The second-largest Ebola outbreak in recorded history left deep scars across the eastern Congolese city of Beni, claiming over 2,200 lives between 2018 and 2020 as more than 3,400 cases spread through a region bordered by Uganda and Rwanda. Now, those who survived the catastrophe are stepping forward with a sobering message: the virus itself was not the only killer. Just as lethal were the misconceptions, mistrust, and miscommunication that turned communities against public health workers and kept people from seeking timely treatment. As the Democratic Republic of Congo grapples with a fresh Ebola outbreak caused by the rare Bundibugyo virus strain, with 550 confirmed cases and 101 deaths reported by early June, these survivor testimonies carry renewed urgency for health authorities across the region.
Vianney Kambale Kombi contracted Ebola during the peak of the 2018 outbreak while living in Beni, a major commercial and transport hub that serves as a crucial junction for trade across the eastern border zones. He recalls a pervasive sense of denial within his community, where many residents rejected the very existence of the disease. Rather than accepting medical explanations, significant portions of the population attributed the outbreak to supernatural causes, interpreting the cluster of deaths and sickness through the lens of witchcraft and spiritual malfeasance. This belief system, deeply rooted in local culture and reinforced by historical grievances toward outside medical interventions, created a formidable barrier to public cooperation with response efforts and drove many sick individuals away from treatment centres.
Kombi's experience extended beyond mere superstition. He describes how alternative narratives circulated through his community, with some residents dismissing Ebola entirely as a manufactured crisis designed to extract international funding and maintain Western geopolitical influence over Congo. These conspiracy theories, which framed the disease as a political construct rather than a biological threat, actively discouraged people from adopting preventive behaviours or seeking diagnosis. The combination of spiritual explanations and political skepticism created a toxic information environment where the actual epidemiological reality struggled to gain traction. Reintegrating into his community after recovery proved exceptionally difficult, as neighbours and family members remained unconvinced that Ebola survivors could genuinely heal, viewing them as perpetually cursed or dangerous.
Bienfait Wanzire, another survivor from the same outbreak period, echoes this pattern of misinterpretation. In his account, initial community responses to Ebola deaths and illnesses were filtered through multiple competing frameworks—first attributing cases to spiritual illness, then reinterpreting the crisis through the lens of electoral politics. The timing of the outbreak coincided with election campaigns in the region, and some residents converted the disease narrative into a political weapon, viewing health authorities' warnings as propaganda rather than protective guidance. This weaponisation of health information against the backdrop of broader political tensions between local populations and state institutions reflects a deeper crisis of institutional credibility that extends well beyond epidemiology.
Dr Babah Mutuza Lusungu, a physician at Dieu Est Grand Medical Centre in Beni, witnessed firsthand the human costs of this mistrust. Even as he laboured to convince patients and community members of Ebola's reality, the disease claimed his uncle and two colleagues. The professional experience of healthcare workers became shadowed by a climate of intense scepticism, as populations questioned the motives of both foreign and local medical personnel. The fracturing of trust created a vicious cycle: patients avoided healthcare facilities, transmission accelerated, death tolls mounted, and public confidence deteriorated further. Dr Lusungu identifies a critical gap in response strategy: youth, who might have served as trusted intermediaries and information disseminators within their peer networks, were largely sidelined from response planning and implementation.
This generational oversight represents a significant strategic failure that current outbreak responses must address. Young people in Beni possess social networks, credibility among their cohorts, and cultural positioning that could translate public health messages into locally acceptable formats. By working through youth leaders rather than imposing top-down health messaging, authorities could potentially counter misinformation before it metastasizes through communities. Dr Lusungu warns that waiting for case counts to escalate before mounting an effective response is itself a losing strategy—by the time visible disease clusters emerge, misinformation has already become entrenched and behavioural patterns of avoidance are well established. Early, community-embedded communication strategies during the inter-outbreak period would provide a foundation of trust upon which crisis response can build.
Esperance Masinda, who worked for the United Nations Children's Fund during the outbreak, encountered another dimension of the crisis: the vulnerability of children who lost parents to Ebola. Her professional work exposed her to the disease while she was caring for her husband, a medical doctor who had also contracted Ebola. Though both eventually recovered through access to vaccines—a resource unavailable to the general population and a factor that may have accelerated transmission among the unvaccinated—their survival came with a social cost. Neighbours and family members harboured dark predictions about their futures, spreading claims that the vaccines administered during treatment were themselves fatal and would claim their lives within five years.
The stigmatisation of survivors, particularly among vaccine recipients, reveals how medical interventions themselves become contested terrain in environments of deep mistrust. Vaccines, which should symbolise hope and recovery, instead became markers of separation and suspicion. Masinda describes how her recovery was shadowed by isolation from her social networks, as people maintained distance based on beliefs about contamination and the supposed lethality of the medications she had received. This stigmatisation extends beyond mere social discomfort; it fundamentally undermines public vaccination campaigns, as communities observe that vaccine recipients remain ostracised rather than celebrated. When people see that survival through medical intervention leads to prolonged rejection and suffering, rational cost-benefit analyses tip toward avoidance of health services.
Yet Masinda's testimony also offers a path toward healing and reconciliation. She describes how, over time, the stigma attached to survivors has gradually diminished as her community has come to recognise her and her husband's humanity. Their visible health and ordinary functioning in daily life have begun to contradict the dire predictions circulated about vaccine recipients. This gradual normalization suggests that survivor testimonies, precisely because they challenge misinformation through lived experience rather than abstract argument, possess unique persuasive power. When former patients walk through markets, maintain employment, raise families, and participate in community life, they become living refutations of conspiracy theories and witchcraft narratives.
The implications for Malaysia and other Southeast Asian nations are significant, as regional health systems increasingly face the prospect of novel or re-emerging infectious diseases in an era of rapid travel and trade. The Congo experience demonstrates that biomedical containment measures alone are insufficient without parallel investment in community trust-building and culturally appropriate communication. In multicultural contexts like Malaysia, where various communities may hold different explanatory frameworks for disease, health authorities must develop sophisticated approaches to infectious disease communication that acknowledge legitimate sources of institutional skepticism while anchoring messaging in accessible, local information sources. The lessons from Beni suggest that effective outbreak response begins years before cases emerge, through quiet relationship-building with community leaders, youth organisations, and trusted intermediaries.
For the current Bundibugyo outbreak in Congo and future outbreaks across Africa and beyond, survivors like Kombi, Wanzire, Masinda, and healthcare workers like Dr Lusungu are advocating for a fundamentally different approach to epidemic response. Rather than treating communities as passive recipients of top-down health directives, this approach positions survivors and local leaders as central to the response strategy. The vaccines that ended the 2018-2020 outbreak may not be available for this current strain, making non-pharmaceutical interventions and community cooperation even more critical. Building this cooperation requires acknowledging that the disease narrative competes with alternative explanations rooted in local culture, historical trauma, and political grievance. Success in future outbreaks will depend on whether health systems can harness the credibility and moral authority of survivors to counter misinformation at its source.
