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Over 1,000 people have died in an Ebola outbreak in the Democratic Republic of Congo (DRC), one of the deadliest outbreaks of the disease in history.
With efforts to bring it under control hampered by civil war and mistrust, health minister Oly Ilunga said 1,008 lives have been claimed by the virus.
While the crisis is a long way off the 2014-2016 outbreak in West Africa’s Guinea, Sierra Leone and Liberia, which killed more than 11,000, people experts warn its true extent in DRC is not clear.
“There might be double this many cases in reality that we’re just not aware of,” Tariq Riebl, emergency response director for the Ebola response crisis with the International Rescue Committee.
Despite the risk of spread across the highly porous borders with Uganda and Rwanda or further afield, in April the World Health Organisation (WHO) again opted not to declare a global health emergency.
Life after Ebola: a community rebuilds in Sierra LeoneShow all 27 1 /27Life after Ebola: a community rebuilds in Sierra Leone Life after Ebola: a community rebuilds in Sierra Leone Haja Bobor, 31 ‘During Ebola, they quarantined areas. My husband was at Kailahun and couldn’t cross the boundary, so we were separated. They taught us how to wash our hands and we were all washing our hands every day; even my children were washing their hands.’ Haja is the mother of three surviving children, two of her children died from diarrhoea
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Life after Ebola: a community rebuilds in Sierra Leone Aruna Bockarie, 24 ‘This is the finished toilet that we have built in our compound, I am very happy to have my own toilet and I will be proud to use it’
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Life after Ebola: a community rebuilds in Sierra Leone Aruna Bockarie, 24 ‘All the parents came together and built a school in the village, we have just opened the school. The children are at assembly with no uniforms. I am the teacher at the school so I took this photo to show how we have been working hard for our children to be educated’
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Life after Ebola: a community rebuilds in Sierra Leone Haja Bobor, 31 ‘Here is my son, Sessay (left), with his friends. I was happy to snap them. I have given birth to six children, but only three are still alive. The first one I lost was three years ago, and the second was two years ago. Four months ago I lost Senior Lahai. He was six months old and was affected by a runny stomach and a rising body temperature’
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Life after Ebola: a community rebuilds in Sierra Leone Haja Bobor, 31 ‘Four months ago I lost Senior Lahai. He was six months old and was affected by a runny stomach and a rising body temperature. He was really, really sick, he wasn't even taking breast milk, and he died. My heart was broken. My baby used to be strong. He was able to sit by himself and was just starting to practise to crawl and reach for things. He laughed a lot when I played with him, I’d clap and dance. I have a happy moment when he started sitting by himself and learning to crawl. Those are the happy moments that makes a mother most happy. The moment I remember most about Lahai was when he was breastfeeding and was playing with my neck and chin with his hand. I look to the future and hope that such things won't happen again, and that God will give me children that stay with me’
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Life after Ebola: a community rebuilds in Sierra Leone Aruna Bockarie, 24 ‘My step brother Ibrahim is building our toilet with loamy soil because we don’t have cement. WaterAid taught us about good sanitation and I want to show that we are now building our own toilets so that we will not go to the bush or use the stream as a toilet that is why I took this photo’
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Life after Ebola: a community rebuilds in Sierra Leone Aruna, 33 Washing in the stream: ‘When we came here the water system was very bad. I know that when I drink dirty water I get sick. We are getting diarrhoea because we are drinking that type of water. If I am sick I am not able to earn money because I am not able to go to work, and I have to stay at home, which is very difficult for me’
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Life after Ebola: a community rebuilds in Sierra Leone Tailu Yajah ‘These are the contractors that came to build the water well, and they are mixing the stones and the cement to build the cover of the well’
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Life after Ebola: a community rebuilds in Sierra Leone Tailu Yajah ‘I started tree climbing when I was living with my grandmother and she was trying to get some palm kernels and process them to make the oil that we use. I didn’t like doing the processing part so I decided to climb the trees to do the harvest instead. Tree climbing is very difficult. At times you can be confronted by a snake, as you are going up you just see one and it will hiss at you. If you are not strong you are going to fall out of the tree, and could die! I am just doing it for necessity sake. I don’t want to do this job really, but at the moment I have no other means of making money, so I have no choice but to do this to manage my family’
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Life after Ebola: a community rebuilds in Sierra Leone Haja Bobor, 31 ‘They killed my uncle during the war. I was not in this village during the war; I was in Guinea. Just after the war, my mother asked me to come back home. There were no houses when I returned; it had all been destroyed’
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Life after Ebola: a community rebuilds in Sierra Leone Tailu Yajah ‘This is my son Bockarie. He reminds me of his mother, who is not presently here with me, and he resembles me. Recently my son was very sick and we had to take him to the clinic to get treatment. Even getting to the clinic costs money. I didn't have any money, so I had to borrow money from the community people so I could take him to the hospital. Having very good drinking water would ease the issues with having to take people to the hospital because of illness, and the problem of finding the money to manage that’
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Life after Ebola: a community rebuilds in Sierra Leone Tailu Yujah ‘Sidique is 21 years old, he is my daughter’s husband and is drinking from the stream we use to fetch water. Our forefathers created this village, and the water was good. They covered it with a concrete box to keep it safe, but all of that fell down during the war, and afterwards no one could repair it. The water is not good here now and I have worms as a result. It will be very good to have clean water; it would give us a long life. If you have good drinking water, then your life is safe, but if you don’t then your life is not secure. Having good drinking water would ease the issues with having to take people to the hospital because of illness, and the problem of finding the money to manage that’
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Life after Ebola: a community rebuilds in Sierra Leone Matu, 40 ‘We the women of this village are experiencing the problems with lack of water and we pray that things will change. The rain washes everything, including faeces into the water. The children get diarrhoea from the water. With clean water, I would be clean and would not suffer from sickness’
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Life after Ebola: a community rebuilds in Sierra Leone Matu, 40 ‘This is my brother’s wife, she is holding both her daughter and my granddaughter’
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Life after Ebola: a community rebuilds in Sierra Leone Matu, 40 Matu is the life and soul of the village of Tombohuaun. She is a traditional birth attendant and plays an important role within the women’s society. Matu suffers from poor health; she has stomach problems caused by the dirty water
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘My name is Amadou Kokoyeh, but I am more familiar with Kokoyeh [Bush Chicken]. The name Kokoyeh was given to me by father’s older brother. It’s meant to be a bird that is in the bush and mostly eats other people’s groundnuts when they plant them.”
