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Ebola's Inferno: The Limits of Community Engagement and
Neutrality During Politicized Health Emergencies
Melanie Sauter
Humanity: An International Journal of Human Rights,
Humanitarianism, and Development, Volume 14, Number 3, Winter
2023, pp. 471-485 (Article)
Published by University of Pennsylvania Press
DOI:
For additional information about this article
https://doi.org/10.1353/hum.2023.a924874
https://muse.jhu.edu/article/924874
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Melanie Sauter
Ebola’s Inferno: The Limits of Community Engagement
and Neutrality During Politicized Health Emergencies
Commingled are they with that caiti choir Of Angels, who have
not rebellious been, Nor faithful were to God, but were for self.
The heavens expelled them, not to be less fair; Nor them theneth-
ermore abyssreceives, For glory none the damned would have
from them.
— Dante, The Divine Comedy
Introduction
On February, , eight months into the tenth Ebola outbreak in the Demo cratic
Republic of Congo (DRC), youths burned down a health center in Katwa town. A local
community chief testied:
When I was approaching the health centre I saw a crowd of young boys and girls aged
about to years coming to attack the centre. I quickly rushed to alert those who
were inside and went out again. en they started beating me, but thank God I was
able to escape. I was treated in the hospital and as you can see I’m still limping.
e attackers were later identied as angry family members of a diseased Ebola
patient. Two weeks later, again in Katwa, another Ebola Treatment Center ( ETC) was
attacked. Assailants partially burned down the fa cil i ty after throwing rocks at it, forcing
all patients and sta to ee. Following the attack, Médecins Sans Frontières (MSF), who
run the ETC, suspended all activities in the area.
e outbreak that began in August was the rst to take place in a conict zone.
According to Insecurity Insight, throughout the outbreak, incidents of vio lence
against health care damaged forty- eight health facilities, and resulted in twenty- ve killed,
twenty- three kidnapped, and injured health workers. e majority of the violent inci-
dents, out of , took place in , making it the most violent year for healthcare
workers in the DRC. e outbreak mainly aected three provinces in the eastern part of
the country— North Kivu, South Kivu, and Ituri— which have long been opposition areas
suering from serious human rights violations and vio lence. Despite more than one hun-
dred armed groups operating in the Kivus, the government was responsible for over
percent of violent incidents against civilians, which eroded trust in the state. Surpris-
ingly, many attacks against Ebola responders were perpetrated by civilians and not by
organized armed groups. is real ity challenges us to consider why communities were
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attacking those trying to help them ght a deadly disease and to examine the measures
taken to prevent this vio lence.
During the Ebola outbreak, this widespread vio lence contributed to a “narrative of
distrust” toward the Ebola response. Media outlets (such as e Economist and Al Jazeera)
and Ebola responders argued that the responders failed to involve local communities in
planning and implementing protective measures, which resulted in a loss of trust and ulti-
mately led to vio lence.
e argument was supported by prior research conducted by MSF on the West Afri-
can Ebola outbreak in /. In Guinea, for example, rumors spread that Ebola was
planted by the government to suppress the people. Several attacks against Ebola respond-
ers were linked to distrust toward the response or the central government. In e Politics
of Fear: Médecins sans Frontières and the West African Ebola Epidemic, MSF researchers
conclude that “In the international press, the tragic events were often presented as an
example of villa gers’ ignorance and recalcitrance rather than an incursion rooted in long-
term mistrust.”
MSF’s work invites us to think further about the narrative of distrust that circulated
in the international press and to question whether distrust was the main driver of vio lence
against Ebola responders in the DRC. Figure pre sents the weekly trend in attacks
against healthcare since January until the end of the Ebola outbreak in March.
e gure illustrates that during the rst months of the outbreak, the number of violent
incidents did not increase. en, early saw a sudden surge in cases. is trend is odd:
if the narrative of distrust were true, there should have been a gradual increase parallel to
the spread of the virus and the number of Ebola responders deployed.
Research on popular resistance during healthcare emergencies suggests that healthcare
measures that disproportionately aect the poor can lead to resentment within the popu-
lation. e cholera outbreak in Europe during the s oers an example: riots erupted
across the continent, leading to violent mobs burning health centers and attacking medi-
cal personnel. e case suggest that healthcare measures can have wider societal implica-
tions and potentially agitate the broader population.
