4 and 13 June 2026
Drawn from two facilitated peer learning convenings of practitioners already in affected and adjacent zones, on 4 June 2026 (cross-border, English and French studios) and 13 June 2026 (DRC, French).
Prepared by Reda Sadki (TGLF), 15 June 2026. Reviewed by Panu Saaristo (TGLF) and Charlotte Mbuh (TGLF).
For Bundibugyo virus disease (BVD) response working groups in DRC, Uganda, and at the regional and global level.
How to cite: Sadki, R., & Mbuh, C. (2026). BVD Listening and Learning brief: DRC and Uganda peer practitioners (Version 1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.21873679
A note on terminology used throughout this brief. Bundibugyo virus is abbreviated BDBV. The disease it causes is BVD. Ebola virus is EBOV, and the disease it causes is EVD. Diseases have outbreaks, not viruses, so this brief refers to a BVD outbreak and an EVD outbreak, never to a virus outbreak.
A note on method and provenance. Quotes are verbatim and attributions are verified against attendance registers. Translation from French to English was carried out by TGLF using Claude Opus 4.7. The notes, attributions, and translations were validated by Patrice Bamulenga, TGLF leader based in Kinshasa, who was a lead organizer in both convenings.
Responsible for this document. Patrice Bamulenga, Foundation DRC representative, is the operational focal point for working groups, technical groups, and coordination meetings, reachable through the Foundation. The Foundation does not currently fund a dedicated role for this work.
What is novel in this brief, and what is not
The case numbers, case fatality ratio, treatment-centre occupancy, and alert investigation rate are not embedded here, because embedded live figures are out of date the moment they are typed and crude live-event ratios invite amateur interpretation. For current figures, consult the authoritative sources directly: WHO and WHO AFRO, Africa CDC, and INRB Kinshasa for laboratory confirmation.
The novel content is below the threshold of those sources. Five items, ranked by novelty and by the decision they imply for a working group.
| Rank | Finding | Type | Decision implied |
|---|---|---|---|
| 1 | Red Cross safe and dignified burial staff attacked. Two senior DRC practitioners and one Uganda practitioner take opposed protocol positions on family or customary attendance. The phenomenon itself is not new, and a decade of SDB learning offers an established middle path . | Protocol question, not in bulletins | SDB working group must take a defensible position grounded in existing WHO SDB guidance. |
| 2 | Diagnostic delay of approximately one month between first community-clustered deaths and strain confirmation, because Bunia Level 2 laboratory PCR cartridges did not match the Bundibugyo strain. Partly closed by RADI-1 cartridges and mobile labs at Mongbwalu, but the cross-border equivalent in Uganda is not confirmed. | After-action quality, with a specific named fix | Laboratory working group confirms RADI-1 stock at every relevant Level 2 facility within seven days. |
| 3 | Population scepticism on the existence of BVD remains a majority view in Watsa health zone, 14 kilometres from the Mongbwalu epicentre, after one month of mobilisation and radio sensitisation. Raw KoboCollect data available. | Below-threshold quantitative signal | RCCE-SBC working group triangulates with social listening and adjusts message and channel mix in the next coordination cycle. |
| 4 | The interval between the first community-clustered deaths in April 2026 and the strain confirmation in mid-May 2026 was filled by mystical explanations in the community. Lateral alert escalation from Level 2 to INRB was not triggered when the first sample was negative on panel. | Surveillance gap, named cause | Surveillance working group reviews escalation rules for negative-on-panel samples in flagged zones. |
| 5 | Fear-driven IPC failures observed in the Uganda response in a private facility where a suspect case was left until incident command arrived. Verbatim operational script offered for front-line briefings. | IPC gap, cross-border applicable | IPC working group confirms private-sector inclusion in front-line IPC briefings, with the offered script. |
Finding 1. Protocol question, safe and dignified burial in the Bundibugyo strain context
Two senior DRC practitioners and one Uganda practitioner take opposed positions, on the record, on whether family or customary burial-keepers should be allowed to participate in the burial of an EVD or BVD victim, with PPE.