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘This is my father helping to dig the water well, so that we will have clean water to drink. I am happy because we are going to have a well in my village. I don’t think the water we currently collect from the muddy spring is good for drinking because it is exposed, and leaves and other things fall in it. I also get water down there with my mum, and sometimes I go with the other kids. Sometimes when I drink it, I have a stomach pain, and it also brings me headache. I have got sick from that, and I was taken to the health centre’
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘This is my family – my mother, father and younger brother. When I’m not with them this picture will make me feel closer to them’
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘Moserie Yajah was lying down in the grass, and asked me to get a shot of him. At the moment, every day people ask me to get a photo of them. I feel very happy when people ask for a picture. What I love most to get a shot of is people that are well dressed, sitting in a chair or in a very comfortable area that I can snap’
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘We were going down to Matu’s place, and my friends and brother decided to cover themselves with that fishing net, and asked me to take a shot of them. The fishing net was taken from Ginnah’s mother (Massah) and I think the picture is really good. I like the photo mainly because they are standing close to the wash yard, where people go to heat their water and wash. I love it because they are all my brothers, and we look out for each other’
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘I love this picture. I took this photo of Bockarie when he was drinking water. The water was collected from the muddy spring where everyone collects water. I don’t think it is good for drinking because it is exposed, and leaves and other things fall in it. I also get water down there with my mum, and sometimes I go with the other kids. Sometimes when I drink it, I have a stomach pain, and it also brings me headache. I have got sick from that, and I was taken to the health centre. If it rains, we harvest rainwater’
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Life after Ebola: a community rebuilds in Sierra Leone Amadou Kokoyeh (Bush Chicken), 8 ‘This is my cousin Papay; we are very close – he lives nearby and we spend lots of time together. In this picture he is messing around. On his head is what our fathers make to catch fish in small streams. We then eat some fish and they sell the rest. It is important for our survival’
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Life after Ebola: a community rebuilds in Sierra Leone Kempah Ginnah, 42 ‘The community people helping to build the water well, I was glad about this, that is why I took this photo.’ Kempah is a youth leader and mechanic from Tombohuaun
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Life after Ebola: a community rebuilds in Sierra Leone Kempah Ginnah, 42 ‘These children are our next of kin, my children and their friends. They are wonderful children’
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Life after Ebola: a community rebuilds in Sierra Leone Jeneba, 13 ‘Here, my father, brothers and aunt are separating cocoa fruit from pods. By selling cocoa, my family earns enough to pay my school fees’
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Life after Ebola: a community rebuilds in Sierra Leone Haja Bobor, 31 ‘We have now built a small school in our village. This is inside the class for my children’s first day in school. I took this picture to show them in the future so they will know that I want them to be educated and also free from diseases’
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Life after Ebola: a community rebuilds in Sierra Leone Haja Bobor, 31 ‘This is my Aunt Mamie Ansumana. She is 40 and is a farmer. She loves going to the farm and likes to smile. She looked after me when my children died. The dirty water caused the death of two of my children; I don’t want anything to happen to the others. She took me from the room where Senior Lahai died to her own room. I slept in her room for some time. I want to thank to her because she is still taking care of us’
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Ebola treatment centres have come under repeated attack and many international aid agencies have pulled staff out of hotspots, like the towns of Katwa and Butembo, leaving government health workers struggling to cope.
Last month a Cameroonian epidemiologist working with the WHO was killed during an assault on a hospital in Butembo.
Insecurity has become a “major impediment” to controlling the Ebola outbreak, Michael Ryan, WHO’s health emergencies chief, told reporters in Geneva on Friday.
He said 119 attacks have been recorded since January, 42 of them directed at health facilities, while 85 health workers have been wounded or killed.
Dozens of rebel groups operate in the region, and political rivalries in part drive’s community rejection of health personnel.
“Every time we have managed to regain control over the virus and contain its spread, we have suffered major, major security events,” Mr Ryan said.
He added they were “anticipating a scenario of continued intense transmission” of the disease.
Support free-thinking journalism and attend Independent events WHO has said the most recent Ebola outbreak remained contained to eastern Congo even as the number of cases rises in a dense, highly mobile population near the border.
Many people fear going to Ebola treatment centres, choosing instead to stay at home and risk transmitting the disease from the virus to family and neighbours.
Residents of highly volatile Butembo believe Ebola was brought to the city on purpose, said Vianney Musavuli, 24, adding: “I am deeply saddened to learn that the number of Ebola deaths has exceeded 1,000.
“The problem is that people here in this area [people] believe Ebola is a political thing, and that’s why residents are still attacking the teams in retaliation.”
Insecurity also has prevented vaccination teams from getting to some areas, further limiting the health response.
However, more than 109,000 people have received an experimental but effective Ebola vaccine.
Mr Ryan said authorities are looking at introducing another one. He called for more help from Congo and elsewhere to close an “urgent, critical gap” of some $54m in containment funding.
Additional reporting by AP
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