20
10
0
January 2018
Number of incidents
August 2018
(outbreak start)
March 2020
(end of outbreak)
Graph detailing the rise of the Ebola outbreak from January2018 to March2020.
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is essay disentangles the events around the tenth Ebola outbreak in the DRC. It
outlines how the narrative of distrust developed, and how Ebola responders reacted to the
dynamics on the ground. My main argument is that Ebola responders misjudged the situ-
ation on the ground by exclusively focusing on the distrust narrative. Vari ous NGOs pub-
licly criticized the response for lack of community engagement. Several NGOs warned
that more community engagement was needed, and the international response became
xated on measuring community engagement indicators, which resulted in an inade-
quate counter- narrative. Instead, they should have focused on how the government was
politicizing Ebola. e spike in attacks occurred just after two regions of the Kivus were
excluded from voting in the presidential elections due to concerns about the virus.
In order to analyze the events that occurred during the Ebola response, I utilized three
types of public sources. First, WHO’s weekly Situation Reports (SITREPs) and key indica-
tor surveys, which provided detailed information about the epidemiological developments,
response updates, sociopo liti cal events, and activities of partner organizations. Second, I
utilized data from the Social Science in Humanitarian Action Proj ect (SSHAP), which
compiled information from rapid eld surveys regarding the perceptions of local commu-
nities toward Ebola responders. ird, SSHAP monitored local (social) media such as pub-
lic WhatsApp groups, leaets, and statements by local or national politicians and civil
society organizations. Additionally, I cross- referenced some of the information with less
systematic resources such as local newspaper articles, practitioner accounts from the eld,
and less frequent SITREPs from other organizations involved in the response.
In the rst part of this essay, I analyze how the narrative of distrust developed among
Ebola responders and why it became the main explanation for the widespread vio lence
against Ebola responders. e second part shows how the narrative of distrust overlooks
what I consider an impor tant driver of the vio lence— namely, political exclusion. I argue
that the sudden increase in vio lence toward Ebola responders at the beginning of was
the result of voter exclusion in three opposition regions from the presidential elections.
e third part shows that the Ebola response teams were not prepared to face this vio lence
and popular resentment as they had not anticipated that the presidential elections would
aect local population’s trust in them.
The Narrative of Distrust
In May, Oxfam released a report entitled “How to Build Community Trust to Fight
Ebola.” In a previous report, Oxfam noted that community members were obstructing the
response eorts by blocking roads, throwing stones, and damaging community centers,
“delaying all aspects of the response safe burials, contact tracing— and reducing its eective-
ness.” Other humanitarian organizations adopted this narrative of distrust, and national
and international news outlets amplied it. For instance, an AP News article from
July bore the title “Ebola Vaccine Hampered by Deep Distrust in Eastern Congo.” It
argued that the lack of community engagement contributed to negative local perceptions,
creating a sense of distrust toward the Ebola response that ultimately led to vio lence.
e legacies of vio lence and international military interventions in the Kivus provide a
challenging environment for the Ebola response. Trust in the government and interna-
tional actors was already depleted in the Kivus before Ebola. Decades of foreign inter-
vention have made little pro gress in addressing the under lying colonial legacies and
inequalities in citizenship and landownership rights.
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e history of the Kivu region plays a signicant role in the population’s lack of trust
in the international Ebola response. Decades of vio lence have been largely overlooked by
the international community, despite the presence of many aid actors and the armed UN
mission meant to protect civilians. ese eorts have, in practice, achieved little, and as a
result, the population questions why international sta from these organizations earn so
much while they themselves strug gle to secure basic necessities like food. e media
maintained that an inherent distrust in eastern DRC toward international and govern-
ment actors formed the perfect breeding ground for perpetuating distrust toward the
Ebola response, alleviated by a centralized response that lacked community engagement.
e sudden inux of international and foreign personnel, working closely with a govern-
ment known for human rights abuses, produced suspicion toward the response. Interna-
tional media reports perpetuated this narrative. e fact that civilians perpetrated
vio lence supported the narrative of distrust. It seemed obvious to the foreign reporter that
this vio lence stemmed from a deep- rooted distrust in international personnel.
