BUNIA, Democratic Republic of Congo – Victorine Ngwobu Kasemi is the director of nursing at the Evangelical Medical Centre in Bunia, the epicentre of the Democratic Republic of Congo’s record-breaking Ebola epidemic. In recent weeks she’s had to watch colleagues succumb to the virus, and her children isolate themselves from her to keep safe.

“I’m afraid that at any moment I could die or infect my children, because this is a disease we can’t control, and no one knows where or when I might get contaminated,” said Kasemi.

Like hundreds of nurses working on the frontline, Kasemi faces the challenge of providing life-saving supportive care to patients without being infected. The most painful experience, she said, is watching helplessly as her colleagues succumb to the virus.

“There was a woman who came in with a miscarriage, and she had Ebola; two doctors and several nurses who treated this patient were infected,” she said. “One doctor, unfortunately, died from the toll it took. When a nurse was declared positive, she couldn’t bear it and fell into a depression until we lost her. We were unable to save her.”

These cascading infections illustrate a well-documented mode of transmission: Ebola, a severe viral hemorrhagic fever, spreads through direct contact with the blood, vomit, or other bodily fluids of an infected person, or via contaminated equipment – that puts healthcare workers at high risk. The average fatality rate is about 50%.

At home, medical staff have to carry the added burden of protecting their families.

“When I come home, my children ask me to stay on the balcony. They prepare my shower, I leave the balcony to go shower, and my clothes are immediately soaked in water,” Kasemi said. “That’s the life I’ve lived up until now.”

Unpaid wages, anger and infection risks 

In mid-July, the severely underfunded frontline response was thrown deeper into chaos. Dozens of medical workers at Rwampara General Hospital in Ituri, a northeastern province on the border with Uganda where the first case was detected, on strike to protest unpaid wages.

Health workers from epidemiologists to health investigators and gravediggers leading the strike said they had not received pay since the epidemic began. The strike included everyone from epidemiologists and health investigators to gravediggers.

It has been a stop-cycle of strikes since protests began. Health staff walk out, receive new promises of payment, return to work, then resume strikes when the promised money doesn’t materialise.

Visits from top country officials have done little to quell the frustration. Prime Minister Judith Suminwa visited Ituri on July 24 to reassure health staff – they were back on strike within a day, still owed months of pay.

In a separate visit to Ituri, Health Minister Roger Kamba said that the government was in the process of verifying a list of people working on the epidemic response in order to sort out payments. He said the delay was due to unrelated names being added to it.

“We must make sure these payments reach the right people,” said Kamba. “We have the means to resolve this issue.”

Uncontained spread

The DRC’s current outbreak – its 17th Ebola epidemic since 1976 – is spreading faster than any on record globally. It is already the third-largest ever in the DRC – and is on pace to become the largest in the history of the continent.

Africa Centre for Disease Control (Africa CDC) director Dr Jean Kaseya said at a press briefing on Thursday that the current outbreak has recorded seven times more cases than at the same stage of the 2014-2016 West Africa Ebola outbreak,

The critical threshold of 1,000 cases, which signals that an epidemic is spiralling out of control, was crossed in just 40 days, a pace the Africa CDC described as the “fastest-growing” epidemic ever recorded.  The 2,000-day threshold was crossed in only 20 days.

it took 235 days to reach 1000 cases during the 2018 North Kivu epidemic, which until recently, was at the time was the DRC’s worst outbreak on record.

The country has recorded 3,442 confirmed cases and 1,521 deaths – a case fatality rate of 44% – as of July 28, according to the DRC Ministry of Communications and Media. Nearly 800 patients remain in isolation or hospitals.

The toll includes 112 infected health workers – 35 of whom have died – across five provinces in eastern DRC: Haut-Uele, Ituri, North Kivu, South Kivu, and Tshopo.

Contact list far behind the curve

As the response crumbles and contact tracers struggle to track the spread, the epidemic continues to break containment efforts, outpacing the response at every turn.

Over 80% of new cases in Ituri, the epicentre of the outbreak, are not linked to known cases, according to Africa CDC. Over 60% of deaths are linked to communities instead of treatment centres, showing authorities still have major ground to cover to catch up with the speed of the outbreak.

Struggles in contact tracing are compounded by the lack of medical countermeasures. Unlike previous epidemics in the DRC, caused by the Zaire strain for which vaccines exist, this one is caused by the Bundibugyo strain, which remains without a vaccine or approved treatment — making tracing one of the only tools responders have to get ahead of the virus.

The disease often begins abruptly with fever, extreme fatigue, muscle pain, headaches, and sore throat, before progressing to vomiting, diarrhoea, skin rash, and, in the most severe cases, internal and external bleeding, according to the World Health Organization (WHO).

The incubation period lasts 2 to 21 days, and an infected person becomes contagious only after symptoms appear. Close contact with a sick person, particularly during care or funeral rites, is the main route of transmission.

‘Heroes’ on the frontline

Dr Mubarack Kano, Medical Director of the Ituri Neuropsychopathology Centre in Bunia, said those risking it all to contain the virus are “heroes.”

Kano, who leads Ebola investigation in Bunia’s CNK Sayo health area, said this is especially true as they face backlash from community members who want to maintain traditional funeral customs like washing, dressing, and even kissing deceased victims that are still carrying massive viral loads.

