Mass displacement due to ethnic conflict may contribute to the spread of Ebola outside of the Congo.

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Conflict between ethnic groups in the Democratic Republic of Congo has displaced more than 300,000 people in the Ituri province since the beginning of June, making it difficult to contain another of the region’s most dangerous threats — the Ebola virus.

Violent exchanges between the Hema herder and Lendu farmer groups have resulted in 161 deaths in the last week, officials said on Monday. Aggressive attacks from both groups are responsible for the high death toll, with additional reports of kidnapping and sexual abuse.

Hema herders and Lendu farmers have historically clashed over grazing rights and political representation, with the groups fighting a five-year war starting in 1998 that claimed thousands of lives. If such violence became widespread again, it would displace more people and pose health risks to neighboring Uganda, as large numbers of Ebola-infected people may be forced to cross Lake Albert to find refuge.

The government is working to gain control and mitigate the conflict, but the UN Refugee Agency (UNHCR) believes that the violence could overtake the province, increasing casualties and displacement, according to spokesman Babar Baloch. The UN peacekeeping mission has formed three temporary military bases in the Djugu and Mahagi territories in Ituri and dispatched teams to work with locals to prevent the violence from escalating and forcing people to flee.

Official figures show that around 800 Congolese cross into Uganda every day through the Mpondwe border post, but that number does not reflect the many people entering the country illegally through unguarded footpaths. Though Uganda has been vigilant in its Ebola prevention efforts — including screening travelers at the border and vaccinating health workers — these unauthorized travelers evade medical observation and treatment, and could unintentionally cause the international spread of the epidemic.

“We are always saying the mobility of the population in North Kivu and Ituri is a risk factor,” World Health Organization spokesperson Tarik Jasarevic said.

Ebola is a highly contagious virus contracted through contact with an infected person’s bodily fluids through broken skin, the mouth, or nose. Symptoms include fever, extreme weakness, muscle pain, and sore throats, and the disease eventually causes vomiting, diarrhea, and internal and external bleeding. An experimental vaccine has proven to be effective and is being implemented widely.

“Every time you have people moving in high numbers, it’s more complicated to work on [patient] follow-ups: contact-tracing, follow-ups on people basically who are supposed to be observed on a daily basis, or for 21 days [the length of Ebola's incubation period],” he added.

Since the presence of the disease was confirmed in the Congo last August, it has infected 2,168 people and killed 1,449, as of Tuesday. Approximately 10% of all infections and deaths in the country occurred in Ituri.

Last week, Ebola claimed its first life in Uganda when a 5-year-old Congolese boy crossed the border with several of his family members, who had also been exposed to the disease. His grandmother, age 50, died just a day later. All their other family members agreed to return to the Congo to participate in clinical trials; however, 112 people in Uganda have been flagged as having come into contact with an Ebola-infected person so far.

“The numbers are overwhelming,” Primrose Natukunda, a branch manager with the Uganda Red Cross, said. “So, it’s not easy. It’s constant. Every minute you have to be on alert.”

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