Bunia, Democratic Republic of the Congo—The ongoing Ebola outbreak in the Democratic Republic of the Congo has been exacerbated by traditional funeral practices and delays in medical care, according to recent findings and responses from health organizations. The virus, which has already claimed 458 lives out of 794 confirmed cases in the Nizi health zone of Djugu (Ituri), faces challenges that include direct contact with deceased individuals during rituals and late-stage medical consultations, as highlighted in a study published by the World Health Organization (WHO).
Traditional Funeral Practices Under Scrutiny
A study conducted in August with support from the WHO revealed that direct contact with the bodies of Ebola victims during traditional funerary rites significantly increases transmission risks. In the Nizi health zone, where 458 deaths have been recorded, researchers emphasized the need to adapt local customs to align with public health guidelines. Jacques Malirwa, the WHO’s national risk communication focal point, stated, The goal is not to abandon traditions but to find alternatives compatible with health requirements. Rites can be adapted during the epidemic period.
The study also noted that communities often attribute Ebola symptoms to other illnesses or mystical causes, leading to delayed medical care. Alain Bahati, the study’s lead researcher, explained that many patients initially self-medicate for malaria or seek traditional healers, only arriving at healthcare facilities when the disease is advanced. They arrive when the situation is irreversible,
Bahati said, emphasizing the urgency of community education and safe burial practices.
Tackling Medical Delays and Pediatric Needs
While adults account for most Ebola cases, children under five face a fatality rate exceeding 60%, higher than the 40% observed in adults. Dr. Daniel Youkee, WHO’s Ebola case management team lead, highlighted the unique challenges of treating young patients: Young children have lower physiological reserves and underdeveloped immune systems. They require specialized care, including pediatric-sized equipment and medications.
WHO guidelines stress the importance of monitoring blood glucose, managing fluids, and addressing shock in pediatric cases. Dr. Chaka Keita, a pediatrician with ALIMA, added that emotional stress from isolation worsens outcomes. Care must be comprehensive, including emotional support and caregiver involvement,
he said. Efforts are underway to adapt treatment centers to allow family visits and reduce the psychological burden on children.
Decentralizing Care to Curb Transmission
Médecins Sans Frontières (MSF) has shifted its strategy to decentralize Ebola care, aiming to reduce delays in patient admission. Pierre Boulet-Desbareau, MSF’s mission head in Ituri, explained, The principle is that the Ebola treatment center goes to the patient, not the inverse.
This approach seeks to overcome geographic and security barriers, such as those in Mambasa and Damas, where access remains limited.
MSF also emphasizes community engagement, partnering with local leaders to foster awareness. Communities are the first victims of this epidemic and must play a key role in ending it,
Boulet-Desbareau noted. The organization continues to advocate for safer burial practices and early medical intervention, aligning with WHO recommendations to adapt cultural practices without erasing them.
As the outbreak evolves, the interplay between tradition, healthcare access, and public health measures will remain critical in curbing the spread of Ebola in the region.
Grace Chen — Board-certified physician and medical writer.