The World Health Organization says success in ending the Ebola epidemic in eastern Democratic Republic of Congo hinges upon improving security in North Kivu and Ituri provinces. The region has been engulfed in conflict for many years, and many locals do not trust outsiders, even the ones trying to stop the spread of the deadly virus.
The U.N. health agency reports security incidents in eastern DRC have increased dramatically in the past few months. So far this year, it reports 174 attacks by armed groups in North Kivu on health care facilities, workers and patients. These include five deaths and 51 injuries.
In mid-April, Cameroonian Dr. Richard Mouzoko was shot and killed while working in a hospital in Butembo, North Kivu. This incident was seen as a big setback to the Ebola operation. This past Saturday, villagers killed a health worker in the health sector of Mabalako.
WHO Regional Director for Africa, Matshidiso Moeti, says health workers are being intimidated and threatened by armed men and live in fear, not knowing when the next violent attack may occur. She says this insecurity is leading to a lack of access and driving the increase in cases.
“When the response cannot reach people,” she said, “they do not get the chance to be vaccinated or to receive life-saving treatment if they do fall ill.
“The technical means to stop this Ebola outbreak are available,” she added. “But without access or a secure operating environment, they cannot be deployed optimally and effectively enough. …This is why the response is one of the most complex health emergencies the world has faced.”
The latest WHO figures show 1,920 Ebola cases in the region, including 1,281 deaths. A new structure for coordinating and strengthening the Ebola response was presented at the World Health Assembly this week.
WHO Executive Director of Health Emergencies Michael Ryan says key partners will have to scale up their operations and take charge of crucial aspects of the new strategy.
“We believe the work on security, the work on non-humanitarian interventions and the work on sustainable financing are the things that need to happen to provide the environment in which public health operations can continue to progress and be successful,” he said.
However, he warns if there are further large-scale security incidents than all bets are off. He says the likely impact of this ongoing instability will have on the Ebola emergency operation is unpredictable, but worrisome. (VOA)
The isolation ward for Ebola patients is a tent erected in the garden of the local hospital. Gloves are given out sparingly to health workers. And when the second person in this Uganda border town died after the virus outbreak spread from neighboring Congo, the hospital for several hours couldn’t find a vehicle to take away the body.
“We don’t really have an isolation ward,” the Bwera Hospital’s administrator, Pedson Buthalha, told The Associated Press. “It’s just a tent. To be honest, we can’t accommodate more than five people.”
Medical workers leading Uganda’s effort against Ebola lament what they call limited support in the days since infected members of a Congolese-Ugandan family showed up, one vomiting blood. Three have since died.
While Ugandan authorities praise the health workers as “heroes” and say they are prepared to contain the virus, some workers disagree, wondering where the millions of dollars spent on preparing for Ebola have gone if a hospital on the front line lacks basic supplies.
“Even the gloves are not enough,” the hospital administrator said Thursday. “I give them out small small.” A nurse nodded in agreement.
The World Health Organization on Friday said the Ebola outbreak is an “extraordinary event” of deep concern but does not yet merit being declared a global emergency . Such a declaration typically triggers more funding, resources and political attention. WHO said $54 million is needed to stop the outbreak.
And yet both Congo and Uganda appeared to lobby against a declaration, with Congo counting the Uganda-related Ebola cases as its own, saying Congo was where the family members began developing symptoms. Ugandan authorities on Friday said they had only one suspected Ebola case remaining in the country.
More than 1,400 people have died since this outbreak was declared in August in eastern Congo, one of the world’s most turbulent regions, where rebel attacks and community resistance have hurt Ebola response work. The virus can spread quickly via close contact with bodily fluids of those infected and can be fatal in up to 90% of cases, and identifying people who might have been exposed is crucial.
While Ugandan health workers aren’t facing the violent attacks that have killed several Ebola responders in Congo, they remain at risk as they seek to isolate, test and treat for the virus. Basic equipment such as gloves is essential.
At least two nurses at Bwera Hospital might have been exposed as they offered first aid to the infected family. They and some other contacts have since been quarantined in their homes. WHO says at least 98 such people have been identified in Uganda since the outbreak crossed the nearby border.
A nurse, who spoke on condition of anonymity to avoid possible retribution, questioned why some people who might have been exposed to Ebola are allowed to stay at home.
“I wish we could coordinate,” the hospital administrator said of the apparent confusion over how to manage the outbreak.
Ugandan Health Minister Jane Aceng told the AP on Saturday that district officials in Kasese were to blame for limited medical supplies after delaying in submitting their budget.
“It is clearly the responsibility of the district to order supplies,” she said. “If they haven’t done the orders we can’t supply because we don’t know how much they need.” As for upgrading the makeshift isolation ward in the hospital garden, she said “it is not economical. It is not cost-effective” to build permanent structures.
Uganda has faced multiple Ebola outbreaks and is a regional leader in battling Ebola, even if this part of the country has never experienced an outbreak. Some Ugandan physicians were deployed to the West African outbreak of 2013-2016, the deadliest in history.
Health workers in this outbreak now have the benefit of an experimental but effective Ebola vaccine that is being widely used, with more than 130,000 doses distributed. Uganda has vaccinated nearly 4,700 health workers, with more vaccinations set to begin Saturday.
Still, corruption is rampant, and many local people are scornful of government officials seen as out of touch.
As Bwera Hospital tried to arrange a safe burial Thursday for one of Uganda’s first Ebola victims, officials quickly realized there was no vehicle. The burial took place hours later and in darkness , which some residents called a sign of the government’s shortcomings.
“This should have been done by the health office, the district health office,” said Moses Mugisa, clerk of the border town of Mpondwe-Lhubiriha, who eventually found transport for the corpse.
In addition, he said, voluntary health teams screening for Ebola on the border have gone unpaid for about four months. He criticized the decision of government officials from Kampala, the capital, to visit only briefly after Uganda’s first Ebola case was announced. “We have a lot of work to do,” he said. (VOA)