DR Congo

Attacks on Health Care During the 10th Ebola Response in the Democratic Republic of the Congo

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NEW ANALYSIS: During the 10th Ebola Response in the Eastern DRC, over 450 acts of violence or threats against health workers were reported.

This document summaries the known information and discusses the context and contributing factors of such violence that hindered the health response. You can access the data cited in this document on HDX.

Community resentment and resistance to the Ebola effort put health workers at risk.

  • Threats and assault of health workers peaked during the height of the Ebola response. Health workers were sometimes targeted directly, most likely in relation to their work. Some health workers may have been threatened as a result of patron-client expectations. Many health workers reported having been threatened or assaulted by community members. National health staff workers were most at risk -of the 277 health workers who were threatened, only 17 were international staff members.

A complex system of expected kickbacks in relation to recruitment and supplier subcontracting put health workers at risk during the Ebola response.

  • The influx of Ebola responders and associated cash flows allowed for an abuse of power by intermediaries and managers and exposed health workers involved in the Ebola Response to corrupt practices ranging from intimidation to exploitation and revenge.Abuse of power by those in control of recruitment and subcontracting places those of lower socio-economic status at risk of exploitation. Some female health workers experienced sexual violence and abuse during the recruitment or work process.

The safety of health workers was further impacted by insufficient consideration of how to respond to outbreaks of infectious disease in the context of an on-going humanitarian crisis in a protracted conflict.

  • The murder and kidnapping of health workers increased during the Ebola response. However, violent murder and abductions were not uncommon in the area before the disease outbreak.
  • At least 25 health workers have died in violent attacks between August 2018 and June 2020. 13 of the 25 health workers who were killed worked for an international aid agency.
  • At least 27 health workers were abducted by non-state armed groups while travelling to and from intervention sites, at health facilities, or during wider assaults on civilians. Eight of the 27 health workers kidnapped worked for an international aid agency. Approximately half of the 27 abducted were released within 72 hours.