MSF DRC Ebola: Providing mental health support for patients and their loved ones

In the corridor of Kitatumba's Ebola treatment centre (ETC) in Butembo, North Kivu, Kasoki Zawadi sits on a plastic chair facing the window that separates her from her husband, Victoire. He has been in hospital for 13 days. On the other side of the plastic screen, he smiles from time to time.

The hospital where Victoire is being treated is one of the facilities where MSF supports treatment for patients with Ebola. In Butembo, 1,472 cases were confirmed and 735 deaths recorded between May and 22 October 2026.

The outbreak is hitting people already facing insecurity and economic hardship. Many families are sheltering relatives displaced by fighting in neighbouring areas, while movement restrictions and reduced trade have made daily life even harder.

At the treatment centre, teams support not only patients but also their loved ones as they cope with fear, uncertainty and the wait for test results. From the moment of admission, psychologists are there to listen to concerns, explain the care being provided and help families manage the mental strain of hospitalisation.

Every morning, Kasoki arrives at around 6:30am and stays until 6:30pm. Her brother-in-law takes over at night. “We manage to communicate despite the window,” she says. “We’re allowed to see each other, and this brings us comfort.”

Since her husband was admitted, she has stopped working as a teacher. Their family is supporting them during this time. She also worries about her own health. And when she leaves the centre, the separation weighs heavily on her.

“In the evening, when I go home and can’t see my husband, I find it hard to sleep,” she says.

A few days later, Kasoki explains that a negative test result had given them hope that they would soon be able to go home. But a second test came back positive.

“When he tested positive again, we were exhausted, mentally and physically,” she says. “Fortunately, the psychologists’ support helped us feel calmer, and we managed to wait.”

Staying in touch during hospitalisation

The disease and hospitalisation can be distressing for both patients and their loved ones. In Butembo, mental health activities supervisor Patrice Muyisa Kokotz provides psychological support. He describes people who arrive not only fearing the disease, but also worried about what awaits them at the centre. Some fear that isolation means they will be abandoned.

“We give them time to express themselves, talk about their past and their emotions,” Patrice explains. His team introduces them to how the centre works, explains the care provided and organises visits. He says seeing other patients and their caregivers helps reassure families.

Some suggest that psychological support can have an impact on patient outcomes.

“Ebola disease is traumatic and sudden; it is a viral illness. So you are under stress, always expecting death at any moment,” said Rachel Kashimoto, a clinical psychologist working with MSF in Beni, also in North Kivu. ​

“If you are not mentally stable and not well cared for, even physically, things may not go well. But if you are mentally stable, well supported and well monitored, there will also be physical improvement. Because when you have hope of recovering, you follow all the instructions the medical staff give you, and then there can be rapid improvement.”

Supporting the return home

Psychological support does not end when patients leave the centre. In Mongbwalu, Ituri, it continues through the survivors’ clinic.

“We organise individual consultations as well as group discussions,” explains Phoebe Zueya Yonkeu, who manages mental health activities at MSF’s ETC in Mongbwalu. “Many tell us they faced stigma when they returned home, lost their jobs or were rejected by their communities, who believed they were still contagious. Others feel guilty towards loved ones who did not survive the disease, and they even wonder whether they were the ones who infected them.”

While some patients face stigma after leaving the ETC and the trauma of having come close to death, returning home can also bring immense relief to them and their loved ones.

In Butembo, on the twenty-third day of Victoire’s hospitalisation, the couple learns that he is due to leave that same day. The positive result, following the first negative result, prolonged their wait: now that he has finally tested negative twice, Kasoki and Victoire say they are very happy to finally be going home.

“Kasoki’s presence really is part of my care. I feel comforted. When I see her, it reduces my stress,” says Victoire.

“Some Ebola survivors feel guilty about those who did not make it. We try to help them move forward.”

Phoebe Zueya Yonkeu recently returned from Mongbwalu, in eastern Democratic Republic of Congo (DRC), where she worked for six weeks as the mental health activity manager at Médecins Sans Frontières’ (MSF’s) Ebola treatment centre (ETC). She reflects on her experience working in what was then the epicentre of the Ebola disease outbreak, and on the essential care that her team provided to patients and their loved ones.

“It starts from the moment people are admitted,” says Phoebe Zueya Yonkeu. “Everyone is worried, and many are afraid when they arrive at the ETC, because they know the possible outcomes of the disease, but also because they may have heard false rumours about the centre and what happens there.”

Composed of psychologists, community mental health workers and their supervisor, the eight-member mental health team at Mongbwalu ETC supports patients at every stage of their care within the facility.

“We make sure that a health worker is present whenever a new patient is admitted, to take the time to explain to patients and their families what to expect, to reassure them and tell them that we are there to help them,” says Zueya Yonkeu. “Often, this simple exchange is enough to calm them down.”

