"I have just come from Bunia. What I saw there stays with you.
"The context is the first thing that hits you. Eastern DRC has endured decades of conflict. Many children and families have been displaced. Hospitals and clinics are often short on supplies. People are constantly on the move - fleeing violence, following mining routes, seeking services - which makes surveillance and response especially difficult.
"And the situation of children is challenging. In Ituri, more than half of children under five are chronically malnourished. More than one in five are zero-dose children - which means that they have never received their first dose of the basic diphtheria, tetanus, and pertussis vaccine. A proxy for limited access to healthcare. These are already very vulnerable children.
"The capacity to absorb any additional stressors was already stretched to the breaking point. Then Ebola arrived.
"Past Ebola outbreaks in the region show what this can mean for children. They have made up a significant share of cases and an even greater share of deaths, with the youngest facing the highest fatality rates, and many left orphaned or separated from caregivers.
"During my recent visit to Rwampara Hospital in Bunia, at the epicentre of the outbreak, health workers told me people had stopped coming in for routine care because they were afraid. But when families stop seeking care, children miss vaccinations and illnesses go untreated, and the outbreak starts costing lives it never directly touched.
"As of 11 June, the DRC has reported 676 confirmed cases and 136 confirmed deaths. Most cases to date have been among socially and economically active adults, but as the outbreak evolves, we must be prepared for increasing household transmission, which means we may see more children affected in the days ahead.
"Early symptoms in children - fever, diarrhoea, vomiting, tiredness, and loss of appetite - are hard to tell apart from other diseases, such as malaria, which is common in Ituri. So precious time can be lost before Ebola is even suspected.
"For the Bundibugyo species, there is no approved vaccine or specific treatment beyond supportive care. That means preparedness, infection prevention and control, and building community understanding and trust are our frontline tools.
"And that trust cannot be taken for granted. A recent UNICEF U-Report survey of 50,000 young people in the DRC found that two thirds were not aware how Ebola spreads or how to protect themselves, about one in five didn't believe the disease is real, and nearly a third would not welcome a survivor back into their community.
"When in one of the hospitals, I was told there was a body in a nearby displacement camp, and the community were not yet ready to give it up. Dialogue between the health professionals and community were underway, but it was a reminder that building shared understanding and trust is essential. That's why UNICEF works with partners to prioritize community engagement, understanding, education, and ownership in health systems.
"UNICEF's six-month response plan targets 3.7 million people. We have delivered 150 metric tons of supplies to Bunia, trained and deployed more than 1,600 community health workers and mobilisers, and 24 decontamination teams, already reaching over 160,000 households.
"We are also establishing nurseries in facilities close to Ebola Treatment Centres - these are safe spaces where children can be cared for while their parents are treated. Our first crèche opens in Bunia in the coming days.
"And the need for this support is real. Our staff on the ground were told of a family in which the grandmother, father, and mother died from Ebola, leaving a week-old baby who is now being closely monitored.
"The outbreak has also crossed into Uganda, where 19 confirmed cases and two deaths have been reported. Uganda remains at risk, particularly along the 800-kilometre porous border between the two countries. UNICEF is supporting the national response across 37 high-risk districts, including refugee-hosting areas, border districts, and greater Kampala.
"Let me finish by saying that we can spare children the worst of it. Fast detection, strong paediatric care, monitoring of contacts, and communities that are informed and engaged can help us bring this outbreak under control.
"What we need now are the resources, humanitarian access, and the trust of communities to succeed. UNICEF is appealing for US$70.7 million over the next six months, of which US$17.4 million remains unfunded, as part of the broader continental response plan.
"DRC and Uganda have contained Ebola before, and with the support of the international community they can do it again."