The trigger event is on or around 11 June 2026.
Marlène Kapinga Mulumba, TGLF Ambassador and Chief of Service at the national Directorate of Continuing Education in DRC, reported in the 13 June session:
“Two days ago, we received information that the people from the Red Cross are being attacked. Why are they being attacked? We know our African cultures and traditions: when there is a death, you must be present for your family member. But in the context of the disease, specifically the Bundibugyo strain, you cannot be present. That is how a psychosis sets in within the population, who say that they are lying. The population tries to go and take the body, and that multiplies the cases. If family members are to be allowed to be present, they must be given the equipment.”
Source: Marlène Kapinga Mulumba, 13 June 2026
Dr Évariste Kayembe, GBV specialist at the DRC Health System Development Programme Management Unit, on mission to Bunia and Rwampara two weeks after the official declaration, reinforced the position and extended it to community members customarily responsible for burials:
“We have seen teams who conduct safe and dignified burials being threatened. That is because, within the community, there are people who are usually in charge of burial. We need to lean on those people, build their capacity, give them personal protective equipment so that they themselves can conduct the burials of their community members. When you bring in teams from elsewhere to bury the dead in the villages, that creates a cultural problem.”
Source: Dr Évariste Kayembe, 13 June 2026
The opposed position was stated on 4 June by Dr Hilary Okello, Lera City Council, previously directly involved in the Gulu response:
“In Africa, what people still try to cling to so much is the burial of their loved one. Once somebody has died of Ebola, let the burial team handle, not you the family member. And this one should be done with all the precautions, because I remember the other one in Gulu, what made it spread most was at the burial site.”
Source: Dr Hilary Okello, 4 June 2026
Context from established SDB practice. The tension above is real, but the phenomenon of family resistance to externally led burials is not new, and it is not unusually prevalent or violent in this outbreak compared to past responses. A decade of SDB learning offers an established middle path that the working group does not need to reinvent. Strong SDB teams are the most coherent, skilled, and experienced available, include a cultural mediator, have a strong supervisor, negotiate so that one or two family members in full PPE participate while others observe at a safe distance, and assign each family member in PPE a dedicated safety observer. WHO guidance on safe and dignified burial should be the reference point for the working group.
Decision implied for the SDB working group. A current SDB protocol that substitutes for the family is being violently rejected in some Ituri zones. A modified protocol that admits the family or customary burial-keeper with PPE, as the established middle path already provides for, has cultural-acceptance reasons in its favour and operational risks against. The working group must take a defensible position grounded in existing WHO SDB guidance, not leave the tension to be resolved by attack and counter-attack on the ground. The two named DRC practitioners and Dr Okello have offered to co-author a protocol-question paper on the specifics, in dialogue with SDB technical leads.
Finding 2. Laboratory gap. RADI-1 cartridges and the one-month diagnostic delay
Dr Évariste Kayembe stated in the 13 June session what had been a quiet operational fact through April and May:
“Our organisation had supported the rehabilitation of the large Bunia laboratory, with World Bank funding. But the device that allowed diagnosis was the PCR. This strain of the virus could not be detected by that. There had to be the cartridges, the RADI-1 device. That is how the first detections were made from INRB Kinshasa. Our project then brought considerable support in strengthening the capacity of the laboratory so that the diagnoses could be made locally with mobile laboratories, notably at Mongbwalu.”
Source: Dr Évariste Kayembe, 13 June 2026
On 4 June, Dr Géou Molékou, WHO consultant and epidemiologist, had put the structural question:
“We learned that the alerts that went up to the Bunia labs had a problem of cartridges. That means that for the reading, to do the analysis of the Bundibugyo strain, you do not have cartridges for that, you rather have cartridges for the Zaire strain. How is it that, already, the sixth epidemic in 2012 here in Tuelet, it was the Bundibugyo strain. How is it that you could not have that cartridge to be able to detect in time with the alerts that you had?”