The mental health team continues to support patients throughout their stay, which lasts between seven and ten days on average.

Members of the mental health team are stationed near the high-risk zone. Through specially designed transparent panels fitted into the rooms, they can talk to patients, listen to their concerns and reassure them without exposing themselves. This follow-up also allows them to keep patients’ relatives informed and maintain a vital link between patients and the “outside world”. The aim is to safeguard patients’ wellbeing while maintaining the trust of their communities.

“We also sometimes put on the personal protective equipment required to enter the high-risk zone inside the ETC, in order to provide confidential psychological consultations to people who need them,” says Zueya Yonkeu.

She stresses that supporting a patient at every stage of their care also means being there for their family and loved ones when, despite the efforts of the medical team, the patient does not recover.

“When a person’s health deteriorates and we know that, unfortunately, there is nothing more we can do, we are the ones who tell their family. We take the necessary time and try to prepare them for the loss that is to come.”

The mental health team stands alongside families when the body of their deceased loved one is shown to them for a few minutes, still from the other side of a transparent barrier, before being taken away for safe burial.

“Even though this is the last time the family will see their loved one’s face, there is no other way, because the bodies of people who have died from Ebola are extremely contagious,” continues Zueya Yonkeu. “In a part of the world where people are accustomed to touching and embracing their dead to say goodbye, this can lead to frustration, misunderstanding and even anger. So here too, we make a point of being present to listen, explain, reassure and support them.”

Patients who recover and leave the ETC receive follow-up care for several more months through the “survivors’ clinic”. There, they receive regular medical check-ups to help prevent potential complications following the disease. They also receive longer-term psychological support.

“We organise individual consultations as well as group discussions with recovered patients,” explains Zueya Yonkeu. “Many tell us that they experienced stigma when they returned home, that they lost their jobs or were rejected by their communities, who believed they were still contagious. Others feel guilty about loved ones who did not survive the disease and even wonder whether they were the ones who infected them. Unfortunately, this is a feeling they will have to learn to live with, and we try to help them move forward.”

In addition to patient follow-up, the team also organises group psychoeducation sessions — mental health awareness sessions — for those accompanying patients in the ETCs.

“We explain what mental health is, what signs to look out for and what those signs can mean, to help them put their distress into words. For some, these concepts were completely new. But many told us they found these sessions comforting.”

Phoebe acknowledges with regret that mental health issues are still poorly understood and given too little attention, despite their importance. During her assignment in Mongbwalu, this was also the case for the ETC staff themselves, who face the death and suffering caused by the disease every day, both in the centre and in the communities.

“When I started my assignment, I felt that many people were extremely tired because of the emotional burden they faced every day,” says Zueya Yonkeu. “The same was true of the two mental health workers already there. They had had to announce dozens of deaths and had themselves been exposed to a great deal of psychological distress.”

Since then, awareness-raising activities have also been set up for medical and non-medical staff at Mongbwalu ETC, alongside group mental health sessions when teams change. These initiatives have encouraged staff to turn more readily to the two psychologists dedicated to supporting them whenever they feel the need.

When asked which particular memory she will take away from her experience, Zueya Yonkeu recalls a happy moment.

“I remember this little girl,” she says. “When she was admitted and separated from her mother, things were really difficult. Both were in tears. So the mental health team intervened. We asked her what she would need to feel better. She answered immediately: a doll.”

Zueya Yonkeu remembers rushing to the ETC medical manager’s office to tell her that she needed a doll.

“Of course, she looked at me somewhat puzzled… But as soon as I explained what it was about, she approved the order, and someone immediately went to the market in Mongbwalu,” she says. “Less than half an hour later, this little girl had her doll. When I think back to her joy and her smile when we gave it to her, and how the whole team talked about it for days afterwards, I think we probably needed that moment just as much as she did.”

The current Ebola disease outbreak has affected more than 10,000 people and caused 4,800 deaths in DRC. MSF has 2,900 staff members working tirelessly alongside partners and local health teams to contain the spread of the disease and save lives. The organisation runs eight ETCs and numerous isolation units, where more than 4,159 patients have already been admitted. In parallel, MSF is strengthening epidemiological surveillance and prevention activities by working closely with communities affected by the outbreak.

Broll - Victoire, patient with Ebola Virus, and his wife Kasoki

Ebola patient discharged in Mongbwalu

In DRC, the Ebola disease outbreak is far from over and continues to spread. The number of cases has now exceeded 10,000.

But in Mongbwalu, Ituri, the historical epicenter, last week was marked by moments of joy and celebration. For the first time since the Ebola outbreak was declared in May, the MSF-run Ebola treatment centre has no confirmed cases in beds, after its last patients with confirmed diagnosis were discharged, fully recovered.

Still, dozens of new cases are still being detected every day in other parts of the country. MSF teams continue to work tirelessly, across six of the eight affected provinces, to contain the outbreak and save lives.