Some people feared the health care response because they were suspicious of alternative
intentions. One nurse recounted: “I do not want to be a member of the response because the
others will think that I receive money from their blood.” e fear that body parts would
be misused for medical experiments had long since developed during the cholera outbreak
in Europe in . In Britain, people believed that newly established anatomy colleges were
in dire need of cadavers, and that health care personnel had the task to “make people dead”
to supply their colleagues with dead bodies. However, there were also critics of the dis-
course arguing that the narrative of distrust often implied that the population was not
enlightened enough to understand the logic of modern medicine and how a virus spread.
Further, the narrative of distrust does not explain the sudden spike in early . Sev-
eral doctors reported that more and more patients were staying away from or eeing
ETCs. ose who distrust doctors would stay away from them instead of attacking them
directly. Why should distrust suddenly grow amid the outbreak? If the narrative of dis-
trust can explain the large- scale vio lence against Ebola responders, then many of the inci-
dents would have occurred at the beginning of the outbreak. When the organizations
involved the local communities more in the response, the situation should have improved.
e next section shows that the vio lence increased after Ebola became politicized during
the presidential elections.
Politicization Through Election Exclusion Due to Ebola
In December, the government excluded three opposition regions from participating
in the presidential election, citing security concerns and the risk of Ebola spread. A week
prior to the election, the election committee announced that voting would be postponed
in the regions of Beni, Butembo, and Yumbi, as it was deemed unsafe for large crowds to
gather at the polling stations. e three regions were allowed to vote three months later,
in March, but this delay eectively nullied the votes of over one million voters in the
two largest cities of the outbreak area because the new president had already been sworn
in by the end of January.
e regions excluded from the election were areas with little support for the central
government. Martin Fayulu, the candidate who came in second, drew most of his support
in the Kivu regions, and some political analysts believed that he should have won by a sig-
nicant margin. However, after a week of intense negotiations, the electoral commission
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announced Félix Tshisekedi as the winner. Tshisekedi was accused of having reached a
deal with Kabila, the former long- time president, in order to secure his victory. e fraud
allegations could not be substantiated and Tshisekedi was sworn in as president on Janu-
ary, . e controversial deal between Kabila and Tshisekedi added to the bitter-
ness felt by the people in Beni and Butembo.
Following the announcement of the election postponement, protesters stormed an Ebola
triage center in Beni and set it on re. A wave of street protests erupted the day after the
election, although most of them remained peaceful.xli Nonetheless, many humanitarian
organizations temporarily suspended their activities. Because the Ebola responders stayed
home, the protests cannot explain the vio lence against them. What else drove the vio lence?
roughout the outbreak, multiple surveys and focus group interviews from SSHAP
show that across all Ebola- aected regions, the discourse was dominated by suspicion
about the virus, or connecting the virus to the economic or political interests of the elites.
In Beni and Butembo, both hot spots of the virus, misinformation was most prevalent,
with around percent of people not believing that the virus was real, and another
percent believing that the government created the virus for nancial or political gain.
Local civil society organizations and politicians started to publicly construe Ebola as a
tool of the government to suppress the Kivus. e remaining part of this section pre sents
an overview of the narratives about Ebola that began to circulate within opposition circles
and on social media after the election. Several public statements directly framed the
election exclusion as a political— not a health care— measure. For example, civil society
members in Butembo circulated an open letter on WhatsApp. e letter stated:
e postponement of elections in Beni and Butembo cities and Beni territory demon-
strates that the epidemic became a political bargaining token. We believe that the
decision by CENI to suspend elections was made for electoral reasons, not health rea-
sons. e epidemic was not a valid reason to delay the elections . . . Sucient precau-
tionary measures were already in place to allow the elections to go forward.
e letter was originally in French and addressed to the DRCs’ Minister of Public
Health, WHO, MONUSCO, and the coordinators of the Ebola response. e authors
stressed that they did not believe that the election exclusion was a health care measure,
but were convinced that Ebola was used to steal their vote. A similar statement was found
on the “Beni- Lubero Online” news platform:
Ebola became the reason to deprive the population of Beni- Butembo of its voting
rights: it didn’t take long to discover the political signicance of this epidemic. On the
instruction of president Joseph Kabila, Corneille Naanga, the president of the Com-
mission Electorale Nationale Independante (CENI) prevented millions of voters from
Beni and Butembo from participating in the December elections, with the
sole purpose of sabotaging an electorate who supported the opposition co ali tion.
