Dr. Rupa Narra is providing supportive care to children at an Ebola treatment unit in Butembo, Democratic Republic of the Congo, amid a severe outbreak.

Dr. Rupa Narra, a U.S. pediatrician working with Doctors Without Borders, is treating pediatric patients at a 30-bed Ebola treatment unit in Butembo, Democratic Republic of the Congo. The facility is currently at full capacity as the region faces an outbreak that has resulted in over 3,310 deaths since May. Narra reports that the rapid transmission of the virus and the lack of approved vaccines or antivirals have made this the most devastating crisis she has encountered.

Challenges in Pediatric Care

The outbreak is driven by the Bundibugyo strain, which lacks approved medical treatments. Because the virus is often fatal for newborns and children, whose immune systems are less developed, Narra has shifted her focus from curative care to minimizing suffering. Pediatric patients account for one in four confirmed cases but represent one in three total deaths in this outbreak. Medical staff face significant logistical hurdles, including the need to wear protective gear that limits patient interaction to about one hour at a time. This equipment prevents doctors from comforting children, who are often frightened by the appearance of staff in hazmat suits. The unit also struggles with space, as quarantine beds intended for patients awaiting test results are increasingly being used for confirmed cases.

Regional Context and Conflict

The outbreak is concentrated in the eastern border region of the DRC, where ongoing conflict between the Congolese army and paramilitary forces has displaced families into cities like Butembo. This instability, combined with cuts to foreign aid, has further strained a healthcare system already managing malnutrition, malaria, and measles. Narra notes that the combination of rapid viral transmission and a fragile healthcare infrastructure creates a uniquely difficult environment for medical responders.