Date of Award

5-15-2020

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Gerardo Chowell

Second Advisor

Dr. Monica Swahn

Abstract

Background: The Democratic Republic of Congo is actively experiencing its tenth outbreak of Ebola Virus Disease. This outbreak is the second-largest in history. This outbreak of Ebola virus is taking place in North Kivu and Ituri provinces in the eastern part of the country. The North Kivu and Ituri provinces are two of the most populous, conflict-torn, provinces in the DRC, and border three other countries, Rwanda, Uganda, and South Sudan. This current outbreak has been marked by numerous attacks against health care services and the inability to bring this outbreak to a swift end like the outbreak in Équateur province DRC.

Aim: The intent of this thesis is to quantify the frequency of attacks on health care using publicly available data in order to have a better understanding of how violent attacks towards health care are impacting the Ebola response efforts in North Kivu and Ituri provinces.

Methods: This study is a cross-sectional examination of data collected from publicly available resources to characterize the violence towards the Ebola response teams. This study includes data from the Surveillance System for Attacks on Health Care published by the World Health Organization, data collected from local media outlets, social media, international organizations, universities, and non-profit organizations.

Results: There were 102 attacks that were confirmed to have taken place in one of the two affected provinces. The peak of violence towards health care in the DRC occurred during May 2019. Health care facilities were the most affected health care resource. Also, more attacks occurred in North Kivu province compared to Ituri Province.

Conclusion: Our study, one of the first to demonstrate the prevalence and context of violent attacks related to health care resources and delivery during a health crisis, indicates the need for deliberate planning and preventative measures when mitigating an infectious disease outbreak during an active conflict.

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