Exhausted health workers in Congo struggle to keep up as Ebola outpaces
contact tracing
[August 15, 2026]
By CONSTANT SAME BAGALWA and MARK BANCHEREAU
NIZI, Congo (AP) — Every day, community health worker Gédéon Banga
Ngbape and his team fan out across communities in eastern Congo looking
for people who may have crossed paths with the country’s fastest-growing
Ebola outbreak in history.
The workers investigate dozens of alerts, search for those exposed to
suspected or confirmed cases and try to get anyone showing symptoms into
care before the virus spreads further.
But the surveillance system is increasingly failing to keep pace with
the virus. Between 60% and 70% of new Ebola cases are being detected
among people who were not already being monitored as contacts, meaning
health workers may only discover infections after patients become sick
and have had opportunities to expose others.
“If surveillance does not work well, the entire response suffers,”
Ngbape said. “Surveillance is the engine of a response.”
The outbreak has killed over 2,200 people out of more than 4,700 cases,
according to the latest government figures. This death toll has been
reached almost three times faster than in the 2014-16 Ebola outbreak in
West Africa — the worst in history. That outbreak claimed over 11,000
lives.
“We are chasing the virus; the virus is ahead of us,” said WHO regional
director for Africa, Dr. Mohamed Yakub Janabi, this week.
U.N. humanitarian chief Tom Fletcher on Friday announced an additional
$30.5 million in emergency funding to help tackle the Ebola outbreak.
Response teams work long hours, often without pay
In Nizi, Ngbape’s surveillance teams say they receive an average of 60
to 70 alerts a day. They move through communities to investigate
suspected infections, follow people who have been in contact with
suspected or confirmed cases and direct those showing possible symptoms
to health facilities.
The work can stretch deep into the night.
“I leave in the morning at 8 and return around 11 p.m., sometimes
midnight,” Ngbape said. “I still have to follow up and plan the next
activities. I feel really tired, but what matters to me is always being
of service to the community.”
He did not say how many days a week he works or how often he is able to
take time off.
Community health workers who go door to door face risks of their own.
Ana Ndroy Kasime, a community health worker in Nizi, said she visits
homes to educate residents about Ebola and reports suspected cases to
health officials. But she said workers like her lack basic protective
supplies.
“When we go door to door, we don’t have protective equipment, like
boots, disinfectant and other supplies, even though we are at risk,”
Kasime said. “We buy disinfectant with our own money.”
The current outbreak, caused by the rare Bundibugyo Ebola virus, is
unfolding in some of the most challenging conditions imaginable. There
are no approved vaccines or treatments for the Bundibugyo virus, though
trials are underway. Strikes by some unpaid health workers, threats by
rebel groups, anger from long-traumatized communities and misinformation
asserting that Ebola isn’t real have significantly hindered the
response.
The gaps are especially consequential in Nizi, one of the most affected
health zones in Ituri province, which accounts for about 90% of Congo’s
Ebola cases and 80% of its deaths.
“We started surveillance with fewer workers,” Ngbape said. “The
challenges are enormous,” he added.
On Thursday, health workers at the Nizi Treatment Center went on strike
and the facility temporarily closed. Ngbape said the health workers have
not been paid in over three months.
The head of Africa CDC, Jean Kaseya, on Thursday called on Congo’s
government to pay the outstanding salaries, saying money was available
and that paying workers was the government’s responsibility.
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Gédéon Banga Ngbape, left, an Ebola surveillance officer, does
contact tracing in Nizi, Ituri province, eastern Congo, Friday, Aug.
14, 2026. (AP Photo/Dieudonne Dirole)
 The government says payments are
delayed because it’s verifying worker payroll lists after finding
unrelated names had been added and while it shifts payments from
cash to mobile money.
Kasime said community health workers like her have received their
payments, but at about $50 a month, she considers the amount
inadequate for the work and risks involved. She said other Ebola
response workers should be paid quickly.
“They are making sacrifices and taking risks,” Kasime said. “If
these workers decide to stop working, the epidemic will spread
further into the population.”
Insecurity and displacement put contacts out of reach
Surveillance workers in Nizi often struggle to get around, making it
harder to investigate alerts and follow contacts across the health
zone, Ngbape said. Frequent population movements linked to mining
and people fleeing armed conflict add another complication, as
people can move before surveillance teams are able to follow up with
them.
Poor and sometimes impassable roads can also make remote areas
difficult to reach, while insecurity restricts where health workers
can safely operate. It remains unclear how many communities in the
province are currently inaccessible to surveillance teams.
Dozens of rebel and militia groups operate across eastern Congo. The
Allied Democratic Forces, which is tied to the Islamic State group,
is among those active in Ituri. The insecurity has forced some
health and aid workers to leave remote Ebola hot spots for the
relative safety of the provincial capital, Bunia.
Violence affecting the Ebola response has also come from residents.
At least a dozen attacks on health facilities and workers were
recorded as of mid-July, according to local health authorities. In
one incident, residents attacked a hospital in Nyakunde and entered
a nearby Ebola treatment center, forcing patients and staff to flee
before operations resumed the following day.
Many residents’ anger is caused by misinformation about the virus
and bans on traditional burials — when families prepare the bodies
and people gather for a funeral, which can lead to further
infections.
Ngbape, however, said his surveillance teams in Nizi have not been
attacked.
He said cooperation has improved as residents have become more
familiar with the surveillance teams and their work. Ngbape also
said he does not believe people in Nizi are widely concealing
suspected infections, though population movements and limited
transportation can still make contacts difficult to follow.
For Ngbape, maintaining that surveillance is critical to preventing
individual infections from developing into wider chains of
transmission. The long hours and limited resources have left him
exhausted, he said, but not ready to stop.
“I am here to save the lives of the population,” he said.
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Banchereau reported from Dakar, Senegal.
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