While medical personnel and international aid agencies are working tirelessly in the Democratic Republic of the Congo (DRC) to fight the ongoing outbreak of the Ebola virus, a select few medical workers may be engaging in a “sex for treatment” scam. According to a report published last week in The Guardian, researchers with several non-governmental organizations (NGOs) discovered that some women in the DRC may have been asked to perform sex acts on healthcare personnel in exchange for potentially life-saving treatment, such as the Ebola vaccine. This sexual predation only adds to the cultural mistrust many Congolese already harbor against government aid workers. This culture of mistrust is further dampening relief efforts and contributing to the spread of the virus.

“This region of DRC has a long history of sexual violence and exploitation of women and girls. Though shocking, this is an issue that could have been anticipated,” said Trina Helderman, who serves as Medair’s global emergency response team’s senior health and nutrition adviser. “Humanitarian actors should have been more prepared to put safety measures in place to prevent this from happening.”

The ongoing exploitation of women and girls in the DRC was brought to light during a DRC Ministry of Health meeting earlier this month. Focus groups conducted by the International Rescue Committee (IRC) revealed that women and girls are feeling increasingly stigmatized as the outbreak continues. The DRC Ministry of Health has refuted the reports, saying that although some women in affected areas feared exploitation and attacks by healthcare workers and the local population, the ministry isn’t aware of any reported occurrences.

“More importantly, no women reported individual cases of sexual exploitation to the IRC during the focus groups,” the DRC Ministry of Health said in a statement, according to the Guardian. “These women and girls expressed their fears and concerns about the Ebola response considering the social and security context they live in.”

At the time of this writing, more than 850 Congolese have contracted Ebola, and another 531 have died. According to the World Health Organization (WHO), the outbreak’s original epicenter of Beni in North Kivu province hasn’t seen a new case of the hemorrhagic fever in nearly a month. However, Ebola is still spreading in several surrounding areas, and earlier this month experts asked the WHO to consider declaring the current Ebola outbreak, which is the second largest in history, an official threat to global health. Remarkably, the virus has not yet spread outside the borders of the DRC, but experts warn that increased vigilance is needed to contain the current outbreak.

“As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities,” wrote WHO representatives in a recent Ebola outbreak news update. “The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread.”