As night falls in Kamituga, a mining town in eastern Democratic Republic of Congo, gold diggers, hawkers, and sex workers flock to local bars, where some blame the vibrant nightlife for the region’s growing mpox outbreak. Bitama Sebuhuni, a prospector who contracted the viral disease through unprotected sex, warned, “Life in Kamituga drives people to sin.”

Health authorities have identified Kamituga as the starting point of the mpox epidemic that has plagued the DRC since September. The town, once thriving under Belgian companies, has become a hub for DIY diggers and prospectors seeking riches from its gold mines. Officially home to around 300,000 people, though estimates suggest the population is double that, Kamituga features colonial-era buildings overshadowed by gold-buying bureaus, mining equipment shops, and numerous nightclubs.

The close physical contact often found in these establishments has created a breeding ground for mpox transmission. After a long day in the mines, locals emerge to socialize and seek companionship, leading to increased encounters with sex workers. “When we talk about atmosphere, in our country we talk about women, prostitutes and alcohol,” Sebuhuni remarked, reflecting on his past habits of engaging in unprotected encounters.

At the Kamituga hospital, patients are treated in a rare oasis of calm amid the town’s chaos. Dr. Dally Muamba Kambaji of the ALIMA international medical NGO noted that about 20% of mpox cases are transmitted sexually, emphasizing that condoms do not provide full protection against the virus.

The resurgence of mpox was first noticed by hospital doctors in September when unusual skin lesions appeared on a nightclub manager. Concerns grew when several women from the same venue exhibited similar symptoms. The nightclub, dubbed “Mambengeti,” has since closed, yet its name has become synonymous with mpox in the region, highlighting the role of sex workers in the disease’s spread.

In a hidden bar known as “The Sage’s Corner,” members of a local association of sex workers gathered, discussing the challenges posed by the outbreak. Nicole Mubukwa, one of the women, acknowledged the impact of mpox on their business, saying, “Since the outbreak of this disease, customers have been few and far between.” Many women infected with mpox remain silent about their condition, fearing it will cost them valuable income.

Alice, another member of the association, shared her struggles after contracting the virus. “I was infected without knowing it, and that was tough for me because I couldn’t sleep with a man,” she explained, drawing parallels to the stigma surrounding HIV/AIDS. Despite the challenges, Alice said she earns between 3,000 and 10,000 Congolese francs (approximately one to three and a half dollars) per engagement, having migrated from the provincial capital of Bukavu in search of better opportunities.

However, not all sex workers have agency over their situation. An anonymous woman at the hospital revealed that gangs of pimps deceive young women into prostitution, luring them with promises of work as waitresses before demanding repayment for transportation costs.

Despite the poor state of roads linking Kamituga to the rest of the DRC, mpox has spread throughout South Kivu, making the province the epicenter of the epidemic in a country that has been hardest hit by the disease in Africa.