As of Sunday, there were 1,088 confirmed cases in the country, with another 66 probable cases, which caused 731 deaths, according to data from the World Health Organization (WHO), making it the second worst outbreak in history. A further 172 confirmed cases were confirmed in the last three weeks until 2 April, with outbreaks affecting 42% of the sanitary areas of the Congo. The problems were exacerbated by a lack of trust in public health workers, with two treatment centers run by MSF recently subjected to malicious attacks, which prompted the organization to suspend its operations in Butembo and Katwa.
A lack of understanding of the nature of the disease is partly to blame, with some residents preferring to rely on the power of prayer rather than life-saving vaccinations.
An MSF spokeswoman said: "People are still dying from the Ebola in their communities rather than seeking health care in Ebola treatment centers – a clear signal that they do not trust the answer.
"In recent weeks, up to half of the deaths in the community have occurred".
It was vital to ensure that patients and the community were included in the planning, he emphasized.
He explained: "We need to adapt our approach and return the choices to patients, actively involving them.
"People in this region have suffered for many years from a general lack of health care and insecurity and violence, and Ebola is not necessarily their priority.
"We need to think about tackling the Ebola as part of the overall health care supply.
"The use of coercion has created animosity towards the Ebola response.
"The police are involved in surveillance, contact tracking and various other activities.
"This outbreak is happening in a conflict zone and we do not question the role that the police and other security forces can play in protecting the people involved in the response.
"But their current role in the response is counterproductive to gaining the trust of the population and containing the epidemic."
Speaking last week, a spokesman for the WHO said: "The recent shift of emphasis in response strategy to promote greater involvement and ownership by affected communities is starting to produce results.
"While the reluctance and distrust of the community remain present in some areas around Butembo and Katwa, other areas have seen a significant decrease in resistance to the presence of response operators.
"Diligent efforts in engaging with community committees through direct dialogue led to the reopening of the ETC in Katwa, bringing the total number of operational facilities providing assistance to up to six ETCs in Beni, Butembo, Goma, Komanda , Mangina and six transit centers in Beni, Bunia, Katwa, Kayna, Bwanasura and Oicha.
"A more proactive approach to investigating and resolving incidents in communities is also undertaken to minimize the risk of misunderstandings and to mitigate potential sources of distrust between local residents and health professionals."
Ebola is a hemorrhagic fever with a high risk of death, which kills between 25 and 90% of those infected, with an average of about 50%.