Medical staff stand at the doffing and decontamination station at the Evangelical Medical Centre of Nyankunde after providing care to patients suffering from or suspected of having Ebola virus disease. Photo / Jospin Mwisha, AFP
Since the outbreak was declared on May 15, 808 cases have been confirmed in the DR Congo, including 192 deaths, according to the latest World Health Organisation figures.
Feared ‘geographic expansion’
The response to the epidemic, the 17th to hit the vast central African country, has faced towering challenges.
No approved vaccines or treatments exist for the Bundibugyo strain of the virus responsible for the current outbreak.
The three affected provinces in the northeast – Ituri, North Kivu and South Kivu – have long been gripped by conflict and mass displacement, complicating the response.
And the region has seen conflict casualty figures climb higher since the outbreak began, according to the Red Cross, placing further pressure on an already fragile health system.
“A sudden geographic expansion of the epidemic is feared if public health measures are not implemented quickly,” the Congolese National Institute of Public Health warned in its daily situation report.
Family members pay their last respects to a relative who died from Ebola through a window at the morgue of the Evangelical Medical Centre of Nyankunde. Photo / Jospin Mwisha, AFP
The outbreak has already spread to neighbouring Uganda, which to date counts 19 confirmed cases, including two deaths.
In the DR Congo, Doctors Without Borders (MSF) and Oxfam warned this week that the full extent of Ebola, which is spread by close contact and infected bodily fluids, remained unclear.
“No one knows the true scale or exactly where the disease is spreading,” Kate White, MSF’s emergency medical co-ordinator in the DR Congo, said yesterday, warning that “testing remains one of the most significant weaknesses”.
Michon agreed.
“It’s very difficult to know exactly to what extent the epidemic is spreading,” he said.
‘Blind spots’
Oxfam attributed insufficient contact tracing to “the withdrawal of US funding for disease surveillance and severe funding shortfalls”.
The aid organisation also pointed to a dire lack of clean water in the Ebola-stricken areas, as well as a dearth of basic protective equipment for health workers.
While testing capacity has been significantly ramped up in recent weeks, World Health Organisation spokesman Tarik Jasarevic acknowledged that “blind spots” remain.
“There may be transmission chains that are not being detected,” he told reporters in Geneva.
The mistrust of the population in a region where the Congolese state has been absent in many areas for decades is another major hurdle, Michon said.
Like in past outbreaks, hospitals and medics in the eastern part of the country have reported attacks and riots, with some criticising the Congolese Government’s response and others denying that Ebola even exists.
“To stop this outbreak, we need to invest not only in medical response, but also in trust, local volunteers, community engagement and operational access,” Michon said.
He pointed out that “in recent days, DRC Red Cross volunteers have faced verbal abuse, threats and even physical attacks while carrying out their work”.
“Trust is central,” he said.
“Without trust, we cannot detect cases early. We cannot ensure safe burials. We cannot protect families. And we cannot stop transmission.”
– AFP