“The workers responsible for breaking the chain of transmission by organising safe and dignified burials are the most exposed people, in a community that struggles to accept giving up customary funeral rites,” said Kano.

As medical workers and authorities refuse to hand over highly contagious bodies, it is only sowing deeper mistrust among some community members, who see it as part of a cover-up and even doubt the virus’s existence and see it as part of a resource grab.

Bahati Jhon, a father of eight, is a member of a safe and dignified burial (SDB) team in Rwampara.

“Since May 15, we’ve been doing this work. We face all kinds of risks. We’re sometimes physically attacked, threatened with death, chased,” Bahati Jhon, a father of eight and member of a safe and dignified burial (SDB) team in Rwampara, explained.

“During a burial the other day, someone in the community threw a stone at me, which unfortunately damaged one of my teeth, which I ultimately lost,” Jhon said.

It was not a one-off incident. In Rwampara, a centre was burned down on 21 May after authorities refused to return a body to its family. Elsewhere, burial teams were forced to abandon a coffin under pressure from angry residents.

Workers like Jhon keep taking on these risks, even as they go unpaid. “Since the epidemic began, we haven’t received a single franc. We don’t know what to do, as we can no longer provide for our families’ basic needs,” he said.

‘No one is coming to our aid’

Despite efforts by relief teams to build trust and awareness, healthcare workers remain frequent targets of disinformation. In some cases, they’re being blamed for having invented the disease to enrich themselves.

“We are not here for the money. We face a critical situation,” Dr Kamara, a Rwampara health zone doctor, said. “There is a disease that is very real, and the goal of every healthcare worker is to treat, to save lives, and to limit the spread of the disease.”

An important part of the local response now centres on building local capacity to fight disinformation. The National Institute of Public Health is training local journalists, and MONUSCO has trained community leaders in Mambasa. DRC Authorities are also calling on community radio stations to step up awareness efforts.

The response is also being hamstrung by ongoing war. The armed conflicts in eastern DRC between Congolese forces and the Rwanda-backed AFC/M23 rebellion in North Kivu, South Kivu, and Ituri have displaced over a million people and blocked health workers’ access to affected areas, putting strain on an already fragile health system and exposing frontline workers to even more insecurity.

A patient inside one of the ETCs in Ituri, who declined to give his name, described the situation as becoming dire.

“We are shocked to see the absence of caregivers. What’s even more serious is that there are patients who arrived yesterday, and others even today, in critical condition. These patients are calling for help,” he said. “But no one is coming to our aid. We are here with no medication, no nurses.”

He said patients have had no food since last Monday morning.

Beyond the treatment centres, the war is fuelling another dark crisis for eastern DRC’s civilians. Panzi Hospital in South Kivu reported an 85% increase in newly registered survivors of sexual violence in the first half of 2026 compared to the previous year.

Sexual Violence Surges in Eastern DRC as Conflict and Ebola Overwhelm Health System

Who’s stepping up?

The early weeks of the Ebola response were difficult and unbalanced, delaying the construction of Ebola treatment centres and proper patient care. Since then, funding has poured in, though not always fast enough to keep pace with the outbreak.

In June, Africa CDC and the WHO launched a joint response plan costing $518 million for the period June-November 2026.

Since then, the DRC government has already injected more than $50 million into the response. Paid in two instalments ($20 million then $30 million) by the public treasury, the funding pales in comparison to the overall national response plan budgeted at $319 million, and the continental Africa CDC/WHO plan of $518 million for June-November 2026.

In total, nations and international organisations have pledged around $1 billion to the response. Some 472$ million of that total has been distributed so far, according to Africa CDC. The agency estimates $1.4 billion will be required to fully quell the outbreak.

Among the main donors: the United States ($270 million), the United Kingdom (£20 million), the EU (€15 million), and the World Bank ($243 million). The WHO Foundation is running a campaign to raise $115 million, but so far has received less than half of that amount.

While international mobilisation remains visible, execution on the ground has struggled. Among the main donors: the United States ($270 million), the United Kingdom (£20 million), the EU (€15 million), and the World Bank ($243 million).

Questions and hope

US Support for Ebola Response is Unclear Amid Opaque Funds Disbursement and Non-Engagement with WHO

Some donor countries are channelling funds directly through NGOs, which are involved in awareness campaigns and the construction of treatment centres. But in some cases, including funds allocated by the United States, questions have also arisen around the opacity of fund recipients and how they have been used.

Criticisms have also arisen that the WHO-Africa CDC coordination effort may have diffused, rather than sharpened accountability over the management of the crisis.

John Katabuka, a doctor at the ETC of La Grâce General Referral Hospital in Bunia and deputy coordinator of the Bunia health zone, is looking at the future with caution, but not without hope.

“We need to monitor entry and exit points and rely on community-based surveillance to track every alert – contacts, suspected cases, and contacts of contacts,” he said, adding that disinformation and community resistance early in the epidemic caused delays in care and a cascading rise in deaths.

“We are not pessimistic. We believe treatment centres and their equipment can be brought up to standard, so that even expatriates who fall ill can trust the local ETC rather than being evacuated abroad.”

 This article is published in collaboration with Egab.

Image Credits: Anicet Kimonyo.