Test kits for this species of the disease are very hard to come by, and there is no triage station, so arriving patients who do not have Ebola risk being infected by those who do. In fact, it is hard to know who has Ebola because test results from the regional capital, some 50 miles away, take four days or more to arrive, said the hospital director, Dr. Richard Lokudu.

By then, many patients have already died.

“I’ve been telling people that we need results immediately,” Dr. Lokudu said.

Wailing drifted into his office. Several times a day, news of the death of an Ebola patient sets off explosions of grief, he said. Relatives screamed, gesticulated and rolled around on the grass. Looking into his notebook, Dr. Lokudu produced a tally: At least 30 patients had died at the hospital over the previous 12 days. Many more had died in their homes across the town.

Beyond the hospital gates, residents were gripped by fear and confusion, he said. Mongbwalu had not been touched by the last Ebola outbreak in Ituri, which began in 2018 and did not end until 2020. Now, faced with a sudden surge in deaths, many refused to accept that the virus was real and focused their ire on the hospital, Mongbwalu General, which has 135 beds.

Some said the outbreak was a moneymaking plot concocted by Congolese doctors and foreign aid workers. Others called it a curse. Often, doctors say, the early symptoms of Ebola resemble other ailments, like malaria or typhoid, so by the time patients go to the hospital, many are already very sick and die quickly, heightening suspicion and distrust.

An angry crowd gathered outside the hospital’s front gate, where armed soldiers stood guard. “Killers!” people shouted at us when we arrived, confusing us for foreign aid workers.

Two nights earlier, assailants had burned down an isolation ward in the hospital, shortly after Doctors Without Borders put it up. In the chaos, 18 patients suspected of having Ebola fled their beds and vanished into the town, potentially spreading the virus even more.

A four-wheel drive vehicle with a smashed window was parked outside Dr. Lokudu’s office. A day earlier, angry residents had chased him through the hospital grounds, flinging rocks, he said.

“We really are in a terrible crisis,” he said.

“We’re here to save them,” he added. “They think we want to kill them.”

Other factors help explain why Mongbwalu is the center of the outbreak. Fruit bats, which scientists believe are a natural reservoir for the Bundibugyo virus, roost in huge numbers in trees on the edge of the town, introducing the risk of transmission.