“Like hyenas on a dead body”: a Congolese aid veteran on the Ebola response
Fear-indexed aid follows the disease donors are afraid of catching, not the diseases a community is dying from, and eastern Congo has noticed.
What 30 years of outbreaks taught one Congolese aid veteran.
When Ebola arrives in eastern Congo, as it has many times before, Karume B. Augustin told me the aid agencies arrive with it, “like hyenas on a dead animal body.” Augustin (aka “Gang”) is an advocate for stronger political and economic control and a technical advisor to humanitarian agencies. He’s spent 30 years watching outbreaks land in his country. The last big Ebola response left behind new Land Cruisers, big salaries for outsiders, and a hardened belief that the disease is a hoax. When I asked him why people call it a fake, he talked about money.
The outbreak gives that warning new weight. It is now the third largest on record — more than 708 confirmed cases across the Democratic Republic of the Congo and Uganda, and 141 deaths — and the machinery for containing it is failing. On June 11th, fewer than 3 in 10 contacts of known cases were tracked down, far short of the 95% needed to box the virus in. After his second visit to the zone, WHO director-general Dr. Tedros Adhanom Ghebreyesus told STAT News’ Helen Branswell he was “really worried,” and that the response’s deepest problem was the community’s distrust. To many residents, he said, Ebola has become “a lesser evil” beside war, hunger, and the diseases that kill more of them. His answer was political. Augustin’s answer starts with the money.
A billion dollars, and few local hires.
Augustin traces it to the last big response. That one, in 2018 and 2019, cost close to $1 billion, and people watched nearly all of it drive past them.
“First, they could see brand new Land Cruisers circulating, people coming from Goma, from Bukavu, from worldwide, making $10,000 a month, $15,000 a month, $30,000 a month, and they did not hire any person locally,” Gang said. “Even the people to manage the Ebola treatment centers, all of them they’re coming from outside.”
An outbreak is supposed to pour money into a local economy: rented trucks, hired hands, leased buildings, orders at the local pharmacy. Instead, Gang says, the cash circled among outsiders and drove off, leaving behind body counts and quarantine cordons. People began saying Ebola meant dollars more than a deadly virus. They started calling the whole response a business.
Some of what grew from that is false, and Gang relays it without endorsing it: that health workers fill patients with poison, that burial teams lower empty coffins into the ground, that the wards exist to kill people for money. But the suspicion about the money tracks something real, that people did watch a dollars arrive and leave them with nothing.
Fear-indexed aid.
The suspicion has a history. For years, Augustin says, armed groups swept through Ituri, “machete-ing people like cows or burning houses,” and no aid convoy came. Then Ebola arrived, and so did everyone. “You’re coming for something else,” he says people concluded. If the outsiders really wanted to help, he said, “way, way before, you’ve been there to see all these people who are killing us.”
This is fear-indexed aid: money chases the threat the donor fears could reach them, not the threats the community is already dying from. In Ituri, malaria kills more. The militias kill more. Neither summons emergency funding, a global declaration, or the full machinery of international alarm. Ebola does, because Ebola can board a plane. People there have learned exactly which of their killers makes the world come running.
Trust belongs to the ones who never left.
Gang draws a hard line between the people who stay and the ones whose embassies fly them home. “When a crisis strikes, international organizations are the first to pull off,” he said.
The ones who stay are the churches and the small outfits. Caritas was in the village before the outbreak and still there when it hits. Pastors, priests, and imams hold their ground when everyone else scatters, so people listen to them. The war sharpens the divide. With Rwanda-backed M23 holding Goma and the government holding Beni, an outsider who crosses the line between them gets taken for a spy by whichever side he reaches. Someone rooted in the community can move through territory where a flown-in expert would be stopped at gunpoint.
Then there is the matter of who gets sent into the wards. The easy retort is to ask local health workers why they need to be paid to save their own neighbors. Augustin flips it. “You want me to be motivated, and put my life at stake to die for an outside person, even if it’s within my community,” he said. “But if I die, that person will never take care of my wife and of my children. And the government or the rebellion, they don’t have the resources to pay us. Why would I take that risk?”
A machine that bypasses locals.
Augustin’s deepest objection is to the architecture itself. Tedros framed his trip as listening rather than dictating. Augustin’s point is that the system dictates no matter who runs it.
“International organizations and the UN, they take advantage of the government weaknesses to come and dictate the rules,” he said. “That is the root cause.” In Congo, he says, the humanitarian plan is drawn up not by the government but by OCHA, the UN’s coordination office, and the big international agencies rather than the government or the groups rooted in the villages. When the WHO declares an emergency, the billions flow through the WHO, the World Food Programme, and UNICEF — not through Caritas, or a parish, or a Congolese organization.
So the director-general can mean every syllable about listening and still command a machine built to do the opposite. The one thing the response cannot do without, trust, sits with the local actors the budget doesn’t reach. A funding system that routes around them cannot buy the trust it runs on.
Pledged 25%, delivered 4.5%.
Routing money through local responders gets waved off as politics, or charity, or a dream that corruption will always wreck. In an outbreak it’s also pragmatic. Getting contact tracing to 95% takes people who can slip across front lines and be believed when they knock: someone the household already knows, not a stranger who flew in for the outbreak. Trust can’t be airlifted.
The fix even has a number. In 2016, donors and aid groups signed the Grand Bargain and pledged to send at least 25% of humanitarian funding straight to local and national responders. By 2023, the share landing there directly was a mere 4.5%.
“The virus is ahead of us,” Tedros said. In eastern Congo, the distrust got there first, earned by watching where the money went.
Other Ebola news…
The outbreak is now the third largest on record. Uganda, with political stability and past experience, looks largely contained at 19 confirmed cases and two deaths. Northeastern DRC is not.
Contact tracing is the failure point. Only 28.4% of known contacts were followed up on June 11th, against a 95% target. WHO ties the collapse to insecurity in Ituri and to communities hiding the sick. Without it, isolation and testing fall apart.
Ebola reached a displacement camp for the first time. Two deaths were reported in the overcrowded Kpangba IDP camp in Ituri, a new setting where crowding and poor sanitation invite rapid spread.
The US pledged $50 million for a Bundibugyo countermeasure. The U.S. State Department said on June 12th it intends to fund the Coalition for Epidemic Preparedness Innovations (CEPI) to develop a vaccine and treatment for this specific Ebola specis, for which none are approved. Any product is months away at best, so it doesn’t change the current outbreak.
Washington is pressing Europe on travel restrictions. A State Department cable instructs diplomats to push European governments to match US Ebola travel measures before the World Cup, or face possible “unilateral measures.”
Pledged funding has nearly halved. Africa CDC says voluntary commitments fell from about $500 million to roughly $290 million since June 1st, though the Pandemic Fund’s $220.6 million offsets part of the gap.