The town where the latest Ebola outbreak likely began

0:00Today on State of the World, the town where the latest Ebola outbreak likely began. You're listening to State of the World from NPR. We bring you the day's most vital international stories up close where they're happening. I'm Greg Dixon. An Ebola outbreak is spreading across the Eastern Democratic Republic of Congo. Health experts warn it could become one of the largest Ebola outbreaks in recent years. In just over a month, Congo's health ministry says more than 1 ,000 cases have been confirmed and more than 250 people have died. The outbreak was first detected in the gold-mining town of Mangualu, where health workers began noticing a cluster of mysterious illnesses and deaths earlier this year.

0:45By the time authorities officially declared an outbreak in May, the virus had already gained a foothold. Since then, cases have been reported elsewhere in eastern Congo and across the border in Uganda, but Mangualu remains one of the outbreak's hotspots. Health workers there are battling not only the virus itself, but also fear, misinformation, and deep mistrust of medical authorities. Reporter Emmett Livingstone takes us to ground zero of this Ebola outbreak. Mongualu has grown accustomed to the sound of loss. On a green hilltop in the town's only hospital, relatives of a patient who has died of Ebola openly grieve.

1:28In this impoverished town of about 130 ,000 people, there are Ebola deaths almost every day. No one is sure how long the disease has been circulating here, but it was spreading before health workers raised the alarm. Joseph Moutet is a community leader in the Mongualu neighbourhood worst hit by the virus. The blood in the mouth and the blood in the nose. So, we believe that it's the type of disease. He says that from at least March, people started dying in their homes with blood in their mouths and blood in their noses. Bleeding is a hallmark of Ebola infection, but no one suspected the disease at first.

2:09Tuberculosis, AIDS and mercury poisoning were all advanced as possible reasons. Another popular theory was that the burning of a damaged coffin in February had placed a curse on the area.

2:26Burning the coffin violated a taboo. As Joseph Moutet put it, some believed that the flames of the coffin spread through the neighborhood bringing illness. The community leader pointed out several empty houses where Ebola had decimated whole families. About 50 people have died in his neighborhood alone, Joseph says.

2:50Few residents agreed to talk to us. This is a rough and remote mining town where people live close together in unsanitary conditions. It's been over a month since Congo officially declared an outbreak, and while the reality of Ebola has set in, there are still parts of Mongualu that are hostile to health responders. This resistance, coupled with poverty, partly explains how Ebola spread. Another reason is gold, the bedrock of Mongualu's economy. I'm in a gold mine in Mongualu. It's in a valley surrounded by steep green hills with lush grass, palm trees, eucalyptus trees. You can hear the sound of a generator, and that's pushing sands down a sluice.

3:39workers then look through that sluice to try and find bits of gold. There are, I'd say, maybe 20, 30 pits here. Dozens and dozens and dozens of people are working, despite the Ebola outbreak. The workers that we've talked to are from everywhere across eastern Congo. People travel far and wide in search of economic opportunity. It gives you a hint as to how the disease spread from Anguala over such a large region. One of them is Bisimwa Biragi.

4:12He says that he fled conflict with Rwanda-backed M23 rebels much further south and ended up here. With such a mobile population, it's easy to see how Ebola spread. We are afraid. We are afraid. We are afraid. We are afraid because it's a very bad disease. Biraghi says he's afraid of catching the disease. He tries to take precautions, but his work puts him in proximity to others. Most people find it a challenge to protect themselves. Only about 20 % of Mongualu has access to running water. At the hospital, six staff members already died. But on the evening we were there, as dusk settled over Mongualu, a recovered hospital staffer walked free alongside a three-year-old girl.

5:01In an instant, the town's prevailing gloom gave way to joy.

5:11Medical personnel sang about God's grace and danced as the two discharged patients looked on in a daze. One of them was Florence Mangembo, the hospital's bookkeeper. It was hell, she said, minutes after leaving the Ebola ward. My body ached, I was weak, and I had no appetite. Mangembo said that she got sick trying to help her sister, who she'd found collapsed and vomiting in a field. She insisted that her sister go to the hospital, where she then died. Some family members have since blamed Mangembo for causing the death. A lot of people in Mongualu are afraid of the hospital, where admitted Ebola patients often don't come out alive.

5:56There is no vaccine for the species of Ebola virus spreading in eastern Congo. The virus exists, Manghembo said, and it's very stubborn. Despite surviving the disease, she says she feels stressed. With infection and deaths weighing on the town, stress is a feeling common to everyone here. But at least for a fleeting moment, the hospital celebration offers a rare release from a nightmare that shows no sign of disappearing soon. For NPR News, I'm Emmett Livingstone in Mongualu.

6:40That's the State of the World from NPR. Thanks for listening.