Bunia, Democratic Republic of the Congo// — Since the start of the Ebola outbreak caused by Bundibugyo virus disease in the Democratic Republic of the Congo, surveillance has been one of the main lines of defence against the disease.
By enabling the rapid detection of alerts, investigation of suspected cases and monitoring of contacts of confirmed cases, it helps interrupt chains of transmission and protect communities.
To date, the outbreak has affected seven provinces and 63 health zones, with 7773 cases and 3759 deaths recorded, representing a case fatality rate of 48.4%.
In Bunia, this early detection work largely depends on the ability of surveillance teams to gain the trust of communities. Célestin Ndaliko, surveillance focal person for Bunia health zone, often meets families hesitant to report a sick person or accept an investigation.
Yet he knows that every alert notified in time can help limit the spread of Ebola. “The first step is to convince families that the disease exists and that action must be taken quickly so patients can receive care in time,” he says.
To strengthen early detection, community volunteers move through neighbourhoods and villages to engage with families, identify people showing signs of illness and quickly report alerts to health authorities.
With support from the World Health Organization (WHO), 680 community volunteers had been deployed across 17 health zones by 17 September 2026, as part of community surveillance and contact-tracing activities, with the goal of reaching 1603 by the end of October 2026.
For Célestin, trust is essential to detect patients quickly and guide families toward health services. “The community is often the first to know when someone falls ill. A mother may notice that a child is unwell even before a health worker arrives. When communities trust us, they help us act faster,” he says.
This trust is not always easy to obtain. Célestin recalls a family he met after an alert was reported by a community volunteer: “The family told me, ‘What we have here is what we’ve always had. Don’t say it’s Ebola.’”
In such situations, teams prioritise listening and dialogue. By taking time to address concerns and explain the importance of rapid investigation, they often succeed in gaining families’ cooperation and facilitating patient care.
Once communities decide to report an alert, a broader mechanism is set in motion. At the Provincial Health Division of Ituri, Sandrine Karungi receives and channels alerts from communities and health facilities to the relevant zones for verification and investigation. Her phone can ring at any hour. Some alerts concern people with suspicious symptoms; others involve deaths requiring rapid investigation. “Even in the middle of the night, we must respond. When someone calls, they expect help and guidance,” she explains.
In the Rwampara health zone, its chief, Dr Patrick Basara, witnesses daily the importance of this early detection chain. “Surveillance enables early detection of cases in the community. It triggers investigation, allows rapid isolation of patients, contact tracing and interruption of the transmission chain,” he says.
He cites the recent example of a pregnant woman identified thanks to a community alert in the Kabarole health area. After symptoms appeared in her family, teams quickly went on-site to verify the alert, conduct necessary investigations and organise care for those affected. Contacts were identified and monitored, while local leaders and community volunteers were mobilized to strengthen vigilance within the community.
To support these efforts, WHO works alongside the Ministry of Health to strengthen national surveillance capacities and assist field operations. According to Dr Jean Marie Tshilumbu Kaboya, WHO surveillance focal person for the Ebola response, WHO has supported the training of 36 zone chief medical officers and 36 community agents. The Organisation has also deployed about 97 national and international epidemiologists, along with 22 field coordinators and five provincial coordinators.
The results are already visible. While only about ten alerts were recorded daily at the start of the response in May 2026, around 2000 alerts are now reported each day, 90% of which are verified by field teams. Contact tracing has also risen from less than 15% at the start of the outbreak to over 85%.
These results demonstrate the progress achieved through strengthened surveillance. However, several challenges remain, including difficulties accessing certain localities, limited human resources and community reluctance that can still delay case notification and alert investigation.
For Dr Tshilumbu Kaboya, community participation remains a decisive element of surveillance. “We can train teams, deploy experts and set up all the necessary tools, but early detection largely depends on community trust and participation,” he says. For him, the speed at which alerts are reported continues to play a crucial role in the ability of teams to identify cases, trace contacts and limit the spread of the disease.
In Bunia, Célestin continues his work with families with the same conviction: community participation remains essential to detect cases quickly and interrupt transmission. “It is not inevitable. There is hope when patients are detected and treated in time. The more communities participate and report alerts quickly, the greater our chances of protecting families and stopping the disease,” he says.