e two statements represented a variety of local voices that suspected a connection
between the political exclusion and Ebola. Some went a step further and directly linked
attacks against Ebola responders to the election obstruction. For example, Simon Kazungu,
the North Kivu provincial deputy from a local opposition party, stated that: “e attacks
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against the ETCs in Butembo should be seen as retaliation for using Ebola as a pretext to
not hold elections in this part of the province . . . Ebola was manipulated as a tool of
political exclusion to stie the civic rights of citizens. is manipulation is now turning
against the medical assistance centers.” Kazungu not only framed Ebola as a political
tool, but also linked the politicization to the vio lence. e following statement (originally
in Swahili) is from a leaet that was dropped in the community of Katwa when the attack
against the MSF- run ETC on February, took place:
Alert!!! Alert!!! Alert!!! Us voters, we won’t tire until we receive justice at the polls. We
are informing you, all the citizens of Congo, that we will never tire until we receive
our rights, so long as thieves steal the elections, even if Felix Tshisekedi became presi-
dent though electoral theft. We are reminding them that we have no prob lems with
the police or the national army, so long as they build up our homeland. Following
these events [e.g., arson of Katwa treatment center], we will carry out even larger plans
than what you have seen today. Citizens, let us rise up!!!
e perpetrators were motivated by the belief that the presidential election was rigged.
ey were not inherently against the state (“we have no prob lem with the police or the
national army”), but rather responding to convictions about a corrupt election.
e framing of Ebola as a political tool resonated with a lot of people. Indeed, survey
data show that rumors and conspiracies about Ebola were already circulating before the
election. e centralized response was detached from the local population and fostered
the perception that Ebola responders were part of the government. e narrative of dis-
trust was constructed by leveraging the violent legacies of the Kivu regions, which had led
to general suspicion toward outsiders who resembled previous international interveners
that had failed to protect the population; however, it failed to acknowledge that this same
legacy had deprived the population of its political rights for a long time. is legacy of
political disenfranchisement politicized the Ebola outbreak, especially after the govern-
ment used it as a pretext for excluding certain areas from the elections.
As such, the violent legacy was not a precondition for the distrust of all foreign actors,
but rather a precondition that led the population to believe that Ebola was just the latest
weapon of war. e international community, which had long failed to protect them, was
seen as working with the government to inict harm upon the Kivu population. After the
election exclusion, the link with the government created the impression that Ebola respond-
ers were part of a new political strategy to suppress the Kivus. e toxic mix of early distrust
toward the response and local leaders who publicly framed Ebola as a political tool of the
government increased the vio lence against Ebola responders.
The Response
e next section examines how humanitarian organizations responded to the rising vio lence,
failing to appreciate the importance of the election exclusion.
A Matter of Community Engagement?
Already years before the Ebola outbreak, humanitarian organizations like Oxfam realized
that they lacked community engagement in the DRC. In an “Accountability Eectiveness
Review” in , Oxfam evaluated its work in the Kivus and found that local partners
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viewed their role as subordinate. e review came to the conclusion that communities
were neither involved in nor consulted on the proj ect designs.
For a considerable period, there had been tensions between international and national
sta in the Kivu region. International organizations relied on local sta for safety analy sis
and communication with the local population. Nevertheless, many international sta
remained suspicious of their national counter parts, given their integration into the local
communities, which could compromise their impartiality and neutrality.
Indeed, several national politicians were involved in scandals that corrupted the Ebola
response funds, leading to the emergence of the term “Ebola business,” with negative sto-
ries surrounding the response. For instance, some politicians rented their private cars to
the Ebola response at triple the normal market rates. Additionally, some Ebola respond-
ers engaged in sexually exploitative practices, especially toward local women, demanding
sexual favors in exchange for well- paying jobs in the response. ese incidents undoubt-
edly contributed to the negative public perception of the Ebola response.
