Responding to Ebola in Congo is hard work, but made that much harder by violence

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• Judy Woodruff:

  Now, we turn to the Democratic Republic of Congo in Central Africa.

  The country has been racked by decades of instability. And since this summer, eastern parts of the country have been racked also by the second worst outbreak of the Ebola virus in history, more than 500 cases reported to date and over 300 deaths thus far.

  As Nick Schifrin reports, managing this crisis is proving more challenging than any previous outbreak, because it's not just a public health challenge. It is spreading in a war zone. And a warning: Images and accounts in this story may be upsetting to watch.

• Nick Schifrin:

  In Northeastern Democratic Republic of the Congo, the dead are left on dirt roads and at the grassy edges of remote villages.

  Families are targeted, and homes are burned in a conflict that started before many victims were born.

• Kavira Marie:

  They arrived in the village and immediately started shooting, looting the shop and setting fire to the shop. They asked me and my aunt to come out from under the bed, and if we refused, they would burn us alive.

• Nick Schifrin:

  For a quarter-century, this region's residents have fled from armed extremist groups and local militias. They attack the military and anyone they accuse of collaborating with the government, and have left villagers in coffins, killed by brutal violence.

  And now villagers are being killed by brutal disease. Ebola causes high fevers and fatal bleeding, and spreads through the exchange of bodily fluids of the sick or already dead. And in this outbreak, the main problem is instability, says community leader Jamali Musa.

• Jamali Musa:

  Insecurity will scare away the doctors helping to fight against Ebola. If they leave, then the virus will spread and it will kill even more people. It's a real danger.

• Nick Schifrin:

  Already, the violence intermittently forced authorities to suspend their efforts, and pushed the U.S. Centers for Disease Control out of the region completely.

  That has helped allow the disease to spread to a major city, where mass vaccination is impossible. Young children are particularly vulnerable, says UNICEF regional director Marie-Pierre Poirier.

• Marie-Pierre Poirier:

  Over 30 percent of affected people by the Ebola crisis are children, and this number is not decreasing. Fatality rates are also much higher for children than for adults.

• Nick Schifrin:

  But doctors have managed to reduce fatality numbers where they can provide vaccines. More than 40,000 have received shots. Many others are on experimental drugs that doctors consider effective.

  In remote villages that historically resist outside help, international groups educate families to recognize Ebola, and prevent it, says Save the Children's Paul Lopodo.

• Paul Lopodo:

  Ebola in the eastern part of the Congo has been one of the issues that the population has not understood properly. Through communication and sensitization, the masses have really understood about Ebola.

  It was really incredible to see a child showing us how to do properly washing in this area. Even the number of cases have been reduced.

• Nick Schifrin:

  That good news helps convince families Ebola isn't necessarily a death sentence.

  Kasereka Mulanda talks to his wife, who's infected, through plastic.

• Kasereka Mulanda:

  When we look into each other's eyes through the cubicle and smiling, she asks how the family is and how the children are. I reply that they're all good and that the children are waiting for her. I feel that we are together again, and she is confident that she will return home very soon.

• Nick Schifrin:

  The smallest patient just did return home. Benedicte began treatment at 6 days old after her mother died. But doctors say she is now fully recovered. They call her — quote — "the young miracle."

  But, for the vast majority here, that optimism is tempered. The World Health Organization warns this outbreak won't be contained for at least six months, and that it will get worse before it gets better.

  And for more on this Ebola crisis, we turn to Nancy Aossey, the chief executive officer of the International Medical Corps. They have over 200 people on the ground there responding to the Ebola outbreak.

  Thank you very much for coming on the "NewsHour," Nancy Aossey.

  Give us some perspective. How bad is this outbreak?

• Nancy Aossey:

  Well, it's bad because there's a tremendous amount of violence in the Eastern Congo.

  And, as a result of that, we're not able to do all the things that we need to do to contain the outbreak. For instance, when you have a lot of violence, you have a lot of people that are displaced from their homes and who lose track of, you know, people in their family.

  And also, when people are on the move, it is hard to reach them with education efforts. It's harder to do contact tracing. That is, if somebody does present with Ebola symptoms, we want to go back and find all the people that they came into contact with.

  It's very difficult to do that when the — because of the violence and because of the instability that has been there for a long time.

• Nick Schifrin:

  Because of the violence, because of the instability, but also, it seems, because of the distrust that a lot of these people have.

• Nancy Aossey:

  Yes.

• Nick Schifrin:

  Is that right?

• Nancy Aossey:

  That's correct.

  And we often see that with such outbreaks. There's a lot of education that has to be done in the community, so that they understand what is needed to overcome the outbreak, and so that they trust health care workers, who just want to help them.

• Nick Schifrin:

  On the flip side, you have — it seems like there has been some bits of good news here, quite a few number of people vaccinated and also new medicine being deployed that we haven't seen before.

• Nancy Aossey:

  Yes.

  And we have seen the results so far of that are very positive. And so we remain optimistic that those efforts will continue and that they will be very fruitful in the future. But, at the end of the day, it still comes down to being able to find those individuals who have the symptoms and to treat those individuals.

  So what's happening, what's alarming right now is that we have new cases that are popping up that are happening outside of Ebola treatment units. And, as a result, we don't know where they're coming from, and we don't know what contacts that person has had with other people.

  That's the concern in an area where there's so much instability.

• Nick Schifrin:

  And is there not only concern outside the treatment units, but is there also now concern outside the country? Is there any fear of this crisis spreading beyond the eastern part of the Democratic Republic of Congo?

• Nancy Aossey:

  Well, certainly, any time you have an Ebola outbreak, you're always worried about it getting into dense cities or urban areas of that particular country, and certainly very concerned about it crossing over into borders.

• Nick Schifrin:

  And very quickly, in the time we have left, we have heard the U.N. basically say that this is going to be an outbreak for at least another six months, that possibly it could get worse before it could get better.

  Is that your fear?

• Nancy Aossey:

  It's definitely our fear.

  We think that — unfortunately, we think that it will get worse. And it won't be for lack of trying. We're working with all of our partners who are at the table trying to do their part. But what we don't have in the Eastern Congo is a political solution.

  There are between 40 and 100 rebel groups operating in the Eastern Congo. And we are doing our best to support the Ministry of Health. But, because of the fighting, we have a tremendous concern and fear that things will get worse.

• Nick Schifrin:

  Nancy Aossey with the International Medical Corps, thank you very much.

• Nancy Aossey:

  Thank you.