JOHANNESBURG -- The awarding of the Nobel Peace Prize to a Congolese surgeon brings rare global attention to a region surging for decades with rebel conflict that now threatens efforts to contain a deadly Ebola outbreak.
As Dr. Denis Mukwege describes to the world how he stays in his hospital, protected by United Nations peacekeepers, to avoid further attempts on his life, teams of health workers not far away in eastern Congo feel an uncomfortable kinship as they combat Ebola amid the daily ring of gunfire.
War in the vast region once had the aim of trying to unseat a president, or hunt down those suspected of genocide in neighbouring Rwanda, or simply claim a piece of Congo's trillions of dollars in mineral wealth. Now the conflict has splintered, with dozens of rebel groups traumatizing a population that sometimes has little idea who is behind a deadly attack.
That chaos has brought a steady, horrific flow of women, girls and even babies into Mukwege's hospital as he operates day by day on survivors of the harshest kinds of sexual violence. Women and girls are raped with the barrels of guns. Their genitals are shot or burned. The new documentary "City of Joy" focuses on the survivors and on Mukwege's work.
Trauma can beget trauma, and the emergence in August of the Ebola virus in the jittery region for the first time has posed the kind of challenge many health workers have never seen before. So far 140 Ebola cases have been confirmed including 76 deaths.
Fears and rumours about the virus have spread as quickly as outreach teams can refute them. Some health workers, confronted by angry families or communities, have been attacked as they try to carry out vaccinations or promote safe burials. The virus is spread via the bodily fluids of those infected, including the dead.
Some suspected of having contact with Ebola victims have fled. The World Health Organization worries openly about the virus spreading into "red zones" where the rebel threat is so high that carrying out health work is almost impossible.
"It's a totally unprecedented situation ... potentially explosive," said Anne Rimoin, an associate professor of epidemiology at UCLA who directs teams of researchers in the Ebola outbreak zone. One team member was lightly injured by people throwing stones, she said.
The threat of attack means Ebola efforts are limited to daylight hours as teams and their armed escorts, usually UN peacekeepers but also Congolese security forces, hurry to get off the roads before dark.
"That is very unlike other outbreaks," Rimoin told The Associated Press. With communities "already traumatized by decades of conflict," the presence of armed escorts can bring further anxiety.
Meanwhile, local authorities who have had contact with rebel groups in previous efforts such as routine vaccination campaigns are negotiating with the fighters for urgent access, as any Ebola victim left untracked could cause a new round of cases.
Alarm about the insecurity has grown. Last week after Red Cross workers were attacked and badly hurt, the UN Security Council called for an end to hostilities as it prepared to visit Congo and discuss, among other things, the fighting that has displaced about 1 million people in the Ebola-affected North Kivu province alone.
"An extremely challenging and dangerous environment," WHO director-general Tedros Adhanom Ghebreyesus told the council, describing the attacks since the outbreak began: a "full-scale" assault on a Congolese military base, ambushes of UN peacekeepers, a rocket explosion and an attack on the town at the centre of Ebola efforts that killed at least 18 people and shut down health work for days.
Friday's announcement of the Nobel prize, the first in Congo's history, brought a burst of jubilation and tears in Panzi hospital as Mukwege was finishing his second operation of the day. "Hallelujah," people said, as medical workers in scrubs danced and women wiped their eyes.
The award brought a new round of global calls to end the sprawling conflict and let health workers across the region care for others without fear of violence.
"A durable peace," the UN secretary-general's special envoy to Congo called it while congratulating Mukwege on his win.
But it won't be easy. Even as Congo's government claimed partial credit for the efforts of the Nobel winner, who has been an outspoken critic, the outgoing President Joseph Kabila wants the UN peacekeepers, one of the region's few stabilizing forces, to prepare for withdrawal.
Both Congolese and health workers also are bracing for December's long-delayed presidential election, which could bring fresh unrest. All hope the Ebola outbreak can be ended before then.
The vote, Mercy Corps' deputy country director Whitney Elmer said on Friday, "may lead to more violence and make an already unstable situation worse."
