# The forgotten health crisis

An episode of [7am](https://invisiblenetwork.ai/podcast/1461999702), 22 Oct 2026, 17 min.

Audio: https://p.podderapp.com/2544644999/traffic.omny.fm/d/clips/2fb3740d-3436-44af-8cc0-a91900716aa5/62723a1f-3e96-4fc4-882c-b25e0181da4d/a44fdd76-c86a-41bd-8747-b4eb003fbb63/audio.mp3?utm_source=Podcast&in_playlist=70f29d90-2a63-48aa-bf8f-b25e0181da70

In an Ebola treatment centre in eastern Congo, young children are being cared for by people in protective suits – isolated from the love and comfort of their families, who can only watch on from a window. For paediatrician Rupa Narra, it was unlike anything she’d experienced in 16 years working in global health. Some of her patients were too young to understand why their parents couldn’t hold them in what would be their final hours. And as health workers confront the outbreak, the international support they once relied on has been stripped away. Today, Médecins Sans Frontières doctor, Rupa Narra, on the children caught up in the Ebola crisis and what happens when the world retreats from helping contain it. If you enjoy 7am, the best way you can support us is by making a contribution at 7ampodcast.com.au/support. Socials: Stay in touch with us on Instagram Guest: Médecins Sans Frontières doctor, Rupa Narra Photo:msf.org.au See omnystudio.com/listener for privacy information.

## Transcript

[0:04] Speaker 1: In an Ebola treatment centre in eastern Congo, young children
[0:07] Speaker 1: are being cared for by people in protective suits, isolated
[0:11] Speaker 1: from the love and care of their families, who can
[0:13] Speaker 1: only watch on from a window. For paediatrician Rupa Nara,
[0:20] Speaker 1: it was unlike anything she'd experienced in 16 years working
[0:24] Speaker 1: in global health. Some of her patients were too young
[0:27] Speaker 1: to understand why their parents, couldn't hold them in what
[0:30] Speaker 1: would be their last hours. And as health workers confront
[0:35] Speaker 1: the outbreak, international support they once relied on has been
[0:39] Speaker 1: stripped away. I'm Daniel James, and you're listening to 7am. Today,
[0:47] Speaker 1: Médecins Sans Francières' Dr Rupinara on the children behind the
[0:52] Speaker 1: Ebola crisis and what happens when the world retreats from
[0:55] Speaker 1: helping contain it. It's Friday, October 23. Rupert, take me
[1:08] Speaker 1: back to the Ebola Treatment Centre at Butembo. When you
[1:13] Speaker 1: arrived there back in August, what were you walking into?
[1:16] Speaker 2: Yeah, so we were working in Butembo and that area,
[1:21] Speaker 2: it's actually, it's at altitude. It's about around 1500 metres
[1:26] Speaker 2: of altitude and And it's a beautiful area.
[1:33] Speaker 3: And when I first arrived, it's the first time I.
[1:37] Speaker 2: Worked within what I'll use as red zone means that
[1:41] Speaker 2: is the isolation area where you're putting on all the
[1:43] Speaker 2: gear and going inside. I would be dripping wet like
[1:52] Speaker 2: I came out of a pool every time with sweat.
[1:55] Speaker 3: My fingers looked wrinkled.
[1:56] Speaker 2: It's supposed to be 13 beds meant for suspect Ebola
[2:00] Speaker 2: virus disease cases. and 15 beds for laboratory-confirmed Ebola cases.
[2:07] Speaker 2: When I arrived, there were a few children, I think
[2:10] Speaker 2: only two or three that were admitted at the time,
[2:13] Speaker 2: and every day was variable. So some days we'd go
[2:18] Speaker 2: up and we'd be 100% capacity. Sometimes these children would
[2:22] Speaker 2: come in waves. We'd receive three or four kids in
[2:25] Speaker 2: one day. And the challenging part was the presentation of
[2:30] Speaker 2: cases whether it's a suspect or an actual confirmed case,
[2:35] Speaker 2: this could look like anything.