International organizations acknowledged their lack of community engagement dur-
ing the Ebola outbreak. WHO and the national government jointly led the response
eort. One of the key ele ments in containing infectious diseases is rapid response. To th is
end, international medical teams with experience from the / West African Ebola
outbreak were quickly deployed. However, while these teams were experienced in ghting
Ebola, they lacked familiarity with the local culture and languages. is centralized and
rapid response approach came at the expense of community engagement. MSF sta
reported tension between the government and international organizations, with the gov-
ernment wary of international organizations interacting too closely with the local popula-
tion, which might suggest that the government was not fully in control of the response.
From August to October, Oxfam published three reports urging for more local-
ized action. WHO’s weekly SITREPs started mentioning the lack of community
engagement and documenting eorts from vari ous organizations in that regard from
October onward. Although WHO identied “risk communication, social mobiliza-
tion, and community engagement” as impor tant pillars in the ght against Ebola, the
only measure mentioned in the reports was occasional meetings with community lead-
ers. Despite vari ous organizations involved in the response calling for greater commu-
nity engagement, the implementation fell behind. Even a year into the outbreak, most
communication materials were produced in languages that local communities did not
understand, such as English, French, or formal Swahili.
It was long unclear what was meant by community engagement. In January,
WHO introduced new indicators to track the level of community engagement in its
weekly key indicator surveys. It measured community engagement by the percentage of
people who knew “at least three ways of preventing the spread of Ebola” and the percent-
age of school children who received “reliable information about Ebola.” Additionally,
WHO created a new weekly monitoring tool to report on the Ebola response’s activities,
dividing community engagement into ten categories: community dialogue, studies and
surveys, brieng of key people, supervision of risk communication, active community
relays, training of actors, focal points, response to resistance, public communication, col-
lection, analy sis, and response to rumors.
e reports show that not even the WHO oce in the DRC had a unitary denition of
what community engagement should entail. In one product, WHO measured community
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engagement through a supercial understanding of how the virus spreads. Community
engagement was calculated not by what the organizations did, but rather by what infor-
mation about the virus reached the population. e other report presented more detailed
categories but did not clarify how the categories were dened and determined.
Nonetheless, there have been eorts to improve community engagement. In
April, Ebola response became decentralized and coordinated at the health- zone
level, allowing health workers at the frontlines to adapt more rapidly to local chal-
lenges. While there is no clear denition of community engagement, the reports
indicate that activities such as door- to- door outreach, small group training sessions,
information dissemination in schools or churches, awareness- raising of leaders and jour-
nalists, and cooperation with the media were implemented. e eectiveness of writ-
ten advocacy yers and leaets was mixed, as many communities were unable to read
them due to language or illiteracy, and communities requested more movie- based
campaigns.
As women were disproportionately aected by Ebola, the response shifted its focus by
providing messages to women’s groups that explained the realities of the disease. In Feb-
ruary, UNICEF reported providing bikes and phones to community workers and
local leaders to facilitate their movement and improve reporting of suspected cases,
rumors, and so forth. MSF began providing treatment for non- EVD patients for free
and covered the costs of patients when they were transferred to government- run non-
EVD medical facilities. e response also focused on malaria prevention campaigns to
alleviate the burden on the medical system. Additionally, response teams organized
tours of ETCs for the local population to demystify rumors about the facilities and set up
creches for children of sick mothers. In North Kivu, ambulances stopped using sirens to
reduce the stigma surrounding the Ebola response.
ese reports highlight that despite eorts to increase community engagement, the
real ity on the ground during the Ebola outbreak was somewhat di er ent. As the outbreak
occurred in an active conict zone, some organizations had to rely on armed escorts to
access communities and enforce measures such as “safe burials.” However, this practice
was criticized by MSF as a “militarization” of the response, and the IFRC warned that
it could worsen tensions between communities and responders. In July, the UN’s
Oce of the High Commissioner for Human Rights also highlighted the “disproportion-
ate use of force” by state agents responding to Ebola- related protests. Given the history
of violent state abuses in the Kivus, the use of armed state escorts likely contributed to
negative perceptions about the Ebola response.
Ignoring Politics
While the election had a direct impact on the work of Ebola responders, as many
organizations had to suspend their operations due to the protests, surprisingly little
acknowl edgment was given to the event’s impact on the response. In the rst week of Janu-
ary, WHO reported for the rst and only time that “Several security incidents related to
the elections have been noted.” It appears that WHO considered the violent dynamics a
nuisance unrelated to the response. Similarly, SHHAP’s material showed no questions
related to the election among the eld surveys, interviews, and focus group discussions
conducted throughout the outbreak. e only hint can be found in a number of surveys
after the election that showed considerably higher levels of disbelief in the virus or belief
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that the virus served political or economic goals in Beni and Butembo compared to other
regions not excluded from the election.
