An Ebola outbreak continues to claim lives and reach new victims in communities across multiple provinces of the Democratic Republic of Congo and neighboring Uganda. But the ultimate toll of the outbreak must also be measured by its economic and social impact, according to Father Edouard Makimba Milambo, the executive secretary of Caritas Congo.

“Beyond the medical cases themselves,” Father Makimba said, “the crisis also generates significant effects on the daily lives of the population: disruption of economic activities, stigmatization of the sick and of survivors, and the fostering of fear and mistrust within communities.”

“It is a disease with a high mortality rate that places immense pressure on already fragile health systems and profoundly disrupts the functioning of communities,” he said, responding on June 3 to questions forwarded by America.

The region’s chronically weak health systems, “characterized by a lack of adequate infrastructure, qualified personnel and logistical resources to ensure rapid case detection and effective patient care,” have, of course, made a terrible contribution to the accelerating crisis. And misinformation and rumor-mongering are causing broad anxiety and provoking inappropriate responses that have contributed to the spread of Ebola.

“Fear is indeed prevalent within the communities—a reaction that is entirely understandable given the severity of Ebola virus disease,” Father Makimba said. That fear can have a communally salubrious effect, leading to “greater caution and better adherence to preventive measures.” But fear is double-edged, Father Makimba warned: “It may result in mistrust, stigmatization or delayed access to health services.”

People are afraid to leave their homes, wary of government health workers and suspicious of government edicts meant to contain the virus, he said. Some have turned to traditional treatments, distrustful of doctors and hospitals that have become associated with deaths of loved ones. Many persist with traditional burial practices, like the washing of the deceased and overnight funeral vigils that include touching the lost family member, that have helped spread the disease even more deeply into the community.

The Ebola virus is not airborne and is not transmitted by mosquito or contact with food or water. It spreads by direct contact and an exchange of fluid. But the bodies of Ebola victims are highly infectious, with the virus remaining active in bodily fluids.

Health officials have struggled to persuade community members to abandon traditional burial practices. When officials refused to release the body of a suspected Ebola victim to his family, outraged community members overran and burned a health center in eastern Congo on May 21.

Caritas Congo, Father Makimba said, was placing particular emphasis on awareness-raising and community engagement: “The objective is to provide reliable information, reassure the population and promote appropriate behaviors, ensuring that vigilance does not spiral into panic but instead contributes to an effective and solidarity-driven response.”

Among current acute needs in the communities served by Caritas Congo, Father Makimba said, are personal protective equipment for health workers (several have already fallen ill and died after caring for Ebola victims); hygiene kits; and the installation of water, sanitation and hygiene facilities. Rebuilding communal relationships and restoring the capacity of health services will be among the challenges to contend with once Ebola’s immediate threat to life has been addressed, Father Makimba said.

A rare Ebola strain with no vaccine and no treatment protocol

The World Health Organization first confirmed the outbreak with a declaration of a “public health emergency of international concern” on May 17, a declaration reserved for only the most acute crises and meant as an urgent call to action from the international community. On May 26 the International Rescue Committee warned that the escalating outbreak threatened to become the deadliest Ebola crisis on record if the international community does not quickly step up its response.

The rare Bundibugyo strain of the virus currently circulating in D.R.C. and Uganda has neither a vaccine nor an established treatment regimen, Father Makimba said. According to the latest tally, the outbreak has claimed 49 lives among 330 confirmed cases with more than 240 other deaths suspected to be related to Ebola. The W.H.O. reported on June 2 that it had been able to reduce the number of suspected cases from 904 to 116 after a major round of testing. So far, eight Ebola victims have recovered from the illness.

The Bundibugyo strain is less deadly than the Zaire variant—which claims up to 90 percent of untreated victims—but, according to the W.H.O., its mortality rate is still horrific, ranging between 25 and 50 percent. Survival rates increase significantly though with early detection and intravenous intervention;, both are difficult in D.R.C. given the low capacity of its health care sector.

According to an I.R.C. alert, three warning signs suggest that this outbreak could be particularly difficult to contain: “It is spreading faster than the response; conflict and displacement are accelerating the risk of regional spread; and severe global aid cuts have weakened frontline health systems and outbreak preparedness across eastern DRC.”

“The warning signs are flashing red,” said Bob Kitchen, the vice president of emergencies for the I.R.C. “Eastern DRC is confronting this outbreak more fragile and less prepared than during the 2018-2020 outbreak that killed more than 2,000 people—and with fewer resources to fight it…. The lesson from every previous outbreak is clear: delays cost lives. The risks are growing and the resources are shrinking; that is the brutal arithmetic facing global aid today.”

