Hong Kong has stepped up precautions over the Ebola outbreak in the Democratic Republic of Congo (DRC) and Uganda, as the World Health Organization (WHO) declared the epidemic “a public health emergency of international concern.”

The WHO said on Sunday that there had been 246 suspected cases and 80 suspected deaths in the DRC as of Saturday, in addition to a handful of apparent cases in Uganda.

The outbreak was caused by the Bundibugyo virus disease, and there is currently no vaccine.

There are no confirmed cases in Hong Kong, but the Centre for Health Protection (CHP) has enacted a series of precautionary measures, according to a government press release on Sunday.

Although there are no direct flights from the affected areas, “the CHP will strengthen health screening for passengers arriving on flights from Africa at the airport… Suspected cases will be immediately referred to public hospitals for isolation and treatment.”

It will also bolster public awareness and health education efforts, and provide airlines, doctors and hospitals with updated information.

The CHP advises against visiting affected regions.

Highly lethal

Ebola is transmitted to humans through close contact with the blood, secretions, organs, or other bodily fluids of infected animals.

The virus is highly lethal and causes haemorrhagic fever, systemic inflammation, and multi-organ failure. The case fatality rates from past outbreaks range from 25 to 90 per cent, according to the WHO – the average is 50 per cent.

Meanwhile, Médecins Sans Frontières (MSF) is preparing a large-scale response to the outbreak, the humanitarian charity said in a press release on Sunday.

“The number of cases and deaths we are seeing in such a short timeframe, combined with the spread across several health zones and now across the border, is extremely concerning,” said MSF Emergency Programme Manager Trish Newport. “In Ituri, many people already struggle to access healthcare and live with ongoing insecurity, making rapid action critical to prevent the outbreak from escalating further.”

The NGO is mobilising more teams comprising medical, logistical, and support staff experienced in responding to viral haemorrhagic fever outbreaks, it said.

Médecins Sans Frontières’ (MSF) hospital in Lankien, a town in South Sudan’s Jonglei state, was hit by an airstrike in February, although the medical charity’s bright red logo was painted on the building’s roof.

Lucy Lau, an MSF project coordinator deployed to the eastern African nation, said she believed the airstrike on February 3 was not a coincidence.

It was a tactical attack targeting the hospital’s main warehouse, destroying not only the building but also most of the critical supplies stored inside, she said in early April.

Before the airstrike, MSF received information about a possible attack on Lankien and decided to evacuate the hospital. Lau and other staff members were able to escape unscathed, but one worker was injured in the strike, which MSF blamed on the South Sudanese military.

She and her team were forced to cut their six-month mission short and leave the country the same evening.

Lankien is an opposition stronghold in South Sudan, a country that has been wracked by political instability since a civil war erupted in 2013. Despite a 2018 peace deal, armed conflict has continued between President Salva Kiir’s government troops and rebel forces loyal to former vice president Riek Machar.

Citing the UN, MSF said the renewed conflict killed 2,000 people and displaced 320,000 in 2025.

The humanitarian aid NGO also said that its health facility in Pieri, another town in Jonglei, was looted by unknown assailants on February 3, hours before the airstrike in Lankien.

In a statement issued the day after, MSF lambasted the attacks. ”While we are aware of the enormous needs in the country, we find it unacceptable to be a target for attacks,” said MSF operations manager Gul Badshah.

MSF suffered eight targeted attacks in 2025, forcing the charity to close two hospitals and suspend medical activities in Upper Nile, Jonglei and Central Equatoria states. The UN said an aerial bombing of an MSF hospital in Old Fangak, also located in Jonglei, in May last year “could amount to a war crime.”

Lau said the attacks were meant to cripple healthcare systems in an area controlled by political opponents, disregarding the effect on civilians.

Lau, an engineer by training, joined MSF’s logistics team in 2011. She said she had noticed an increased willingness in recent years to target civilian infrastructure and aid organisations in armed conflicts, resulting in greater difficulty in delivering humanitarian aid.

It “feels like a growing trend worldwide,” the 46-year-old said.

Underfunded

Lau was deployed to Jonglei state in October, four months before the airstrike, to work as a project coordinator.

She was responsible for managing MSF’s emergency medical projects, coordinating operations between different departments: medical, human resources, finance, and logistics.

