Assessing the risks faced by the city of Goma in the Democratic Republic of Congo (DRC) would go well beyond the norms of the insurance industry. On January 17, 2002, a large part of the city center was destroyed by an eruption of Mount Nyiragongo, about 20 kilometers (12.4 miles) to the north. Volcano hazard is not a significant risk factor for many towns and cities – and nor is Ebola. Goma is exceptional in being at risk from both.
Outbreaks of Ebola have occurred in the DRC sporadically in 1976, 1994, 2003, 2007 and 2012. The most recent outbreak started on August 1, 2018, and even with the infection of 2,500 and the deaths of more than 1,700, the Ebola virus is still not contained. Endemic hostilities in the DRC make it hard for health organizations to track contacts of those infected, and to operate treatment centers without fear of military attack. Health workers expose themselves daily to lethal infection – and should not be exposed also to armed assault. But they are – two health workers were killed in mid-July.
The worst outbreak of Ebola in the DRC (Democratic Republic of Congo), Africa’s second largest country by area, with a population of over 77 million, has already claimed several hundred lives, and there have been more than three hundred and fifty cases.
Many of the Ebola cases have been in Beni (pop. ~230,000), a major city in North Kivu province, close to the Ugandan border. DRC is a failing state, where the government regime is weak, and cannot prevent militias from pillaging DRC’s abundant mineral resources. One such militia is the ADF (Allied Democratic Forces), which was formed in neighboring Uganda in the 1990s, and operates in the mineral-rich border area in North Kivu province.
The geography of the disease spread is intriguing for epidemiologists. Officially declared on August 1, 2018, this is the tenth outbreak of Ebola in DRC since 1976, but this is the first time that Ebola has affected the far northeast of this vast Central African nation. A crucial risk factor hampering the control of Ebola in this region is the conflict over mineral resources. This has limited the number of inhabitants who can be vaccinated, and restricted the access of health response teams, who are exposed to personal danger such as physical assault and kidnapping. Indeed, insecurity was a factor delaying the alert to the actual start of the outbreak, which was several months before the official declaration.