The World Health Organization has described itself as “heartbroken” after an independent inquiry it commissioned said scores of women and girls were sexually abused by aid workers during the devastating 2018-2020 Ebola outbreak in the Democratic Republic of Congo. The findings were described as “harrowing reading” by the WHO’s director general, Dr Tedros Adhanom Ghebreyesus, while its regional director for Africa, Matshidiso Moeti, said she was “humbled, horrified and heartbroken”. The commission, which examined about 80 cases of women and girls aged 13 to 43, identified 21 employees working for the UN global health body among perpetrators of serious abuses, including a number of rape allegations. According to the report, the abuse led to 29 pregnancies, with some of the perpetrators insisting the women have abortions. The report added that the WHO perpetrators included local and international staff. Western diplomatic sources said four people had been dismissed and two placed on administrative leave, based on a closed-door briefing involving WHO that was provided to diplomatic officials in Geneva on Tuesday. The report detailed a far-reaching breakdown of responsibilities for protecting against sexual exploitation and abuse in a health emergency in an insecure region, largely dominated by male responders. The investigators found that most victims were “highly vulnerable”, often younger women in precarious economic situations, with some of the abusers holding responsibilities for preventing sexual exploitation and abuse. “I’m sorry. I’m sorry for what was done to you by people who were employed by WHO to serve and protect you,” Tedros said. “I’m sorry for the ongoing suffering that these events must cause. I’m sorry that you have had to relive them in talking to the commission about your experiences. Thank you for your courage in doing so.” The panel released its findings on Tuesday, months after media reports that senior WHO management had been informed of multiple abuse claims in 2019 but failed to stop the harassment, and even promoted one of the managers involved. The review team was able to obtain the identity of 83 alleged perpetrators – Congolese nationals and foreigners. In 21 cases, the team established with certainty that the alleged perpetrators were WHO employees during the Ebola response. The commission’s findings confirm reports that workers involved in the Ebola relief effort demanded sex in exchange for employment contracts, threatened women’s livelihoods if they refused, and in the most serious cases were involved in sexual assaults. It described how “Jolianne”, said to be the youngest of the alleged victims, recounted that a WHO driver had stopped to offer her a ride home as she sold phone cards on a roadside in the town of Mangina in April 2019. “Instead, he took her to a hotel where she says she was raped by this person,” the report said. Malick Coulibaly, a panel member, said during a media briefing on Tuesday that there were nine allegations of rape. The women interviewed said the perpetrators used no birth control, resulting in some pregnancies. Some women said the men who had abused them forced them to have an abortion, Coulibaly said. The inquiry sheds light on the latest in a series of exploitation scandals among aid and development workers and comes after similar claims were levelled at Oxfam workers in Haiti after the 2010 earthquake, and at UN peacekeepers in Central African Republic. The abuse in the DRC occurred during an Ebola outbreak in the North Kivu and Ituri provinces – areas marked by political instability and armed conflict in which 2,280 people have died over two years. After the allegations emerged, the WHO’s director general asked Aïchatou Mindaoudou, the former foreign minister of Niger, and the Congolese human rights activist Julienne Lusenge, who has worked widely with victims of sexual violence, to investigate. Some of the women who say they were abused by WHO officials hoped those involved would be severely punished; others said disciplining the WHO employees would go a long way towards ending violence against women. “I have been waiting for this big moment for more than a month to see how WHO will sanction these [doctors],” said Anifa, who alleged she received a sex-for-jobs offer. “We would like to see justice done.” Julie Londo, a member of the Congolese Union of Media Women, a women’s organisation that works to counter rape and sexual abuse in Congo, applauded WHO for punishing the staff but said more was needed. “WHO must also think about reparation for the women who were traumatised by the rapes, and the dozens of children who were born with unwanted pregnancies as a result of the rapes,” she said. “There are a dozen girls in Butembo and Beni who had children with doctors during the Ebola epidemic, but today others are sent back by their families because they had children with foreigners. We will continue our fight to end these abuses.”