[2:37] Speaker 4: Inside the Kitatumba Ebola Treatment Center in Butembo, patients are
[2:41] Speaker 4: monitored around the clock. Since the center opened on June 30th,
[2:46] Speaker 4: it has admitted 239 patients, including 113 confirmed Ebola cases.
[2:53] Speaker 2: These are patients that present with fever, vomiting, diarrhea, headache,
[2:58] Speaker 2: body pain.
[3:00] Speaker 3: That could be typhoid. That could be malaria. That could
[3:02] Speaker 3: be another virus.
[3:04] Speaker 2: And so it's one of the extremely challenging aspects of
[3:08] Speaker 2: managing Ebola because these are very nonspecific presentation complaints.
[3:14] Speaker 1: And so once people were confirmed to have Ebola and
[3:17] Speaker 1: they'd been through the process, what could you actually do
[3:20] Speaker 1: for them? How could you treat them? What was the
[3:24] Speaker 1: process from there on in terms of care for these people?
[3:27] Speaker 2: Yeah, so unfortunately, with this strain of Ebola virus, we
[3:32] Speaker 2: don't have an approved treatment yet or an approved vaccine.
[3:37] Speaker 5: The outbreak has reported seven times more deaths than the
[3:42] Speaker 5: West Africa outbreak over the same period in 2014.
[3:47] Speaker 3: That was the worst outbreak. Number one, we would treat
[3:50] Speaker 3: any immersion issue. So if they needed.
[3:53] Speaker 2: Fluids because they were severely dehydrated, if they needed a
[3:56] Speaker 2: blood transfusion because of anemia, if we.
[3:59] Speaker 3: Assumed or even if we weren't sure about having.
[4:03] Speaker 2: Malaria, we would treat them for all those things and
[4:06] Speaker 2: also correct any regular things, hypoglycemia.
[4:09] Speaker 3: Anemia, dehydration.
[4:11] Speaker 2: It was very difficult to know because in all of
[4:15] Speaker 2: that Ebola gear, you cannot wear a stethoscope.
[4:19] Speaker 3: And you have very limited time inside with these patients.
[4:22] Speaker 2: So it's a very different situation that I'm used to
[4:25] Speaker 2: working with, with children at least, but we would at
[4:28] Speaker 2: least be able to provide all the other supportive care
[4:32] Speaker 2: to cover for secondary infection, malaria, dehydration, anemia, hypoglycemia.
[4:38] Speaker 3: That was usually what we were providing.
[4:43] Speaker 1: Is there something about this particular type of Ebola that
[4:45] Speaker 1: makes it so much harder to treat? And How has
[4:48] Speaker 1: it differed from other outbreaks in recent times?
[4:52] Speaker 2: Yeah, so with this species of Ebola, it's not a
[4:55] Speaker 2: new species, but I would say we haven't had epidemic level.
[5:00] Speaker 3: Of outbreaks with this species.
[5:02] Speaker 2: Additionally, I worked in the 2014 to 2016 West Ebola outbreak,
[5:09] Speaker 2: but I was working there with the CDC as an epidemiologist.
[5:13] Speaker 2: There were several other partners that were present during that time.
[5:17] Speaker 3: And during this outbreak, we were very limited.
[5:21] Speaker 2: We did not have as many partners on the ground
[5:24] Speaker 2: to accomplish what was needed. In addition to that, there's
[5:28] Speaker 2: been thousands of people that were displaced to Butembo because
[5:32] Speaker 2: of conflict that was occurring in other parts of the country.
[5:36] Speaker 2: And so it significantly overloaded this already fragile health care system.
[5:41] Speaker 3: And then you add Ebola on top of that.
[5:44] Speaker 2: And that really was the recipe for disaster, even if
[5:49] Speaker 2: the staff was incredibly intelligent, hardworking, and.
[5:53] Speaker 3: Devoted to the work.
[5:54] Speaker 2: But it was an impossible situation, I think, even for
[5:58] Speaker 2: their staff and also their health care system.
[6:01] Speaker 1: Rupert, you're a pediatrician. What were you seeing in children
[6:05] Speaker 1: that made this outbreak particularly frightening?
