For doctors and nurses fighting mpox in the Democratic Republic of the Congothe virus itself is not the only enemy. They also face swirling rumors and misinformation.
The first of millions of promised doses of mpox vaccine finally did began to arrive. Now the focus is on ensuring people who need them take them when the vaccination campaign starts next month, and teaching wider communities how to protect themselves.
Conspiracy theories spreading across the country include the suggestion that mpox was invented by white people to sterilize Congolese people with vaccines – or that it is just a money-making scheme by pharmaceutical companies. Distrust in medical institutions and treatments are in many cases a legacy of racist colonial policies.
“You see this kind of misinformation – and it spreads [more] faster than the normal information,” said Dr Junior Mudji, head of research at Vanga Hospital in western DRC.
With about 26,000 mpox cases reported across the DRC this year, officials are working to dispel myths, teach people how to prevent infection and where to seek treatment, and lay the groundwork for vaccine acceptance.
The immunization campaign is likely to be highly targeted and initially offered to frontline health workers and other groups particularly at risk, including contacts of known cases. However, information about prevention and self-care, including the importance of regular hand washing, should reach everyone.
Ballot of nearly 200,000 people in the DRC conducted this month by the UN children’s agency, Unicef, found that only 56% had heard of mpox. There was patchy knowledge of symptoms and of how the virus was transmitted and could be prevented.
It is a challenging arena to disseminate reliable information. The DRC is a vast country with many remote areas that are difficult to reach by road, and less than half of the population has a mobile phone.
Many people have been displaced by conflict, and Mudji stressed: “There is a problem of trust between politicians and the population.”
He recently participated in a broadcast call-in about mpox. “From the questions I received, it was clear that people do not have good information. I told them that this is not a disease that comes from American or European people – it has been in our country for a while, and now we have an outbreak. “
Mudji’s hospital is used to seeing cases of mpox arrive from its rural surroundings, typically after people have eaten diseased bushmeat, and treats about five cases a month, typically in young children. “We know this disease,” he said.
But historically it was not common in the DRC, which is now at the center of an international public health emergencythanks to a new variant which has reached as far as India and Sweden. This meant, Mudji said, that “a lot of people don’t know how exactly to manage these affairs.”
Patients with mpox have long faced stigma, he said. “People will find a reason to say, ‘This family, they did bad things, that’s why they were punished.’ It’s not easy, but the only way to fight bad information is to provide good information.”
Conspiracy theories also abound in the capital of North Kivu province, Goma.
“Why is it that epidemics last Ebola and mpox is a regular occurrence in our country but not in other countries? I think the west wants to weaken us by spreading diseases left and right,” said Irankunda Alice, a 40-year-old seamstress.
Gloire Kikandi, 30, a peddler, said: “I believe that the epidemic diseases we have at home are manufactured by foreigners, greedy for money and eager to block Africa’s demographic growth.”
Gershom Risasi, a 60-year-old teacher, said: “Just as paracetamol manufacturers may want to sell their wares when there are several headaches, so foreign pharmaceutical companies may want to sell vaccines and earn billions of dollars. Foreigners are looking for ways to weaken our health and thereby take over the natural resources in the east of our country.”
Dr Rodriguez Kisando, a doctor from Goma, said rumors had also spread during previous epidemics such as Ebola or Covid-19. “When people don’t have access to information, they believe rumours,” he said.
“In the context of the Congo, epidemics occur at a time when there is a crisis of confidence between the governed and those in power. Some people even believe in conspiracy theories; people think that the epidemics are manufactured abroad.
“Therefore, we cannot wait for epidemics to break out before we start communicating,” added Kisando.
Unicef works with the government to disseminate accurate mpox information through a network of “community action cells”, whose members include local chiefs, religious leaders, frontline workers, teachers, social service providers and women.
Sophie Chavanel, a Unicef DRC communications expert, said: “These groups are informed and trained and then go into communities to spread the word, either in public spaces such as markets or motorbikes. [taxi] stations or the like.
“But they also visit families, house by house, to provide the right information. They take a small plastic chair and they sit with a mother or some neighbors and they start to have a conversation.
“Because it’s someone from the community, there’s more trust in what they say, rather than what an outsider might say or what they hear on social media,” she says.
Misinformation is not an insurmountable obstacle. The Unicef poll that found low awareness of the virus nevertheless found a relatively high willingness to take a vaccine – 75% of people said they would accept one if offered.
“There is not a high level of hostility per se. It’s more about opening up a conversation,” Chavanel said.
“From my experience, and having done this for quite some time, it goes a long way to ensure that people have the right information. And it’s very much an exchange: listening to people’s concerns and getting answers to give back.”