Much has already gone wrong during this outbreak, beginning with a long delay in recognizing that Ebola had, for the 17th time since it was first identified in 1976, been unleashed in sub-Saharan Africa. The affected communities are for the most part in the hands of rebel forces fighting the D.R.C. government, and the mining communities and outposts where Ebola is taking hold are crowded with migrant workers, displaced people, truck drivers, sex workers and soldiers—people already on the move or ready to move.

And with cholera, typhus and malaria among the region’s common ailments, many victims did not associate their illness with Ebola until the disease had become quite advanced. Health care workers struggling to understand what they were contending with did not make the connection to the Bundibugyo strain, only encountered three times before, until weeks after the virus began spreading through Ituri Province. Many now fear the true current toll of the infected and the dead is well above the numbers so far confirmed or suspected by health officials.

Adding to the inadequate response has been a broad withdrawal of foreign assistance for medical care and civic development in places like the D.R.C. A historic collapse in such assistance began in January 2025 when President Donald Trump returned to Washington and began a wholesale demolition of the U.S. Agency for International Development. With new military spending accelerating in Europe because of Russia’s war on Ukraine and uncertainty about U.S. support for NATO, European powers followed suit, sharply cutting humanitarian spending.

“The abrupt cessation of international humanitarian aid—specifically the closure of certain U.S.A.I.D. services in 2025—has had a significant impact on the capacity to respond to the Ebola crisis,” Father Makimba said. He has seen a significant reduction in the financial, material and logistical resources available to support already fragile health systems.

“In practical terms, this has resulted in disruptions to the supply of essential medical equipment, a decline in prevention and community awareness activities, and a weakening of epidemiological surveillance mechanisms,” he said. “Several local entities also lost indispensable technical support, which slowed down the rapid identification of cases and the implementation of coordinated response measures.”

Local civic and health systems relied entirely on foreign assistance from Europe and the United States. When the aid flow abruptly ended, he said, Caritas Congo and other local humanitarian actors found themselves hard pressed “to partially fill these gaps using limited resources.”

Since the outbreak was confirmed in mid-May, the U.S. State Department began funnelling resources into the region, including more than $162 million in direct assistance and an additional $50 million to create six Ebola-response clinics and support 43 existing facilities. U.S. plans to quarantine U.S. citizens suspected of Ebola infection in Kenya before allowing their return to the United States have provoked protests and court challenges there.

The difficult terrain, dismal road systems and lack of security in the D.R.C. regions hardest hit by Ebola have also hampered the containment effort, according to Father Makimba. The D.R.C.’s Ituri and Kivu regions are already sites of a long-term humanitarian crisis. The D.R.C. has endured decades of conflict and disorder as scores of armed groups continue to battle over control of the mining of rare earth minerals essential in the production of computers, smartphones and other high-tech finished goods sold across the affluent world.

According to the International Rescue Committee, more than 120 armed groups operate across the region affected by Ebola, provoking repeated population dislocations that have been a central accelerator of the current outbreak. Major conflict continues between government forces and the Rwanda-backed M23 militia, despite a peace agreement reached in June last year.

The people of the region face grinding poverty in addition to violence by armed groups. More than 27 million already endure food insecurity in the Democratic Republic of the Congo, according to the I.R.C. The lack of clean water and sanitation that typifies life in the provinces of Ituri and North and South Kivu—especially in the many camps for displaced persons—have also contributed to the ferocity of the outbreak, according to Father Makimba.

Government health workers, he reported, have severely limited capacity to respond. Caritas and other humanitarian groups have been assisting health teams and supporting families affected by the disease and displacement because of conflict. The Catholic Church and local Caritas, along with other faith-based organizations, directly manage more than 40 percent of the health facilities across the D.R.C.

Intervening in such a dangerous environment comes with great risk, Father Makimba acknowledged. “Caritas health care providers and staff members are fully committed to caring for affected communities while strictly ensuring adherence to infection prevention and control measures,” he said. “Balancing the duty to provide care with personal protection relies on several essential elements: the rigorous use of personal protective equipment, continuous staff training, strict adherence to health protocols and constant supervision.”

He added that caregivers can also expect Caritas to provide “psychosocial support” as “they work in a high-pressure, high-risk environment.”

“Despite these challenges,” he said, “their commitment remains driven by a deep sense of solidarity and service toward vulnerable populations.”

On a positive note, he said, the local population is becoming increasingly involved in the emergency response, “particularly through the adoption of preventive behaviors, participation in awareness-raising activities and collaboration with health teams.”

Community engagement and the strengthening of trust remain central elements if success in containing the outbreak will be achieved, he said. That is where the relationship Caritas has established with the community may make its role crucial in mitigating the worst outcomes as the crisis continues.

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