[6:08] Speaker 2: The difficult part for me, compared to other Ebola outbreaks
[6:12] Speaker 2: and also just pediatrics in general, what I started noticing
[6:17] Speaker 2: when I was admitting these children, number one, this is
[6:20] Speaker 2: significantly younger populations than I'm used to. I'm used to
[6:24] Speaker 2: managing all ages and young children. But most of our kids,
[6:29] Speaker 2: the average age was about a year and a half.
[6:32] Speaker 2: So about 17 months was the average age of these
[6:35] Speaker 2: young children. On top of that, I noticed that their
[6:39] Speaker 2: parents and their siblings were not sick. And the only
[6:44] Speaker 2: thing I could find that was in common with these
[6:47] Speaker 2: children was they were at two or three previous health
[6:50] Speaker 2: care centers prior to coming to us. And I don't
[6:54] Speaker 2: believe they went in with Ebola. I think they went
[6:57] Speaker 2: in for a stomach flu or for malaria or.
[7:01] Speaker 3: Pneumonia or something normal.
[7:03] Speaker 2: And I believe these children were infected in these other
[7:06] Speaker 2: health care centers. And the challenge of that is that
[7:10] Speaker 2: means their family is not infected. And that means the
[7:13] Speaker 2: family cannot come inside the unit with these young children.
[7:17] Speaker 2: So you imagine a six-year-old, a one-year-old, a one-and-a-half, a
[7:22] Speaker 2: two-year-old that's in a cement block smelling like chlorine with
[7:27] Speaker 2: people walking in with these crazy suits by themselves.
[7:32] Speaker 3: So that was.
[7:33] Speaker 2: To me, the most challenging aspect in addition to the
[7:37] Speaker 2: amount of mortality.
[7:39] Speaker 3: We were losing children.
[7:41] Speaker 2: Between 80 to 85% of these kids, they were dying
[7:45] Speaker 2: from Ebola, and they were alone inside the units with
[7:49] Speaker 2: a family through a window. And that was incredibly challenging,
[7:54] Speaker 2: both for just comforting the children, trying to convince them
[7:57] Speaker 2: to eat, and just being able to provide some sort
[8:02] Speaker 2: of comfort and soothing for them, in addition to their
[8:06] Speaker 2: poor families watching them.
[8:08] Speaker 1: It's a horrible situation that you're painting, Rupert. How much
[8:12] Speaker 1: of a personal toll did this take on you?
[8:15] Speaker 3: It was difficult.
[8:16] Speaker 2: I'm very fortunate to have wonderful friends and my parents
[8:20] Speaker 2: and very close colleagues. I had a great team when
[8:23] Speaker 2: I was in the field. Both my Congolese staff, they
[8:27] Speaker 2: eventually became what I consider family. And we kind of
[8:31] Speaker 2: would commiserate together about that.
[8:33] Speaker 3: But this was, I think, my 24th mission with MSF.
[8:39] Speaker 2: I've been working in global health for 16 years, but
[8:42] Speaker 2: I've never seen anything like this. And I've never seen
[8:45] Speaker 2: suffering of this extent. for both these children and their family.
[8:52] Speaker 1: Coming up, the devastating impacts of cuts in aid funding. Rupa,
[9:11] Speaker 1: you mentioned you were involved in the 2014 West African
[9:15] Speaker 1: Ebola outbreak, working as an epidemiologist with the USGDC in
[9:19] Speaker 1: Guinea and Mali. When you compare that response with what
[9:22] Speaker 1: you're seeing now in Congo, what's missing?
[9:26] Speaker 2: Yeah, so when I was in Guinea, I was working
[9:29] Speaker 2: near the epicenter of the outbreak in Guinea. I was
[9:32] Speaker 2: working then as an epidemiologist, and there were several partners
[9:37] Speaker 2: that were on the ground. We had a much bigger
[9:40] Speaker 2: presence of international NGOs, a bigger presence of WHO, ICRC,
[9:47] Speaker 2: and the U.S.
[9:48] Speaker 3: CDC themselves.
[9:49] Speaker 2: We just had a bigger presence of a lot of
[9:51] Speaker 2: these other partners. There were a few other NGOs that
[9:55] Speaker 2: were trying to assist in Butembo, but nothing compared to
[9:59] Speaker 2: the 2014. to 16 outbreak.
