Ebola update and what it means for social work and social development

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The Ebola outbreak in the Democratic Republic of Congo, first confirmed in Ituri province in May 2026, is now one of the largest on record and is spreading faster than any previous outbreak of the disease. For social workers and social development practitioners, the numbers matter less than what sits behind them: children losing both parents within days of each other, communities that no longer trust the people sent to help them, and households pushed deeper into hunger because a market or a field became unreachable. This post sets out where the outbreak stands and what it is asking of our profession, including what an Ubuntu and indigenous health lens adds to that picture.

Where things stand

According to the World Health Organization’s most recent published update (28 August 2026), the outbreak has caused 5,794 confirmed cases and 2,786 deaths in the DRC, with a case fatality ratio of 48.1 percent. A further 20 cases have been confirmed in Uganda, one in France and two in Germany. The outbreak now spans six provinces and 60 health zones, with Ituri province still the epicentre at 4,802 cases, while North Kivu, though smaller in case numbers, has recorded a case fatality ratio of 68 percent. A vaccination campaign using the Ervebo vaccine began on 27 August, and a clinical trial of new treatments has enrolled more than 250 patients. Contact tracing teams report an 82.3 percent follow up rate. The WHO Emergency Committee met again on 18 August and kept the outbreak classified as a public health emergency of international concern.

The virus involved is Bundibugyo ebolavirus, a strain distinct from the Zaire species behind most past outbreaks, including West Africa in 2014 to 2016 and the DRC in 2018. There is no vaccine or treatment developed specifically for this species, and existing tools were built for a different strain.

Why this outbreak is moving so fast

WHO’s director general has described this as already the second biggest Ebola epidemic on record, and moving faster than any before it. It reached 250 deaths in 37 days, compared with 78 days during the West African epidemic. It passed 1,000 confirmed cases in 38 days, compared with over 230 days during the 2018 DRC outbreak. Several factors are behind this speed. Early cases were likely misdiagnosed as malaria or typhoid for months before the outbreak was officially declared. More than 80 percent of cases reported in July could not be linked to a known contact, meaning transmission chains have become difficult to trace. Health workers are short of protective equipment and dozens have died. Armed conflict in eastern DRC restricts movement, disrupts response operations and deepens distrust of outside authorities. The Bundibugyo strain itself appears to replicate more slowly than other Ebola species, which has earned it the description “walking Ebola” because people can carry and spread it before becoming visibly unwell.

That last point matters for anyone working in these communities. A slower moving illness is not a gentler one. It gives the virus more time to travel through households, markets and funerals before anyone realises it is there.

The toll on children and families

By 21 August 2026, 100 days into the outbreak, at least 180 children had lost both parents or primary caregivers, and a further 114 children were temporarily separated from parents receiving treatment. More than 330 children have died from the virus and at least 800 have been infected. Save the Children has set up observation care centres where children can stay safely, with psychosocial support, during the 21 day surveillance period while parents are treated or while their own exposure is monitored. Agencies working on the response are explicit that health measures alone are not enough. Children in this situation face real risks of trafficking, exploitation and abuse if alternative care, mental health support and community based child protection are not in place alongside the medical response.

Community trust and why it matters

Resistance to the response has been a recurring feature of this outbreak. Treatment centres have been burned in Rwampara and Mongbwalu. Patients have escaped isolation. Health workers and burial teams have faced hostility, and some households have concealed cases rather than report them. A commentary published in the Journal of Interventional Epidemiology and Public Health traces this back to fear, mistrust of response institutions, and measures that clashed with local social norms and religious practices. Where communities were not consulted early, and where interventions felt imposed from outside, resistance followed.

The same commentary sets out what a different approach looks like. Social scientists, anthropologists, behavioural scientists and communication specialists should sit inside response teams alongside epidemiologists, not be brought in once things have already gone wrong. Relationships built before an outbreak begins are worth more than any emergency campaign. Community health workers, local and religious leaders, women’s groups and youth representatives are the people communities already trust, and they need to be part of the response rather than messengers for it. Engagement has to run both ways, addressing concerns and correcting misinformation rather than simply issuing instructions. Some responders are now tracking community trust itself as an indicator alongside case counts, which is a useful marker of how seriously this lesson is being taken.

Ubuntu and the ethics of going into communities

Most of the resistance described above did not come from ignorance. It came from an approach that treated communities as a problem to be managed rather than as a set of relationships to be respected. Ubuntu, the worldview described in African social work literature through the saying “a person is a person through other persons,” offers a more accurate map of what an outbreak response actually walks into. It links the individual and family, the community, the wider society, systems of governance, the land and environment, and spiritual life as one connected whole, not as separate boxes a health team can tick off one at a time.

Applied to Ebola, this means a household deciding whether to report a sick relative is not making a private medical choice. It is weighing family obligation, what the community and its leaders will think, what local government officials might do, what the land and ancestors are understood to require around death and burial, and what elders and spiritual leaders say is the right response. A team that only speaks the language of infection control will miss most of what is actually being decided.

This is where the San Code of Research Ethics is useful well beyond research. Developed by the San people of southern Africa after decades of being studied without consent or benefit, its central instruction is to come through the door, not the window. Respectful entry means approaching a community through its own recognised leaders and structures, being honest about purpose in plain language, sharing benefit rather than only extracting compliance, and staying answerable for how the relationship is conducted, including after the immediate work ends. The treatment centres burned in Rwampara and Mongbwalu, and the patients who escaped isolation, are what happens when outside teams arrive through the window instead, moving on a public health timetable without first being let in.