The MSF hospital in Lankien treated paediatric malnutrition and maternity cases and provided treatment for infectious diseases, including cholera, tuberculosis, and HIV.

Disease outbreaks “are indirect impacts of the civil war,” especially in a country whose budget has gone mostly to the military, while healthcare is chronically underfunded, Lau said.

“I was told by officials that only 1 per cent of the 2026 national budget was allocated to the health ministry.”

Those seeking treatment included civilians hit by explosives and gunshot wounds. The hospital also ran programmes for survivors of intimate partner violence.

The Hongkonger, who arrived in South Sudan with a small MSF team, worked mostly with local healthcare workers and engineers. “These people spend most of their lives around this civil war. They’re tired,” she said.

‘Classic dilemma’

Despite the threat to their safety, healthcare workers still feel responsible for their patients.

Lau recalled how a team member, who took shelter in a nearby safe house after the bombardment, asked if they could head back to the hospital to treat wounded patients who had just arrived.

“Our duty is to help [patients], but we also have to consider our own well-being… they were worried about their own safety, then they turned their attention to how they could help the wounded,” Lau said. “It’s a classic dilemma.”

Because of the airstrike, tens of thousands of South Sudanese were displaced. Some fled into the bush and eventually to nearby villages, such as Chuil and Minkaman in Lakes state. Some with more means fled to neighbouring countries like Ethiopia or Uganda, Lau said.

The escalating violence means that local communities will be left without any healthcare in a country where the government’s healthcare budget is almost non-existent, Lau said.

Despite the attacks, MSF teams still in the country have scaled up medical and humanitarian support for displaced people. Since late February, they have provided 2,200 consultations, admitted 172 patients to the healthcare centre in Chuil, and referred 16 patients for further treatment.

US President Donald Trump’s USAID cuts have affected the ability of other international organisations to provide aid in South Sudan, leaving MSF, which does not accept US funding, as one of the few NGOs providing some semblance of a functioning healthcare system in the country, Lau said.

Space for aid

After years of working in conflict zones, including in Ukraine and Afghanistan, the MSF logistician has observed a growing trend of targeting civilian infrastructure, especially healthcare facilities.

In February, four years after Russia’s war in Ukraine began, the World Health Organization (WHO) said it had recorded more than 2,800 attacks on Ukrainian health care, with the highest number logged in 2025.

Meanwhile, United Nations experts called Israel’s destruction of Gaza’s healthcare system, including bombing hospitals, “medicide.” Amid the ongoing US-Israeli attacks on Iran, the WHO said in early April it had verified more than 20 attacks on healthcare facilities in the Islamic republic since March 1.

Attacks on facilities such as hospitals are no longer an unfamiliar sight, Lau said.

According to MSF, the government, opposition forces, and non-state armed groups have all openly violated international humanitarian law by repeatedly attacking its medical facilities and staff.

In August, gunmen intercepted an MSF convoy and abducted a team leader just four days after the abduction of health ministry staff. The MSF team leader was released hours later.

During her deployment in South Sudan, Lau was responsible for negotiating with different factions, including the government and the opposition, to protect MSF’s personnel, clinics, and patients within conflict zones.

Although MSF maintains a neutral stance in the conflict, the government questioned why Lau’s team was operating on opposition territory. “But we had teams providing services on government territory too; it just wasn’t my team,” she said.

MSF said that since December, the government had ordered blockades barring humanitarian access exclusively in parts of opposition-held areas of Jonglei state, in a bid to place pressure on opposition territory, including the civilian populations living there.

The international charity warned that the restrictions could bring “dangerous consequences for children, pregnant women, and people living with chronic or life-threatening conditions.”

Lau and her team had to consider whether certain actions, such as operating in an opposition stronghold, would make them lose access to other parts of the state.

“We used to feel guaranteed that we would be protected working in a hospital. We can’t think like that anymore,” she said.

“The space for our work has become much smaller. There are now many more risks we have to consider, and we need to consider whether those risks are worth taking, and that is a fine line.”

MSF, as an impartial humanitarian aid provider, “can’t really help improve the situation in terms of the war,” Lau said.

“But we can have an effect on the lives of individuals, and to them, that’s what’s important,” especially while international attention and support are limited, she added,