Pastors race to build trust in Congo’s Ebola response

A day before the Ebola outbreak was declared by the Congo Health Ministry, Doctor Déo Ngatane was hospitalized at Centre Medical Evangelique Bunia Hospital (CME). He had treated himself for malaria at home without relief from his symptoms of fever, aching joints, headaches and vomiting. “I was just feeling horrible.”

The next day, Ngatane’s colleague, Doctor Blaise, joined him. “He was in one bed, I was in the next bed. He was in such a bad state that they came to take his blood sample immediately for Ebola. They took mine two days later.” The blood samples were sent to a lab in Kinshasa, the capital of the Democratic Republic of Congo (DRC), almost 3,000 kilometres away.

The two doctors stayed in the same room for three days before Blaise’s results returned. “To my great surprise, I saw that they were separating us. They didn’t say what his results were, just that he had to go somewhere else,” remembered Ngatane. The next day, he learned his colleague had tested positive for Ebola.

“Right then I felt terrible. I was truly traumatized morally. Why? Because when we were together in one room, we were sharing food with each other. We were eating together. We had one bathroom and we were both vomiting there, both bathing. So when I thought about the level of contact we had I really began to worry.” Medical staff and pastors offered support, Ngatane told Christian Courier during an interview on June 5.

After eight days hospitalized, he returned home on a Friday, hearing news that Doctor Blaise was bleeding and had short breath. Three days later, Doctor Blaise died.

The Ebola epidemic was declared on May 15, up to three months after the first cases, leaving medical staff exposed. By June 10, Congo had seen 676 confirmed cases and 242 suspected deaths. And on May 31, a national “rumour response plan” was activated, including a response to rumours of lethal injections being made at Ebola treatment centres as well as rumours about the cost of tests.

“At this stage, the main challenge is not a lack of funding, but rather on-the-ground organisation and community engagement in response measures,” said Dr. Jean-Jacques Muyembe, medical director of National Institute of Bio-Medical Research in Congo. “It is essential that the population trust the teams deployed on the ground.”

“Unless trust is established very, very quickly, there are going to be many hundreds of thousands of deaths,” Bagamba Araali, Bunia resident and founder of Beacon of Hope, told Christian Courier.

The men and women caught up in the first wave of the epidemic, like Doctor Ngatane, are the ones holding the frontline of trust.

Trust broken

Ngatane said that at the start of the epidemic, families panicked. A family member entered the hospital with fairly typical malaria symptoms, only for the body to leave in a coffin without being seen by the family. Families felt they had been lied to. This has caused conflict at cemeteries: “The strong desire of the family was just – they wanted to see the body and especially to touch it.”

Several times, families created so much chaos, the volunteers trained in handling Ebola corpses had to flee. “People touched [the body] and infected themselves.”

On June 1, a Red Cross volunteer was beaten and badly wounded at a Bunia cemetery after someone seized a coffin, opened it and yelled that there was no body. Ngatane explained that there had been no time to measure the body before buying a coffin: “They opened the coffin at the feet. Now the person who died was so short, they saw that it was empty and immediately panicked. So they caused trouble, but afterwards they opened the whole coffin and saw that the body was indeed inside. So you can see the problems we’re having here.”

Jean-Pierre Kamenabake is an assistant professor of theology at Shalom University of Bunia. According to custom, Kamenabake told Christian Courier, families demand “a dignified wake.” “They want to prepare a good ceremony: people should spend the night, it should be organized well, people should eat well, they should console the family, they should put the body in the morgue and make a plan for the burial, they should wait for people who are far away to arrive – all of that, for people who die of Ebola, isn’t happening anymore.”

Kamenebake named some “small solutions”: medical staff call two or three family members to verify the body as they wrap it for the coffin. After lowering the coffin into the grave, Red Cross volunteers leave so that the family can cover it with dirt. “That’s helping families a little. They’re reassured knowing that it’s not someone else, but their own person – there is no lie.” Now that doctors and nurses have died from Ebola, people are beginning to accept that it can’t have been a scam.

Churches mobilize

Kamenebake is also a pastor of a CECA/16 church of around 300 members. They have begun setting up handwashing stations – hand sanitizer prices skyrocketed, making it unaffordable. They are physically distancing: only three people per 1.5 metre bench. When we spoke on June 2, the church was getting ready to start temperature testing the following week. Pastors speak about Ebola and invite doctors to speak.

Because multiple people often die in one family when Ebola strikes, it compounds financial stress. The church struggles to provide for orphans and widows. Some Christians, Kamenebake said: “are asking, ‘How can God, who is love, who created us, who we serve – how can he permit epidemics like this to come to us? That our people die? That our doctors who help us also die?’”

Other believers aren’t afraid: “they know, ‘Even if I die in that sickness, I won’t be lost, but I will go forever to rest with my Lord.’”

Pastors are key figures in responding to the outbreak, but they are reeling, too. “Everyone is caught off guard, and the churches are trying to scramble to adapt,” said Araali, who is an elder at a large CECA/20 church. “This week, we lost four pastors.” One pastor was hospitalized two days after preaching in Araali’s church; his brother and his sister also died. “As church elders, we are sitting on our WhatsApp group all day trying to make decisions.”

Araali’s church cancelled Sunday School, which typically sees up to 1,000 kids, in early June. For the month of June, sermons were planned around Ebola, including a Biblical perspective on trauma and Araali’s sermon on the social aspect of epidemics. For now, the church meets in an unfinished building where they can socially distance. They’re worried about the start of the rainy season in July.

‘Trust by proxy’

Araali is establishing “trust by proxy” in his larger networks. On Saturday, May 30, Araali traveled to Rwampara, one of the first districts hit by Ebola. On May 21, crowds in Rwampara burnt an isolation ward, causing the death of an Ebola patient. Araali gathered local chiefs, leaders and missionary doctors – around 150 people: “I used the respect people have for me. I told them, ‘These are doctors I trust, so can you listen to them?’”

Each leader was asked to communicate the basics of the Ebola virus to their circles and a week later, Araali returned for a follow-up to see if families understood what was happening. “That is my method. Talk to the one person they trust and that person goes to talk to them.”

“We need our brothers and sisters from stable countries,” said Araali. There are initiatives the church is trying to launch, like places for children orphaned by Ebola to isolate, that could use support.

“The first thing [we’d ask Canadian Christians is], that they pray for Congo,” said Kamenabake. “On top of the insecurity and the wars, and the many people who have died because of it, an epidemic has appeared in the East among us. So pray for us, the Christians in Eastern DRC.”

Note: Interviews with Kamenabake and Ngatane were translated from Lingala to English by the author.