupted burials and circulating claims of conspiracy and misinformation sit on top of years of conflict displacement, exploitative extraction and weakened services. While there is clearly an urgent need to counter misinformation as an obstacle to effective public health measures, treating the resulting scepticism as misguided risks neglecting the extent to which community mistrust is rooted in genuine grievances. As Amy Maxman reported of Ebola in 2019, “people think this is just another thing brought from outside to kill”.