Source: Dr Géou Molékou, WHO consultant, 4 June 2026
Decision implied for the laboratory working group. A laboratory readiness check on RADI-1 cartridge availability is owed across every Level 2 and mobile laboratory in scope, including Bundibugyo district in Uganda and the border corridors. The cross-border 2007 and 2012 history of the Bundibugyo strain means this is a strain-specific readiness gap that any country in scope can verify in days. The Foundation can convene Dr Kayembe and Dr Molékou to draft the check list and the supply path.
Finding 3. RCCE-SBC effectiveness check. Watsa health zone, KoboCollect survey, 14 kilometres from epicentre
Pasiko Eza, TGLF Ambassador and health zone focal point in Durba, Ituri, conducted a community perception survey with peers in Kinshasa, using the KoboCollect application that the public health sector uses for household surveys.
The survey was self-designed, self-funded, and executed within days of the official declaration.
“With friends from Kinshasa, we thought of using a KoboCollect application to see the perceptions of the population towards this epidemic. A field descent was carried out, and we collected some data. Unfortunately, the data collected revealed a critical flaw. A major share of the local population remains profoundly sceptical of the existence of the Ebola virus disease.”
Source: Pasiko Eza, 13 June 2026
Decision implied for the RCCE-SBC working group. One month after the official declaration, after intensive radio sensitisation, the majority position in Watsa zone is denial of the disease. This is a clean operational failure signal for the RCCE-SBC pillar in that zone. Triangulate with whatever social listening is in place. Adjust message and channel mix. The instrument and raw data are available on request to the working group.
Finding 4. Surveillance gap. One-month delay from first community-clustered deaths to strain confirmation
From Dr Eli Mutombo, DRC TGLF Ambassador and epidemiology specialist on the national response team, on 4 June:
“The little history for this epidemic in our country is that it started from the month of April, but all the alerts that were going up were not giving us the real situation. It is only in the month of May, around 5 May, that we asked for samples that had been taken to go up to Kinshasa, to the national laboratory, so that the analyses could be deepened. Because at the level of Ituri province, we had already tested the first sample which was negative for almost everything as virus in these corners.”
Source: Dr Eli Mutombo, DRC national response team, 4 June 2026
The interval between the first community-clustered deaths and strain confirmation was filled by mystical explanations in the community, well documented in the 4 June dialogue.
The documented index alert was on 5 May 2026, and the four health-worker deaths occurred at Mongbwalu General Referral Hospital in Ituri, from which cases then spread to Rwampara and Bunia.
Decision implied for the surveillance working group. Review lateral escalation rules for negative-on-panel samples in zones with clustered unexplained deaths. The Level 2 panel did not contain Bundibugyo. The escalation to INRB Kinshasa was triggered three to four weeks later than it could have been. The same pattern can recur in any of the affected Ituri zones or in the Ugandan border districts. The fix is procedural and inexpensive.
Finding 5. IPC gap, private sector, fear among front-line staff
From Dr John Kamulegeya, epidemiologist with Makerere Faculty of Health Sciences supporting the immunisation division of the Ministry of Health, contact tracing and surveillance lead in the Uganda response, on 4 June:
“There is fear in every health worker, among health workers, about Ebola and the possibility of contracting EVD. In one of our areas, in a private facility, a suspect Ebola case came in. And most of the private facilities do not have trained personnel and lack IPC PPE to handle this. So everyone almost left the patient there until we had to call in the incident command, and then they had to come in and support the team.”
Source: Dr John Kamulegeya, 4 June 2026
His verbatim operational response, offered as a script that front-line briefings can adopt without modification:
“You can protect yourself from getting Ebola infection if you strictly observe infection prevention and control. So it is okay to take care of this patient, but you need to take care of yourself, observe the infection prevention and control, and I call the technical people to take care of the situation.”
Source: Dr John Kamulegeya, 4 June 2026
From Dr Hilary Okello, on the supply consequence:
“The implementing partners, some of the IPC, especially those IPCs which are needed at the facility, in the community, provide them, let them be available. Never leave the health workers in the front line to be at the risk of working without the IPCs.”
