The International Federation of Red Cross and Red Crescent Societies (IFRC) says the outbreak of Ebola in the Democratic Republic of Congo is “worsening” and has killed more than 1,000 people.

IFRC said on Saturday that in the past week, 23 cases were reported in one day. This is a record number since the start of the outbreak in 2018. Meanwhile, the DRC health ministry confirmed that the Ebola death toll has risen to 1,008.

This is the second largest outbreak recorded anywhere in Africa and the worst to hit DRC.

It has resulted in a health crisis that has created multiple challenges in rolling out effective treatment.

Violence has complicated efforts to contain the second most deadly Ebola virus outbreak in history, as the number of new cases increases each time treatment and prevention work is disrupted.

In February, a treatment center managed by Doctors Without Borders/Médecins Sans Frontières (MSF) in Katwa was closed after unidentified assailants attacked the seven-bed center with stines before setting it on fire and destroying wards and equipment, and leaving it partially burned. 

As a result of the violence, many people are afraid to go to Ebola treatment centers, may instead choose to stay home where they run the risk of infecting their caretakers and neighbours.

“We are at a critical juncture where we need to step up our support to communities that are facing greater risk of infection, yet Ebola responders face massive security challenges and a lack of resources for the response,” said Nicole Fassina, IFRC Ebola virus disease coordinator.

“An under-resourced operation creates a very real risk of an international spread of Ebola,” she added. 

“We are dealing with a difficult and volatile situation,” said Michael Ryan, the World Health Organization’s executive director of emergencies program. “We are anticipating a scenario of continued, intense transmission.”

Ryan added that insecurity has become a “major impediment.”

Another challenge has been communities’ mistrust of healthcare workers and the fact that 1 in 4 people in Ebola-affected regions think that the disease outbreak is not real, according to a report published in the Lancet Infectious Diseases journal. 

Out of the 961 responds surveyes, less than 40% trusted local authorities to serve their best interests while 230 people believed the Ebola outbreak in the DRC to be fake altogether.

The most deadly Ebola outbreak occurred in West Africa in 2014. More than 11,000 people had been killed by 2016.