When Vianney Kambale Kombi thinks about Ebola, painful memories resurface from his time in Beni, the bustling commercial crossroads of eastern Congo that became a flashpoint during one of history's most severe disease outbreaks. The 2018-2020 crisis claimed more than 2,200 lives across over 3,400 confirmed cases, a toll second only to the West African epidemic of 2014-2016. Yet as Congo now grapples with a fresh outbreak triggered by the rare Bundibugyo virus—already claiming 101 lives among 550 confirmed cases as of June—survivors are sounding an urgent alarm about repeating the mistakes that allowed the previous epidemic to spread so rapidly.

Kombi's journey through the disease itself was harrowing, but what struck him most profoundly was the wall of disbelief that surrounded the outbreak in his community. When Ebola arrived in Beni, many residents rejected the notion that a deadly virus was in their midst. Instead, explanations rooted in traditional belief systems took hold. "We thought it was witchcraft," Kombi recalled, describing how the gap between scientific understanding and local interpretation became a barrier to survival. This wasn't mere superstition—it was a rational response from people whose lived experience with colonial medicine, government neglect, and external exploitation had taught them to view Western medical narratives with profound scepticism. The community's collective rejection of the disease's reality meant that families hid symptoms, avoided treatment centres, and continued traditional practices of touching and preparing deceased bodies, all of which accelerated transmission.

The conspiracy theories that circulated proved equally damaging. Some residents believed Ebola was a fabrication designed to funnel international funding into the region, or alternatively, a scheme by political opponents to undermine a particular community or ethnic group. Bienfait Wanzire, another survivor from the 2018 outbreak, described how these competing narratives fractured the community's ability to respond coherently. "When a pandemic hits here in Congo, we initially think it's a political issue," Wanzire explained. For a population accustomed to viewing health crises through the lens of political calculation, treating Ebola as a genuine medical emergency required overcoming layers of historical mistrust. Some initially attributed the outbreak to spiritual affliction, while others, influenced by the timing of electoral campaigns, saw it as manipulation by political rivals. This fragmentation of reality—where multiple contradictory explanations coexisted—proved catastrophic for public health messaging.

The human cost of community rejection fell heavily on health workers operating in Beni. Dr Babah Mutuza Lusungu, a physician at "Dieu Est Grand" Medical Centre, witnessed firsthand the resistance that met his efforts to mobilise a response. Beyond the emotional weight of losing colleagues and family members to a disease he was fighting to contain, Dr Lusungu confronted the structural challenge of operating in an environment of pervasive mistrust. The atmosphere in Beni became poisoned by mutual suspicion among the population, local authorities, international health partners, and the very medical professionals attempting to save lives. Health workers faced physical attacks and harassment from community members who viewed them as vectors of the disease or agents of some larger scheme. This hostility created a vicious cycle: as health workers retreated or became less effective due to security concerns, cases multiplied, and community scepticism deepened.

The generational dimension of this crisis demands particular attention as Congo now faces the prospect of repeating these failures. Dr Lusungu has emphasised that young people were largely sidelined from the 2018 response, missing the opportunity to become trusted messengers within their own communities. Youth have distinctive social standing and credibility networks that differ from government health authorities or international agencies. Yet they were not systematically engaged to explain the outbreak, counter misinformation, or encourage testing and vaccination. Dr Lusungu's assessment suggests that any effective response to the current outbreak requires identifying youth leaders—both formal and informal—and equipping them with accurate information to disseminate through channels their peers actually trust. Early action through these networks, he argues, is essential; by the time official case numbers climb dramatically, critical windows for preventing transmission have already closed.

The psychological and social aftermath of surviving Ebola created a different kind of barrier to community resilience. Esperance Masinda, who contracted the virus while caring for her husband as part of her work with UN children's agency UNICEF, experienced the profound stigma that attached itself to survivors. Even after recovery—made possible by the vaccines deployed during the 2018-2020 crisis—survivors faced social ostracism. Masinda was told by neighbours that she would not survive five years, that the medications she had received would ultimately kill her, and that her recovery was impossible or fraudulent. The discrimination extended beyond whispered doubts to active social rejection, as family and community members kept their distance from those who had survived, as though proximity to recovery somehow transmuted into proximity to death.

The experience of Masinda and others points to a critical but often overlooked dimension of epidemic response: the need for sustained community engagement after the acute phase has passed. Survivors embody living proof that Ebola is both real and survivable—a combination that powerfully rebuts the various myths that circulated during the outbreak. Yet in the aftermath, these individuals were isolated rather than mobilised. Had authorities worked systematically to integrate survivors into community education efforts, to have them speak publicly about their experiences, and to normalise their presence in daily life, the foundation for responding to future outbreaks would have been substantially stronger. Instead, stigma calcified, and when the new outbreak emerged, the lessons from previous survivors remained largely untransmitted.

The current outbreak of Bundibugyo virus presents Congo with a test of whether these hard-won insights have penetrated government and international response structures. The earlier epidemic benefited from the deployment of effective vaccines that were ultimately crucial in bringing the outbreak under control. However, the new outbreak lacks an approved vaccine, placing even greater emphasis on the fundamentals of community trust, transparent communication, and rapid case identification. Without the pharmaceutical backstop that vaccines provided, the response depends entirely on the speed and coordination of testing, isolation, and contact tracing—all of which fail catastrophically when communities do not cooperate.

Kombi's reflections on reintegration after his recovery underscore the long arc of recovery required beyond the epidemiological definition of an outbreak's end. He described the initial difficulty of rejoining his community, of rebuilding social bonds after being treated as a vector of death. This process, he has come to understand, is not instantaneous. It requires deliberate community processes of welcome, acknowledgement, and normalisation. In the face of the new outbreak, Beni and surrounding areas must draw on these survivor narratives not as historical footnotes but as actionable guidance for building the social cohesion necessary for effective epidemic response. The window for learning from the 2018-2020 crisis remains open, but only if authorities and communities actively listen to those who lived through it.