It is astounding that response actors seem to have completely disregarded the empiri-
cal evidence demonstrating the correlation between political exclusion and the attacks
against the response. Months after the election, the lead organizations of the response
realized that political disenfranchisement may have played a role. In a report to donors,
WHO writes in July that “From December onwards, increased suspicion of the
response and anger towards the government following the postponement of the election
in North Kivu and Ituri fed into a growing undercurrent of resistance to the response in
some, though not all, aected communities.”
Why was it so crucial for these organizations to perpetuate a narrative of distrust? e
reasons could stem from a variety of factors, including the trend toward localizing aid, nan-
cial and existential concerns as well as a misguided attempt to adhere to humanitarian princi-
ples. e vocal support of prominent Ebola organizations for the distrust narrative suggests
that it was imperative for them to make the narrative public. e emphasis on community
engagement was part of a broader push in the humanitarian sector to promote localization.
e localization agenda may have blinded the industry to other, more external factors.
A survey of the lit er a ture on the impacts of attacks on healthcare reveals that humani-
tarian organizations often construct their own narratives about attacks to attract more
media attention and funding. e Ebola response has eectively utilized the attacks as a
catalyst for mobilization. e UN responded by appointing an Emergency Ebola Response
Coordinator in May. is appointment strengthened advocacy and increased dona-
tions, enabling the response to focus on political engagement to create an environment
conducive to the response as well as to improve community engagement. Advocating for
more aid localization and community engagement is currently “in vogue” and may prom-
ise more funding from donors. However, the response has never been truly localized and
there is also a more fundamental debate about the neutrality of humanitarian action.
In terms of localization, regional or national actors had little agency in the response,
yet they were asked to stem most of the community engagement work. As of June, the
response involved fty- six international and state actors, compared to only eleven national
NGOs. All eleven national NGOs were engaged in risk communication and community
engagement activities, whereas only twenty- one international and state actors participated
in such eorts. Despite the dominance of international organizations in terms of nan-
cial contributions, community engagement was left primarily to national actors.
Regarding the debate about neutrality, humanitarian princi ples require the neutral,
impartial, and independent delivery of humanitarian aid. Designed to save lives,
humanitarian princi ples often serve as excuses for inaction. e discussion surrounding
humanitarian princi ples is inuenced by the ambiguity surrounding them, which can
result in di er ent interpretations of what humanitarian aid is or should be. e princi ple
of neutrality is found to be most dicult to uphold in conict settings. In Dante’s
inferno, those who remained neutral in life suer outside hell due to their moral indeci-
sion. e key issues in this debate are whether humanitarian neutrality is feasible and
desirable. Some see the princi ple of neutrality as an absurd Western notion during vio-
lent conicts that are political at their root. Hugo Slim argues that the discussion is
based on a misconception of neutrality as a humanitarian princi ple. Humanitarians are
not indierent and unprincipled, but rather committed to specic ideals of humanity.
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While being neutral during a political conict is a political statement, the goal of human-
itarian neutrality is operational, as it is a means to gain access to every one in need. Con-
sequently, neutrality and independence are political princi ples that allow aid workers to
operate within a conict without becoming excessively involved in it.
Neither the UN nor other international organizations or foreign governments con-
demned the decision to exclude the three regions from voting. One reason could be the
organizations’ desire to remain neutral and avoid taking sides as well as their dependence
on government cooperation. Organizations may have been worried about being expelled
from the country if they spoke out against the government. Some organizations, such as
MSF, have been in conict with the government due to their outspokenness and have
even been banned from certain response activities. When MSF’s international president
made a public statement on March, , that the response was out of control, the gov-
ernment revoked MSF’s permission to work in Butembo and Katwa.
Furthermore, speaking out about the government could have negatively aected how
international donors viewed the country. If the government had been seen as illegitimate
by the international community, less funding for humanitarian organizations would
have been spent— which is what nally happened in June when the third Strategic
Response Plan was proposed. e donors refused to triple the budget without changing
the response strategy. Pressure from the donors replaced the head of response and the
Congolese minister of health nally resigned and was later convicted embezzling Ebola
money.