[10:04] Speaker 6: And we're learning some new details about the White House's
[10:07] Speaker 6: 2026 budget proposal.
[10:09] Speaker 3: President Trump's wish list is.
[10:10] Speaker 6: Topped by $ 163 billion in spending cuts to education, foreign
[10:15] Speaker 6: aid and environmental protection.
[10:17] Speaker 7: The CDC under this budget would see its budget cut
[10:20] Speaker 7: by more than half to about $ 4 billion from roughly
[10:23] Speaker 7: $ 9 billion. We'd also see cuts to the EPA and
[10:27] Speaker 7: other significant agencies.
[10:29] Speaker 2: Being an American, obviously we had significant cuts with USAID
[10:37] Speaker 2: and with the CDC. They were helping with vaccine campaigns,
[10:41] Speaker 2: training staff, procurement of supplies, helping with logistics and and
[10:46] Speaker 2: also overall funding. And that has been significantly gutted, definitely
[10:52] Speaker 2: in the last year or so. And I think it
[10:55] Speaker 2: has made a huge difference, and not just with the
[10:57] Speaker 2: Ebola outbreak.
[10:58] Speaker 1: Yeah, so if we're talking about USAID, the Trump administration
[11:01] Speaker 1: made it a top priority to cut USAID funding, also
[11:05] Speaker 1: with the help of Elon Musk. The Trump administration has
[11:08] Speaker 1: also withdrawn from the WHO and cut thousands of jobs
[11:12] Speaker 1: across US health agencies. From what you've seen on the ground,
[11:16] Speaker 1: how much of what you're describing now could be traced
[11:20] Speaker 1: back to those decisions, Rupa?
[11:22] Speaker 2: Objectively, I can't give an idea, but I will say subjectively,
[11:27] Speaker 2: it was a very, very large change.
[11:31] Speaker 3: And I'm not just speaking about this Ebola outbreak.
[11:33] Speaker 2: I've been working with MSF the last several years and
[11:37] Speaker 2: And even when I was working in Nigeria in a
[11:39] Speaker 2: malnutrition project, I noticed significant cuts to malnutrition supplies that
[11:45] Speaker 2: were there. And I do think it is a huge,
[11:49] Speaker 2: huge loss and deficit in a lot of these countries.
[11:53] Speaker 2: And again, it's not just surveillance and training local staff.
[11:57] Speaker 3: I think it's also laboratory.
[11:58] Speaker 2: Capability and being able to have identified maybe some of
[12:02] Speaker 2: these threats earlier.
[12:05] Speaker 1: This outbreak has crossed borders. There are now more than
[12:08] Speaker 1: 8,000 cases and the virus has spread into Uganda and Kenya.
[12:12] Speaker 1: From what you're seeing, what would have to change now
[12:15] Speaker 1: for health workers to actually get ahead of this outbreak?
[12:19] Speaker 2: I think, you know, the other big challenge with this outbreak,
[12:23] Speaker 2: I think over 60% of the cases are actually occurring
[12:26] Speaker 2: in the community.
[12:28] Speaker 3: And I was only working in the Ebola treatment unit.
[12:31] Speaker 2: And so I was seeing cases that were actually presenting
[12:34] Speaker 2: and agreed to come to an Ebola treatment center. But
[12:38] Speaker 2: a lot of the community, there's still significant resistance. There's
[12:42] Speaker 2: a lot of disbelief about what's happening and there's a
[12:45] Speaker 2: lot of fear. And I think the biggest thing is
[12:48] Speaker 2: ongoing work with community leaders, educating a lot of the
[12:53] Speaker 2: community and doing a lot of community outreach in order
[12:57] Speaker 2: to gain trust within these communities. That's That was, I think,
[13:01] Speaker 2: a turning point with the 2014 West Ebola outbreak.
[13:04] Speaker 3: We started implementing a lot of.
[13:06] Speaker 2: Anthropologists and others to really start working in the community to,
[13:10] Speaker 2: number one, self-report and also seek care and isolate these cases.
[13:16] Speaker 2: They're working on a vaccine and treatment trials now, and
[13:20] Speaker 2: I think that's hugely important. But the number one thing
[13:23] Speaker 2: is isolating these cases and gaining trust within these communities.
