The trauma of Ebola never truly leaves those who have lived through it. For Vianney Kambale Kombi, the mere mention of the disease triggers memories of the fear and devastation that gripped his community in Beni, a commercial city in eastern Congo near the borders with Uganda and Rwanda. The 2018-2020 outbreak that ravaged the region was the second-largest in history, claiming more than 2,200 lives across 3,400 confirmed cases before being brought under control through vaccination campaigns. Today, as Congo faces a fresh outbreak caused by the rare Bundibugyo virus, survivors like Kombi are raising alarms about whether authorities and communities have truly learned from those dark years.
The greatest obstacle to controlling the previous outbreak was not the virus itself, but the collective resistance to accepting that the disease was real. Kombi vividly recounts how his community attributed Ebola to witchcraft rather than a biological threat, a belief that discouraged people from seeking treatment and created an environment where the virus could spread unchecked. This denial extended beyond superstition into political territory. Some residents dismissed the outbreak as a Western conspiracy designed to extract funding, while others saw it as a deliberate political tool deployed during election campaigns. These competing narratives paralysed communities at precisely the moment when collective action was needed most, allowing the disease to gain momentum across the region.
The consequences of this mistrust were catastrophic for health workers on the frontline. Dr Babah Mutuza Lusungu, a physician at the "Dieu Est Grand" Medical Centre in Beni, endured the anguish of losing his own uncle alongside two colleagues while simultaneously battling to convince the public that the crisis was genuine. The resistance he encountered was fierce and structural, creating a chasm between the population, government authorities, international health partners, and medical staff. This fractured trust meant that even those trying to save lives faced hostility rather than cooperation, forcing them to spend precious time and resources on persuasion rather than treatment.
Bienfait Wanzire, another survivor from that period, echoes Kombi's observations about the layers of denial that undermined the response. His community similarly interpreted Ebola through a spiritual lens initially, viewing it as a curse or otherworldly affliction rather than an infectious disease requiring medical intervention. The timing of the outbreak during electoral campaigns only deepened the politicisation, with residents convinced that leaders were manufacturing or exaggerating the crisis for political advantage. This toxic combination of spiritual scepticism and political distrust created an information vacuum that local myths and conspiracy theories rushed to fill.
The stigma that followed survivors even as vaccines offered them salvation presented another dimension of the social crisis. Esperance Masinda, who contracted Ebola while caring for her husband—a medical doctor—during the outbreak, experienced the cruelty of communities turning against those who had been saved. Despite recovering through vaccination, both she and her husband faced social ostracism. Neighbours and family members told them they would not survive five years, implying that the vaccine itself was poisonous. The irony was bitter: the very tool that rescued them from death became, in the eyes of their community, a harbinger of doom. This stigmatisation discouraged people from seeking vaccination and treatment, perpetuating cycles of transmission.
Masinda's work with the United Nations children's agency during the outbreak exposed her to another tragedy—the psychological and social devastation inflicted on orphaned children. Caring for youngsters who had lost parents to Ebola compounded the emotional weight of the crisis, revealing how the outbreak extended its damage across generations. These experiences underscored that controlling an epidemic requires more than medical supplies and personnel; it demands the restoration of trust and the healing of fractured social bonds.
As Congo now contends with 550 confirmed cases of the Bundibugyo Ebola variant as of early June, with 101 deaths recorded thus far, the lessons from 2018-2020 take on urgent relevance. The current outbreak differs in a critical respect: unlike the previous one, which was eventually controlled with proven vaccines, the latest variant has no approved vaccine yet available. This absence leaves authorities and communities without one of the most powerful tools that helped end the earlier outbreak, making the role of public trust and community cooperation even more vital.
Dr Lusungu has become an advocate for preventative engagement with local leaders, particularly youth figures who can amplify messaging within their networks. He argues that waiting until cases multiply dramatically before launching public health campaigns inevitably results in missed opportunities for early intervention. By the time communities accept an outbreak's reality, the disease has often established itself too deeply to contain effectively. This insight challenges health authorities to begin education and trust-building efforts proactively, before panic sets in.
The geographic and political context of Beni compounds these challenges. As a bustling commercial hub, the city facilitates rapid movement of people and goods, accelerating potential disease transmission. The proximity to international borders means outbreaks can easily spill into neighbouring Uganda and Rwanda, transforming local crises into regional emergencies. The lingering memory of the 2018-2020 outbreak—and the mistakes that allowed it to flourish—serves as both warning and potential asset. Communities that lived through that catastrophe understand viscerally what is at stake, yet many retain the same scepticism and mistrust that hindered the previous response.
The path forward requires acknowledging hard truths that survivors have learned through suffering. Combating Ebola is not merely a medical challenge but a social one. Health workers must be protected from violence and given the resources to engage communities respectfully rather than imposing top-down mandates. Religious and traditional leaders need to be integrated into public health messaging rather than positioned as opponents. Political leaders must resist weaponising the outbreak for partisan advantage. Most critically, survivors themselves represent invaluable resources—living proof that Ebola can be survived, that recovery is possible, and that those who survive retain their humanity and dignity.
The current outbreak has already demonstrated some of these lessons taking root. Masinda reports that the stigma surrounding her and other survivors has substantially diminished, suggesting that community attitudes have evolved since 2018. Yet the absence of an approved vaccine for the Bundibugyo variant introduces new variables and uncertainties. The hard-won wisdom from the previous outbreak—about the importance of community acceptance, transparent communication, and protection of healthcare workers—becomes even more precious as authorities navigate these uncharted waters.
For Congo and the wider Central African region, the stakes of this moment extend beyond immediate disease control. How authorities and communities respond to the current outbreak will either validate the lessons learned from the devastating 2018-2020 crisis or risk repeating them with potentially tragic consequences. The survivors speaking out today carry moral authority born from their suffering and recovery. Whether their warnings are heeded, and whether the hard-won insights of the past are applied with urgency and sincerity, will determine whether progress has truly been made.
