As the Democratic Republic of Congo (DRC) grapples with one of the most severe Ebola outbreaks in its history, a concerning trend is emerging: pregnant women are increasingly shunning hospitals. This retreat from healthcare facilities not only heightens the risk of maternal mortality but also exacerbates an already critical public health situation.
Fear and Misinformation Drive Women Away from Care
Health professionals report that anxiety surrounding the Ebola virus is discouraging expectant mothers from seeking essential medical services. In the Ituri province, the epicentre of the outbreak, the United Nations Population Fund (UNFPA) has noted a troubling uptick in maternal deaths, which are believed to be closely linked to the outbreak. According to Noemi Dalmonte, UNFPA’s deputy representative in the DRC, “In three cases, we are certain. Either the woman was scared to go to the health facility because of Ebola, or she had symptoms consistent with Ebola.”
Although confirmed maternal fatalities remain relatively low—with seven reported this week compared to two during the same period last year—the potential for a significant rise in preventable deaths looms large. The ongoing outbreak has seen confirmed Ebola cases soar to at least 894, with over 200 fatalities across the DRC and neighbouring Uganda since its declaration just over a month ago.
The Scope of the Outbreak
The current crisis is driven by the Bundibugyo virus, a rare strain without approved vaccines or treatments. While the DRC has experienced multiple outbreaks in the past, primarily caused by the more common Zaire virus, this latest episode presents unique challenges. The outbreak is predominantly situated in Ituri, which accounts for over 90 per cent of reported cases, with further spread noted in North Kivu and South Kivu provinces, and across the border into Uganda, where 19 cases have been confirmed and two deaths recorded.
In the provincial capital of Bunia, prenatal consultations at local clinics have plummeted dramatically. Dr Sonny Mwembo, a medical director, reported that attendance has dwindled from around 60 pregnant women per month to a mere 10. Many women are opting for home births or requesting that healthcare workers visit them instead, driven by fears of contracting the virus in medical facilities.
Aid Shortfalls and Health Infrastructure Challenges
The DRC’s healthcare system is strained under the weight of this outbreak, a situation worsened by historical reliance on international aid. The withdrawal of US funding for disease surveillance, coupled with significant budget cuts, has severely hampered Ebola contact tracing efforts, which currently sit at just 43 per cent coverage—well below the 79 per cent needed for effective control as seen in previous outbreaks.
Jean Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC), has warned that unless critical weaknesses in response efforts are addressed swiftly, the outbreak could become the most devastating in history. “We are still far from controlling the situation of this outbreak,” Dr Kaseya cautioned, highlighting the need for rapid mobilisation of resources.
Despite pledges of $910 million in global support, less than $90 million has been made available so far. Dr Wessam Mankoula from the Africa CDC emphasised the urgency of converting these commitments into tangible aid, stating, “We’ll keep following up with different member states and different partners about their commitment to turn those pledges into actual money.”
Misinformation and Trust Erosion
Misinformation about the disease is rampant, with some community members mistakenly attributing the outbreak to the activities of international NGOs. This has further eroded trust in healthcare providers, making it even more challenging for midwives and nurses to offer necessary care. Esther Ileli, who supports UNFPA midwives in Bunia, expressed concern about the lack of Ebola-specific protective equipment, which hampers their ability to function safely.
“The situation is incredibly stressful, with a heavy workload,” Ileli said. “We have to balance helping with births while also preventing the spread of Ebola.” Misinformation continues to fuel fear, preventing women from accessing vital medical assistance. In response, UNFPA has initiated outreach efforts in collaboration with local women’s organisations to disseminate accurate information about both reproductive health and Ebola.
Why it Matters
The ongoing Ebola outbreak in the Democratic Republic of Congo is not merely a health crisis; it represents a looming humanitarian disaster that could have far-reaching implications for maternal health and child survival. The intersection of fear, misinformation, and weakened health infrastructure poses a significant threat to vulnerable populations. As pregnant women increasingly avoid healthcare, the potential for a surge in maternal deaths becomes alarmingly real. The global community must respond with urgency and support to ensure that essential health services remain accessible, especially during such critical times.