Exit matters as much as entry. Practice grounded in Ubuntu does not end a relationship the moment a case count falls or funding runs out. Elders and community structures that opened the door during the emergency are still there afterwards, and how a response team leaves shapes whether the next request for entry, whether for Ebola, another outbreak, or an unrelated social work programme, is met with cooperation or refusal.

Indigenous health knowledge and the outbreak response

The World Health Organization defines indigenous health as the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, that are used to maintain health, and to prevent, diagnose, improve or treat physical and mental illness. WHO’s African Region estimates that around 80 percent of the population across the continent relies on this knowledge for basic health needs, and by 2022 more than 40 African countries had developed national policies to recognise and work with it.

In an outbreak like this one, that reliance is not background information. Families affected by Ebola are not choosing between indigenous healers and hospitals in the abstract. Many will consult a healer, a religious leader or an elder before, alongside, or instead of a clinic, particularly where health facilities are scarce, distrusted, or hours away on foot through conflict affected terrain. Burial, which sits at the centre of Ebola transmission risk, is also where indigenous and spiritual understanding of death is strongest, which is part of why safe and dignified burial protocols that ignore this understanding have met the most resistance.

Treating indigenous health as an obstacle to be overcome has not worked well in this outbreak or in earlier ones. WHO’s own guidance, going back to its 1978 recommendation that indigenous birth attendance be incorporated into national health systems, points the other way, toward integration rather than substitution. For a response and a recovery effort to hold community trust, indigenous healers, birth attendants and spiritual leaders need to be treated as a parallel and legitimate part of the health system, brought into surveillance, referral and community communication, rather than worked around.

Hunger, displacement and social protection

The outbreak has landed on top of an existing hunger crisis. Across the DRC, 26.5 million people are already acutely food insecure, and around 8.7 million people in the worst affected eastern provinces face crisis level hunger or worse. The outbreak adds to this directly. Farmers cannot reach their fields, markets close, and movement restrictions disrupt supply chains, while households lose income at the same time as food prices rise. The 2014 to 2016 West African outbreak pushed hundreds of thousands of people into severe hunger through the same mechanism, and the pattern is repeating. Food insecurity and Ebola then reinforce each other: people who are already malnourished are more vulnerable to the disease and recover from it less well.

What this means for social work practice

Child protection work is immediate and concrete. Family tracing and reunification, alternative care arrangements, and psychosocial support for children who have lost caregivers or been separated from them all need to happen quickly and well, drawing on the lessons of earlier Ebola responses about safeguarding children in care centres from exploitation. School reintegration, and the anti stigma work with teachers and peers that makes it possible, matters as much as the placement itself.

Bereavement and psychosocial support extend beyond children. Survivors often return to communities that treat them with suspicion. Families are grieving under restricted burial practices that limit the rituals they would normally rely on. Health workers and burial teams carry both physical risk and the social cost of being feared by the people they serve. All of this is social work territory.

Community based practice is where the outbreak literature is most directly asking for our skills. The case for embedding social scientists and communication specialists in response teams, for working through trusted community intermediaries, and for treating engagement as dialogue rather than instruction, describes core social work method. Where health authorities have relied on top down messaging, that approach has visibly failed, and it is a strong argument for social workers and community development workers to be part of outbreak response structures rather than adjacent to them.

None of this works without Ubuntu as method rather than principle. Entering a household or a village to trace contacts, refer a case, or place a child in alternative care means going through recognised family and community structures first, in line with the San Code’s instruction to come through the door, not the window, and with proper respect shown to elders and local leaders at every step. It also means treating indigenous healers, birth attendants and religious leaders as colleagues in a shared health system rather than as competitors to be sidelined, since they are often the first and most trusted point of contact families have.

Case management also has a social protection dimension. Affected households need support connecting to cash transfers, food assistance and livelihood help, particularly given how directly this outbreak is compounding the existing hunger crisis. Advocacy matters here too, because social protection funding for an epidemic is competing with funding needs from conflict and displacement in the same region.

What this means for social development

The deeper lesson is about what let this outbreak accelerate the way it has. Delayed detection, health worker shortages, armed conflict and a fragile health system did not appear because of Ebola. They were already there, and the virus moved fast because of them. Social development work in fragile and conflict affected settings has to treat epidemic preparedness as part of the same agenda as health system strengthening, food security and protection, not as a separate emergency category that gets attention only once an outbreak is declared.

The community engagement lessons from this outbreak point the same way. Relationships and trust cannot be built during a crisis at the speed a crisis demands. They have to exist beforehand, which means investment in community structures and local leadership between outbreaks, not only during them. Coordination across health, protection, education and food security sectors, rather than each running its own response in parallel, would also reduce the gaps that this outbreak has exposed, particularly for children moving between health facilities, care arrangements and schools.

Ubuntu’s holistic view, linking family, community, society, governance, environment and spirituality, is also a useful check on how social development systems are designed. Systems built only around clinics, cash transfers and case files will keep missing the indigenous health structures, elder authority, and land based and spiritual meaning that around 80 percent of the population already relies on. Recognising and resourcing this parallel system, as WHO’s own regional guidance already calls for, is part of building health and protection systems that fit the societies they serve, rather than systems communities have to be persuaded to fit into.

This outbreak is not finished, and the figures in this post will be out of date within weeks. What is likely to hold is the shape of the response gap: health measures are being delivered, but the social infrastructure needed to make them work, trusted relationships, protected children, supported households, indigenous health systems brought in rather than bypassed, is still catching up. That is where social work and social development have the most to contribute, and where the need is most immediate.

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