AUDIE CORNISH, HOST:
Ebola has now spread to the largest city in eastern Congo, Goma, where at least three cases have been confirmed. Today marks exactly one year since the outbreak was declared in Congo. And so far, more than 1,800 people have died. This makes it the second deadliest Ebola outbreak in history.
NPR's Eyder Peralta has been following this story. He joins us now from his base in Nairobi. Nader, I want to start with just the significance of these cases in Goma.
EYDER PERALTA, BYLINE: Yeah, I mean, what it tells us is that this outbreak is still not contained. And it also tells us that some of the mechanisms that should be in place to contain Ebola still have some problems. Health authorities tell us that the latest case in Goma involves a minor. Authorities believe he was infected when he traveled hundreds of miles back home on a motorcycle. And he started having symptoms shortly after he got back to Goma on July 22. And he sought health care several times. But his case didn't raise alarm until July 29. That's seven days later. That means he had a chance to have contact with a lot of people. And he had a large family. He had 10 kids.
And now we've gotten word that his 1-year-old daughter has tested positive. As health authorities put it, there is now an active transmission chain in Goma. And they are fully expecting more new infections.
CORNISH: But this is a year into this outbreak. So what have been the obstacles to containment?
PERALTA: Yeah, I mean, when this outbreak started a year ago, health authorities, they had just contained another outbreak in northwestern Congo. They seem confident that they could deal with this one. This is a very different part of the country. It's never faced Ebola, and it's a marginalized area. This is a place where many militias are fighting. And health care workers have become targets. They've been attacked. They've been killed. And the people who live there, they don't trust their government, and they don't trust health workers.
CORNISH: I understand that part of it, but Ebola was supposed to have a vaccine at this point, right? I mean, is that not working?
PERALTA: No, it's actually proven super effective. But it goes back to the same problem of insecurity and trust. The way health officials have controlled outbreaks is by doing what they called ring vaccination. And that's to vaccinate the people who have come into contact with a person with Ebola and the contacts of the contacts. But for that strategy to work, health workers need to be able to move around freely, and they need to trace those contacts. And the community has to be willing to vaccinate.
Moving around freely is hard to do in a conflict zone. And trust is hard. One official with Doctors Without Borders says she tried to understand why people were so angry at the Ebola response. And she asked one of her local staff why. And she told her it was because people there in that area have been suffering for so long. Her husband had been killed by militias. Three of her children had died of malaria. And no one - no aid organization, no government - has ever cared.
And now all the aid orgs are here because of Ebola. And people don't trust that they're there to help. They believe that these organizations are there to make money off of the response.
CORNISH: Is there a concern at this point that this outbreak could go beyond Congo?
PERALTA: It's a big concern. The World Health Organization just recently declared this outbreak a public health emergency of international concern. And that means that many more resources are pouring into Congo and neighboring countries. And now it's in Goma. And that presents a whole other challenge. It's the biggest city in eastern Congo. And it's a transit hub along the border with Rwanda. So, you know, there's definitely a worry that it can move from beyond Congo.
CORNISH: That's NPR's Eyder Peralta. He spoke to us from Nairobi. Thanks for your reporting.
PERALTA: Thank you, Audie. Transcript provided by NPR, Copyright NPR.