Research Paper

Peace Operations at the Intersection of Health Emergencies and Violent Conflict: Lessons from the 2018–2020 DRC Ebola Crisis

Dirk Druet
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The unstable province of North Kivu, in the eastern DRC, has hosted an insurgency for almost three decades despite the presence of peacekeepers from the UN peacekeeping mission known as MONUSCO. When Ebola began to spread in an area of active conflict and the World Health Organization (WHO) initiated a large-scale emergency health response program in 2018, the effects on conflict dynamics were immediate, profound, and ultimately undermined both health and peace-building efforts in the DRC.

As part of the Academy’s project on Rethinking the Humanitarian Health Response to Violent Conflict, this research paper asks how the health response impacted the conflict, what roles peacekeepers played in the response, and what can be learned about security, perceptions, and trust in international responses to multidimensional emergencies in conflict environments. As the COVID-19 pandemic brings together conflict dynamics and health emergencies in a wide variety of settings, and as trends in the politicization of humanitarian assistance continue, the study provides insights into how the international community can better manage future multidimensional emergencies.

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American Academy of Arts and Sciences

Table of Contents

II. The Makings of the Public Health System and the Root Causes of Conflict in the DRC

a. The Colonial Origins of an Extractive Congolese Public Health System
b. Centralizing and Hollowing Out the Postcolonial Health System

III. Learning from UNMIL and the 2014–2016 West African Ebola Crisis

a. The Intersection of Ebola and Conflict Dynamics in Liberia
b. UNMIL’s Role in the Response
c. Engagement with UNMEER
d. Lessons Learned (or Not Learned) for Future Crises

IV. The 2018–2020 DRC Ebola Crisis, the Riposte, and MONUSCO’s Role

a. Conflict Dynamics in the Eastern DRC on the Eve of the Ebola Crisis
b. The Outbreak of Ebola, the Entry of the Riposte, and the Spread of Mistrust
c. Violence, the Securitization of the Riposte, and MONUSCO’s Role

V. Reflections on the Role of Peace Operations in Responses to Health Emergencies

a. Conflict and Political Economy Analysis
b. Positioning MONUSCO vis-à-vis the Riposte
c. International Community Engagement and the Ebola “Panic”
d. Logistical and Operational Support
e. Marrying Localized Approaches with Large-Scale International Responses
f. National Ownership and the Legacy of a Predatory State and Health System