Nearly two dozen survivors of the UN’s largest known sexual abuse scandal say the World Health Organization has been slow to make good on promises of support, and that when assistance has come it has been too little to rebuild their lives.

After suffering abuse during the 2018-2020 Ebola outbreak in the Democratic Republic of the Congo, many women who were promised support in 2021 received one-time payments of $250 – the rough equivalent of two days’ worth of per diems for UN staff.

“I was happy, but this is a very small amount,” said one woman who was given $250, money that was drawn from a $2 million survivor assistance fund. 

Others said they were given bundles of toiletries, buckets and three-hour courses in basket weaving or entrepreneurship, in addition to receiving the cash payments. A handful said they were still waiting for help. Several said they were struggling to care for children on their own after being deserted by the aid workers who fathered them.

Some who were promised assistance were also later refused, according to HEAL Africa, one of the main local organisations contracted by WHO and the UN Population Fund (UNFPA) to help implement the support programmes.

The New Humanitarian and the Thomson Reuters Foundation first uncovered the scandal in 2020, publishing a second investigation in 2021. The reporting prompted WHO to appoint an independent commission, which confirmed in 2021 that WHO workers had lured women into sex-for-work schemes. A number of other UN agencies and aid organisations were also named by women.

Reporters from The New Humanitarian met with 21 women in September, and again last month, to ask what assistance they had received. Of the 73 victims uncovered in the 2020 or 2021 investigations, these 21 had agreed for their information to be shared with the independent commission.

In the course of that reporting, 34 more women also came forward in the towns of Cantine and Mangina with new allegations of sexual abuse by aid workers during the Ebola response, mostly by men who told them they worked for WHO.

Although the independent commission recommended in its report that “reparations” be made to the victims, WHO said UN rules prohibit such payments. Investigations into the abuse are still ongoing.

“All I can tell you is WHO is committed to being transparent and to being accountable, and when this process is finalised, I sincerely believe we will do the right thing,” Gaya Gamhewage, who was appointed in 2021 to lead WHO’s sex abuse prevention efforts, said at a 28 February news conference.

After the scandal, WHO established the survivors assistance fund. As of last month, WHO said some $350,000 from the fund had been transferred to organisations in DR Congo, and that it was considering the extension of some contracts related to the support operations there.

WHO’s global budget for the prevention of sexual exploitation, abuse, and harassment is $50 million, according to Gamhewage.

Last week, WHO announced a new policy aimed at addressing “gaps, loopholes, and lack of clarity” in its procedures for preventing and responding to sexual abuse and exploitation.

But the new rulebook, which enters into force today (March 10) amid uproar over a loophole that allowed three senior managers to return to work after they were accused of failing to report sexual misconduct during the Ebola response, comes too late for some victims. 

“I am begging for them to help us,” one woman told The New Humanitarian in September, a year after WHO announced the $2 million fund and promised far-reaching reforms and assistance, including legal aid and counselling.

“They said they’d help us with psychosocial support. We haven’t seen it. They said they will bring financial support. We haven’t seen it.”

Contacted by reporters again last month, she said she had by then received $250, soap, underwear, and a bucket for use in the bathroom. But with so little money, she was still struggling to care for her two-year-old daughter, who she said was born out of the abuse.

One-time payments of $250 were meant to help with “income-generating activities”, with the amount calculated on a number of factors, including costs in the region, as well as the cost of training and materials needed, according to Anna Jefferys, a media adviser for UNFPA, the UN agency that WHO appointed to help lead victims’ assistance efforts.

To help determine the amount, UNFPA said consultations were held with women at risk of gender-based violence and exploitation – including some victims – but that the victims weren’t consulted as one unique group due to confidentiality concerns. 

Some women said they had worked for WHO during the Ebola response as cooks, cleaners, and community outreach workers, earning $50 to $100 a month – more than twice the average wage.

Job opportunities have been scarce for women in eastern DR Congo, which has been embroiled in one of the longest running humanitarian crises in history.

Many women recounted being plied with drinks, ambushed in offices and hospitals, and preyed upon at job recruitment centres. Some said they were locked in rooms by men who promised jobs or threatened to fire them if they refused to have sex. Many said they were impregnated or had contracted venereal diseases. 

WHO was one of the largest organisations involved in the Ebola response, deploying more than 1,500 people to the area amid a number of challenges, including dangers around the disease itself and sporadic violence in the region.

Some of those difficulties contributed to delays in reaching victims over the past 18 months, according to Gamhewage. She said that as of February, 115 victims had been reached and offered monetary payments, psychosocial support, medical care and training sessions. Eleven refused assistance. The payments and assistance were not limited to WHO victims, she added.

“What happened to you should never happen to anyone,” Tedros Adhanom Ghebreyesus, WHO’s director-general, said of the victims at a news conference in 2021, after the publication of the independent commission’s report. He apologised to the women and called it “a dark day for WHO”.

However, similar abuses had been reported earlier, during the WHO-led response to the West Africa Ebola outbreak between 2014 and 2016. Several more UN and aid sector sexual abuse scandals made headlines in the years that followed.

Despite the earlier scandals, the independent commission noted in its report that WHO was “completely unprepared to deal with the risks/incidents of sexual exploitation and abuse” during the DR Congo Ebola outbreak.

It took more than a year after the scandal broke for investigators to reach many of the victims. It took another year for many to be given updates on their cases or to learn what type of assistance they may receive.

“They came to get information from us victims, then left us with nothing,” one 28-year-old woman told The New Humanitarian in September, recalling her interview with investigators from the independent commission.

“That means that they exploited us too. The exploitation hasn’t stopped.”

• The New Humanitarian report