[13:30] Speaker 1: And finally, Rupert, this outbreak isn't really getting much coverage
[13:34] Speaker 1: in the Western media. Do you feel like your patience
[13:38] Speaker 1: and the work that you're doing is being forgotten or
[13:40] Speaker 1: ignored in the Western world by countries like Australia and
[13:44] Speaker 1: America and the rest of us?
[13:46] Speaker 3: I think it's strange.
[13:47] Speaker 2: I wouldn't say my work because, you know, I feel
[13:51] Speaker 2: still guilty even being back.
[13:55] Speaker 3: I was there for six weeks.
[13:57] Speaker 2: I worked almost every day and went into the red
[13:59] Speaker 2: zone every day. And my Congolese colleagues, they are working
[14:06] Speaker 2: night and day. They are living in these communities with
[14:09] Speaker 2: this high transmission rate.
[14:11] Speaker 3: I think of them and that they're being forgotten.
[14:14] Speaker 2: I get to come back to my country and see
[14:17] Speaker 2: my family and they are still living within this horror.
[14:21] Speaker 2: There is definitely a lack of, I believe, coverage and knowledge.
[14:27] Speaker 2: But unfortunately, with the state of the world right now,
[14:30] Speaker 2: I believe that there's a lot of compassion fatigue in
[14:33] Speaker 2: addition to financial cuts. I think anytime someone turns on
[14:38] Speaker 2: the news, there's Flooding in Nepal, there's a war in
[14:42] Speaker 2: a certain part of a country, there's Haitians being sent
[14:47] Speaker 2: back to a gang-ridden country in Haiti.
[14:52] Speaker 3: I think it's easy for people.
[14:54] Speaker 2: To want to skip past that title about Ebola, and
[14:58] Speaker 2: it's a.
[14:58] Speaker 3: Normal human condition, unfortunately.
[15:01] Speaker 1: Well, Ruba, thanks for coming on and describing the situation,
[15:06] Speaker 1: and thank you for all the work that you do.
[15:08] Speaker 3: Thank you.
[15:25] Speaker 1: Also in the news, former soldier Ben Robert Smith has
[15:28] Speaker 1: publicly defended himself against allegations of war crimes, insisting he
[15:32] Speaker 1: never murdered anyone during his service in Afghanistan. In a
[15:36] Speaker 1: lengthy interview with 2GB' s Ben Fordham, Robert Smith denied killing
[15:40] Speaker 1: prisoners or civilians and maintained he had done nothing wrong.
[15:43] Speaker 5: Would I change anything that I've done in my military career? Or,
[15:48] Speaker 5: in fact, even would I change joining the military, having
[15:50] Speaker 5: been now in the position that I'm currently in? And
[15:53] Speaker 5: the answer to that question is no. I wouldn't change
[15:56] Speaker 5: a single thing. I would do it all exactly the
[15:58] Speaker 5: same way because I know that I did the right thing.
[16:03] Speaker 1: The Victoria Cross recipient faces five charges of war crime
[16:06] Speaker 1: murder over the alleged killings of unarmed Afghans between 2009
[16:09] Speaker 1: and 2012, and is due back in court on December 8.
[16:15] Speaker 1: An Airbnb guest will no longer be required to strip beds,
[16:18] Speaker 1: wash dishes or take rubbish off site when checking out,
[16:22] Speaker 1: under new rules coming into effect next month. From November 20,
[16:26] Speaker 1: hosts will be banned from demanding cleaning tasks normally performed
[16:29] Speaker 1: by professional cleaners, although hosts will still be allowed to
[16:32] Speaker 1: charge standard cleaning fees. The changes have sparked complaints on
[16:36] Speaker 1: Airbnb's own host forum, with some property owners warning they'll
[16:40] Speaker 1: have to increase cleaning fees. But the changes have been
[16:42] Speaker 1: welcomed by some guests frustrated at facing extra charges at checkout.
[16:48] Speaker 1: I'm Daniel James. Thanks for listening to 7am. We'll be
[16:50] Speaker 1: back tomorrow.

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