Working conditions, security and grievance management among Bundibugyo virus response personnel: exploratory findings from an anonymous survey in eastern Democratic Republic of the Congo
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Problem
Response personnel in the 2026 Bundibugyo virus disease (BVD) outbreak in eastern Democratic Republic of the Congo work amid protracted conflict and fragile health systems. Working conditions, security exposure and grievance handling were widely reported as sources of stress but had not been documented systematically.
Approach
We conducted an anonymous, self-administered online survey in French among BVD response personnel in North Kivu, Ituri and South Kivu, covering staffing, EPI supply, remuneration, security incidents, grievances and psychosocial well-being. Of 55 submissions, 54 respondents consented and were analysed; denominators fall further, to 21, for grievance items because of within-survey drop-off. Findings are descriptive.
Local setting
Respondents (94% men) worked for the Ministry of Health, international non-governmental organizations, the Red Cross and as unpaid volunteers, mostly with one to three months on the response.
Relevant changes
61% judged staffing insufficient; 67% had one or no rest day per week. 63% reported EPI stock-outs and 43% had performed a task judged riskier than necessary. 44% had pay delayed, partial or unpaid though promised, and 85% had advanced personal funds for work costs. 67% reported a security incident in three months; among the smaller subgroup reaching the grievance questions, 57% feared reprisal.
Lessons learnt
Staffing, supply, payment and security shortfalls compound one another and are visible to communities; weak grievance channels and fear of reprisal let them persist unaddressed. Working conditions, security and grievance management should be monitored as core infection-prevention-and-control and occupational-risk indicators, not as a peripheral human-resources matter.
What was already known on this topic
Previous Ebola epidemics, notably the 2014-2016 West African outbreak, showed that health-worker pay disputes, personal protective equipment shortages and community mistrust can contribute to absenteeism, disengagement and reduced service continuity [2,5,6], and that health workers’ coping depends on training, equipment, a functioning risk allowance and psychosocial support [2]. In eastern Democratic Republic of the Congo, repeated Ebola-family outbreaks have occurred alongside armed conflict and institutional distrust [1], but working conditions, security exposure and grievance handling among response personnel are rarely documented systematically during an active response.
What this paper adds
Using an anonymous survey administered during an ongoing 2026 BVD response, this paper quantifies, in near real time, how response personnel across three eastern DRC provinces experienced staffing, EPI supply, remuneration, security and grievance handling, and how these problems interact. It shows that administrative and security shortfalls are interconnected and visible to communities, and that survey drop-off is itself informative: fewer respondents were willing or able to complete questions on grievances and psychosocial strain than on operational conditions.