However, this approach of neutrality inadvertently led to the population associating
the response with the government, as evidenced by the testimonies presented in section.
A common narrative in the population was: “First the kidnappings [–], then the
massacres [- present], now Ebola.” is narrative succinctly illustrates how the local
population is left feeling marginalized and disrespected by the central government in
Kinshasa. e harmful concept of neutrality can also be observed in discussions about
stabilization in the peacekeeping and peacebuilding culture. While “liberal peacebuild-
ing” approaches were attempted in the past, today there is more focus on stabilizing the
political context, which mainly involves ensuring security. is often means supporting
an existing regime for the sake of neutrality— regardless of how that regime treats its
people, with the sole aim of restoring control and preventing failed states. As such, the
attempt to remain neutral and refrain from speaking out against the election exclusion
ended up making the Ebola responders appear aligned with the government in the eyes of
the communities. Ironically, the perceived non- neutrality was a consequence of the inac-
tion resulting from the desire to maintain neutrality.
When humanitarians ignore the surrounding political context to depoliticize aid, they
become ignorant to dynamics that deeply aect humanitarian aid. Just because humanitar-
ians want to be independent of politics does not make them detached from wider political
dynamics. e consequences of ignoring politics were that the Ebola response was not pre-
pared to counter the narrative of conspiracies that linked the response to an oppressive gov-
ernment. e result was a violent popular backlash against Ebola responders.
Conclusion
is essay reconstructed the events and strategy of the Ebola response during the tenth
Ebola outbreak in the DRC. It rst argues that distrust due to lack of community
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engagement alone cannot explain the widespread vio lence against Ebola responders. After
the government used the virus to justify excluding the main opposition areas from voting
in the presidential elections, local elites publicly framed Ebola as a political tool of the
government. e data on violent incidents, and the content and prevalence of rumors,
show that the election exclusion was the trigger of the vio lence. Meanwhile, humanitarian
organizations drove the narrative that the vio lence was related to a lack of community
engagement. e political context was ignored, which meant that no adequate measures
could be taken to counteract the vio lence.
is study is not arguing against the idea of more community engagement and local-
izing health care responses. However, it tries to show that in the case of the Ebola
response, vio lence cannot be exclusively explained by lack of community engagement.
While every one seemed focused on improving community engagement, the election event
was only identied as a potential factor in hindsight. Had WHO or other actors in the
international community acknowledged earlier that the election politicized the response
and was rigged, it may have disconnected the response from national politics, which
returns us to Crombé etal.’s argument in the introductory essay to this special: that
researchers de- historicized attacks against healthcare, leading to a inaccurate public per-
ception that the vio lence is unpre ce dented. In this case, humanitarian prac ti tion ers
depoliticized the vio lence, leading to the misinterpretation that it is caused by lack of
community engagement.
e implications of this study are twofold. First, the eort to uphold humanitarian
princi ples can make organizations blind to political realities on the ground. Humanitar-
ian organizations could have strongly condemned the exclusion of elections by demon-
strating how safe polling could have been conducted in Ebola- aected areas, thereby
highlighting that there were no legitimate health- related reasons for the exclusion. More-
over, these organizations could have acknowledged the issue and accordingly altered their
programming or messaging. ey should have eectively communicated to the popula-
tion that they are distinct from the government. Ironically, their inaction signaled to the
population their non- neutrality. Hence, condemning the election would have signaled
neutrality. Ebola responders may have wanted to stay away from politics, but sometimes
politics does not stay away from them. e neutrality guaranteed cooperation with the
government and thereby also the access. However, this also led to popular perceptions of
Ebola as a political tool of the government. is leads to the second implication. e
sources of popular discontent must be understood in order to ease tensions eectively.
Following owers of speech because they are a popular discourse hinders us from under-
standing the actual situation. While localizing aid and engaging with communities are
undoubtedly crucial, these measures were insucient in countering the security incidents
directed at Ebola responders.
NOTES
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. Kivu Security Tracker, Crisis Mapping in Eastern Congo, https:// kivusecurity . org (accessed Decem-
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