A remote mining town gripped by fear saw hundreds of suspected cases before the government declared an outbreak, report says

But why, in a country that has seen 16 previous Ebola epidemics, didn’t anyone alert the government to the burgeoning catastrophe? The report suggests people in Mongbwalu had alternative explanations for the symptoms. “Theories included AIDS, tuberculosis, and the working conditions of artisanal gold miners, who inhale dust and use toxic substances,” Villa said at the Zoom meeting. “Mystical causes” were also invoked.

“A culture of secrecy” delayed the alert further, Villa said. Many Mongbwalu residents prefer private clinics over public hospitals, where “care is perceived as expensive and of poor quality,” he said. Those private facilities were afraid to report cases, fearing blame, fines, or even closure.

MSF was alerted by an anonymous group of physicians in early May, Albela says. By that time, “It was already all over Ituri province.”