For doctors and nurses battling mpox in the Democratic Republic of Congo, the virus itself is not the only enemy. They also face circulating rumors and misinformation.
The first of millions promised doses of the mpox vaccine have finally begun to arrive. Now the focus is on ensuring that people who need them get them when the vaccination campaign begins next month, and educating wider communities on how to protect themselves.
Conspiracy theories circulating in the country suggest, among other things, that mpox was invented by white people to sterilize Congolese people with vaccines – or that it is simply a money-making model for pharmaceutical companies. Distrust in medical institutions and treatments there is in many cases a legacy of racist colonial policies.
“You see this kind of disinformation – and it spreads (faster) than normal information,” said Dr. Junior Mudji, head of research at Vanga Hospital in western DRC.
About 26,000 cases of mpox have been reported in the DRC this year. Officials are working to dispel myths, educate people on how to prevent infection and where to get treatment, and lay the groundwork for vaccine acceptance.
The vaccination campaign is likely to be highly targeted, initially offered to frontline healthcare workers and other groups at particular risk, including contacts of known cases. However, information on prevention and self-care, including the importance of regular handwashing, should reach everyone.
Poll Of nearly 200,000 people in the DRC this month, conducted by the UN children’s agency Unicef, only 56% had heard of mpox. Knowledge of symptoms, and how the virus was transmitted and could be prevented, was patchy.
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 the conflict and, Mudji stressed, “There is a problem of trust between politicians and the population.”
He recently participated in a televised interview about mpox. “From the questions I was getting, it was clear that people don’t have good information. I told them it’s not a disease that comes from American people or European people – it’s been in our country for a while and now we have an outbreak.”
Mudji’s hospital is used to cases of mpox coming in from rural areas, usually after people eat sick bushmeat, and treats about five cases a month, mostly in young children. “We know this disease,” he said.
But historically, it has not been common in the DRC, which is now at the center of an international public health emergency thanks to a new variant that has spread far and wide. India and Sweden. That meant, Mudji said, that “many people don’t know exactly how to deal with these cases.”
Patients with MPOX have long faced stigma, he said. “People find a reason to say, ‘This family, they did bad things, so they were punished.’ It’s not easy, but the only way to combat bad information is to provide good information.”
Conspiracy theories are also commonplace in Goma, the capital of North Kivu province.
“How come epidemics like Ebola and MPOX happen regularly 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 street trader, said: “I believe the epidemic diseases we have at home are produced by foreigners, who are greedy and eager to block Africa’s demographic growth.”
Gershom Risasi, a 60-year-old teacher, said: “Just as paracetamol manufacturers want to sell their wares when there are multiple headaches, foreign pharmaceutical companies may want to sell vaccines and earn billions of dollars. Foreigners are looking for ways to weaken our health and take over the natural resources in the east of our country.”
Dr Rodriguez Kisando, a doctor from Goma, said rumours 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 Congo context, 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.
“That is why we cannot wait for epidemics to break out before we start communicating,” Kisando added.
UNICEF is working with the government to disseminate accurate MPOX information through a network of “community action cells,” whose members include local leaders, religious leaders, frontline workers, teachers, social service workers and women.
Sophie Chavanel, communications expert at Unicef DRC, said: “These groups are informed and trained and then go out into the communities to spread the message, either in public places like markets or motorbike (taxi) stations or the like.
“But they also visit families, house by house, to give the right information. They take a little plastic chair and sit with a mother or a couple of neighbors and start a conversation.
“Because it’s someone from the community, there’s more trust in what they say than what an outsider might say or what they hear on social media,” she says.
Misinformation is not an insurmountable obstacle. The Unicef survey that found low awareness of the virus nevertheless found relatively high willingness to take a vaccine – 75% of people said they would accept one if offered.
“There is not necessarily a high level of hostility. It is more about opening a discussion,” Chavanel said.
“From my experience, and because I’ve been doing this for a while, I can say that making sure people have the right information goes a long way. And it’s really an exchange: listening to people’s concerns and providing answers.”