In a key region, near two international borders, where over 8 million people live, the ebola virus is spreading.
And it might be uncontainable, according to world health officials.
The outbreak is happening in North Kivu province in the eastern region of the Democratic Republic of Congo.
And although health workers and aid organizations have learned how to quickly contain and treat the virus, there’s a new obstacle this time.
This is the first outbreak to happen in an active war zone.
[Donnelly]: I think you have to look at the ebola crisis as, in many ways, as a symptom
of the decline of social services in Congo which, in turn, are a symptom of recurrent pervasive conflict.
[Host]: Violence in the Democratic Republic of Congo, also known as the DRC, can clearly be traced back to colonial rule.
But the instability we see in the eastern region of the country today can be linked back to events in neighboring Rwanda in the 1990s.
Some experts point to the the 1994 Rwandan genocide as the starting point of the conflict in the DRC. Here’s why.
That genocide was perpetrated by ethnic Hutu groups.
They carried out mass killings of ethnic Tutsis, and those who supported them, in the small Central African nation.
Within around 100 days, the violence had killed roughly 800,000 people.
The targeting of Tutsis resulted in the uprising of Tutsi-militant groups in Rwanda, most notably, the RPF or Rwandan Patriotic Front.
That group overthrew Rwanda’s Hutu government in 1994.
An estimated 2 million refugees, the majority of them Hutu, flooded over the Democratic Republics of the Congo’s eastern border,
which was then known as Zaire.
Refugee camps in the East of the country ran rampant with militant groups.
According to the non-profit Enough Project, which works to end genocide and crimes against humanity,
Hutu militias in exile essentially used the camps as de facto army bases.
Eventually, local Congolese Tutsis forced the Rwandans out of the Congo.
That led to the First Congo War.
Rwandan and Ugandan armed forces invaded the DRC, backing the revolutionary fighter Laurent-Désiré Kabila.
By September 1997, the country was renamed the Democratic Republic of Congo, and Kabila took control, becoming the country's first president.
Despite this shift in power, the eastern part of the country continued to face violent instability.
Just one year later, the Second Congo war broke out.
This time, Kabila turned on his former allies, Rwanda and Uganda, and allowed the Hutu militants to operate in the East.
Both countries launched an invasion into the DRC, sparking a regional war whose impacts can still be felt today.
Although there is no official death toll, some estimate that at least 6 million people have been killed as a result of conflict in the DRC since 1998.
That would make it the deadliest war in the world since World War II, according to the International Rescue Committee.
[Donnelly]: Conflict in Eastern Congo is really a patchwork quilt.
There are, at best guess, dozens of different groups in constantly shifting alliances motivated by a range of grievances, aspirations, incentives,
and that in itself is one of the biggest challenges in conceiving and implementing a peace process in Eastern Congo.
[Host]: All of this, has created what the World Health Organization calls a 'perfect storm' for an ebola crisis in the country.
Ebola is an infectious disease that affects the way blood clots.
It can be fatal if contracted, which typically occurs through direct contact of bodily fluids.
The virus gained significant international media attention after it swept through urban population centers in West Africa starting in 2014.
From 2014 to 2016, over 11,000 people died from the virus, according to the Center for Disease Control.
Despite the attention the 2014 outbreak received, the DRC has been battling ebola for a long time.
The first strain of the virus was originally discovered in 1976 in a river in the north of the country, called the Ebola River.
[Donnelly]: Congo over the years has experienced many outbreaks of ebola.
The government, National Ministry of Health, the World Health Organization, international NGOs have a pretty good response mechanism
for controlling outbreaks of ebola which tend to happen in isolated remote locations.
[Host]: In fact, there have been at least 10 ebola outbreaks in the DRC since the virus was discovered, according to the CDC.
But this time the outbreak is happening in an active war zone, which complicates things.
According to the DRC health ministry, teams that have been responding to the outbreak have been attacked 3 to 4 times a week on average.
That has made it nearly impossible to follow normal protocol that’s been used during other outbreaks.
Measures that include vaccinating at-risk populations.
Following the 2014 outbreak in West Africa, an ebola vaccine was created with an up to 100% protection rate.
That vaccine has been instrumental in ending recent outbreaks, including ones in the DRC earlier in 2018.
[Donnelly]: It's an essential tool in the ongoing fight against ebola in Eastern Congo, but made all the more difficult because of the conflict on the ground,
the very difficult and dangerous operating environments for the IRC staff on the ground and for other humanitarians.
[Host]: More than 26,000 have been vaccinated in North Kivu, but that number is far from enough eradicate the disease.
The outbreak has already claimed the lives hundreds of people and infected many more.
And it’s likely to get much worse, especially for women and children.
[Donnelly]: Women and children are always most affected in any kind of humanitarian crisis.
We see, for example, schools closing when we see economic impact on communities, we've seen markets shut down when we see increases in displacement.
Women and children are always those who bear the heaviest burden from those kinds of secondary impacts a in a crisis like ebola.
[Host]: And North Kivu shares a porous border with Uganda and Rwanda.
According to government estimates, nearly 20,000 people cross the border between the DRC & Uganda every week,
making the risk of cross-border transmission more likely.
Although no cases have been reported in Uganda this year, according to the government, the country has begun vaccinating some health workers as a precaution.
In case this outbreak seeps across the borders, creating a regional risk of transmission.
Aid groups, like the IRC, are clear on what steps need to be taken to get this outbreak under control and save lives.
But with a looming presidential election approaching this December, the country appears to be on a path of more, not less, political instability in the coming months,
something that won’t help, at least in the short term, solve this ebola outbreak in North Kivu.
This current ebola crisis in the DRC is unprecedented.
How do you think governments or international organizations could respond differently?
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