Source: Dr Hilary Okello, 4 June 2026
Decision implied for the IPC working group. Confirm that private-sector facilities in trade and mining hubs across affected and adjacent zones are included in IPC briefings and PPE distribution, and adopt the offered script. The Uganda case shows the failure mode without script and without supply. PPE references in briefings should give the regional standard equivalence, for example an N95/FFP2 or higher respirator under EN 149, rather than the US standard alone.
Secondary findings, less novel but still relevant
Cross-border economic geography. Fort Portal corridor
From Dr Bwango Benjamin, medical doctor with MPH, Fort Portal, Uganda, on 4 June:
“From Fort Portal to Bundibugyo, they are just a few kilometres. We have one district, Amidish, then you are already in Bundibugyo district. We use the markets with those people from Bundibugyo. The regional referral for the region is also found in Fort Portal. Those people in Bundibugyo come towards this side of the border for exchange markets and so on. Even they normally come gather for prayers. Even recently as Uganda, we normally celebrate Martyrs Day, which occurs every 3 June. And it was even suspended.”
Source: Dr Bwango Benjamin, 4 June 2026
Decision implied for the Uganda-side coordination. Markets, the regional referral hospital, and religious gatherings are the specific vectors named. The 3 June Martyrs Day suspension is precedent for similar precautionary measures around future gatherings.
Adjacent-province preparedness. The rumour-before-cases moment
From Toyi Mirefu, TGLF Ambassador in Bukavu, South Kivu, on 13 June:
“There are not yet many cases recorded in the zone. People are not awakened like in Ituri province. In Ituri, in Bunia, in North Kivu, people are already aware and starting to learn well. Even at school, I was talking with my sister who is in Bunia. She said that even at school, it is her little girl in nursery school who comes home with the preventive measures.”
Source: Toyi Mirefu, 13 June 2026
Decision implied. Pre-positioning of rumour-response capacity in not-yet-affected provinces is the lower-cost moment to act, before the rumour has organised the population. Mitumoresa health zone in South Kivu is the one affected zone in that province and an entry point.
Security as a response pillar in conflict-affected zones
From Joseph Baroani Kikuni Jobacky, expert at the DRC Ministry of Public Health, Hygiene and Prevention and inspector chief of pole at the General Inspectorate of Health:
“When this disease appears in a zone in conflict, in the east, we add the security pillars. You cannot carry out your supervision without the security elements authorising you, because the zone is in conflict.”
Source: Joseph Baroani Kikuni Jobacky, 13 June 2026
Status. Already known to most managers operating in Ituri. Restated here because it shapes the feasibility of every operational item above.
Open operational questions raised in-network
Two of the four questions below have known answers, so they are answered here, with the explicit caveat that the drafted answers still await expert validation, the same validation bottleneck that delays the Foundation primer.
The remaining two are left open as genuine in-network questions for a response manager to answer, with named multiplier effect.
- Can a person in the incubation period contaminate others? A person infected with EBOV or BDBV is generally not contagious during the asymptomatic incubation period, and transmission risk arises once symptoms begin. Asked by Trésor Ntumba Kalonji, Mbujimayi, in chat, 13 June 2026.
- What is the operational difference between EVD and BVD for a midwife at a health facility? For a midwife at the point of care, the IPC precautions, case-recognition triggers, and referral pathway are functionally the same for EVD and BVD, with the principal practical difference being that the GeneXpert panel may return negative for the Bundibugyo strain, so a negative result must not relax precautions in a clinically suspect case. Asked by Guédé Noël, midwife inspector, 4 June 2026.
- What is currently being done in the field to fight the infodemic on social media? Left open for a response manager to answer. Asked by Oger Mulange, in chat, 13 June 2026.
- Are there enough IPC inputs on the ground in the affected zones? Left open for a response manager to answer. Asked by Oger Mulange, in chat, 13 June 2026.