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Jacqueline Weyer, National Institute of Communicable Diseases
In early April, nearly 700 people died of the disease, making it the second most serious Ebola outbreak ever recorded. This is the second most important after the outbreak in West Africa from 2013 to 2016, which claimed the lives of more than 11,000 people. And it seems that the end is not in sight yet. The Conversation Ina Skosana, from Africa, asked Jacqueline Weyer about the worsening public health crisis.
Why can not this epidemic be controlled?
The epidemic is reported in eastern DRC, and more particularly in the provinces of Ituri and North Kivu. Political instability and conflict have ravaged this region for more than two decades; much of the violence is rooted in the 1994 Rwandan genocide.
In this unstable context, the provision of health care services and other public health interventions required to interrupt the epidemic has become a highly problematic and dangerous activity.
In recent months, health facilities and health workers have been targeted by violent groups. In some cases, health services and containment efforts have been interrupted on a large scale.
This has had disastrous consequences: the epidemic has spread to 21 health zones in the two affected provinces. In some of these areas, the outbreak can be controlled. But others, like Butembo, have proved more difficult.
The epidemic is devastating vulnerable communities already affected by displacement and violence. UNICEF has identified nearly 700 orphaned children as a result of this epidemic. This epidemic has all the qualities of a humanitarian crisis.
Could the epidemic spread even further?
The epidemic is occurring where DRC's eastern borders meet Uganda, Rwanda, and southern Sudan, and there is concern that it will spread across borders with these countries. The World Health Organization (WHO) reports that more than 46 million travelers crossing borders in these regions in recent months have been screened to prevent the disease from spreading to other countries. To date, no cases of Ebola have been exported beyond the DRC's borders.
What needs to be done to bring the DRC closer to ending this epidemic?
A major obstacle has been community resistance to health interventions and mistrust of caregivers. It is crucial that measures be introduced to strengthen community engagement and participation in public health activities related to the epidemic. In its latest external status report, the WHO indicates that hard progress is being made to gain the trust of communities.
Secondly, it is important to manage the increasing risk of fatigue among health care workers, public health professionals and other stakeholders as the epidemic continues to evolve. These workers are pushed to the extreme, working long hours, days, weeks and months in very trying conditions.
Responsive and vigorous responses are needed until the epidemic is declared over: it is essential to take care of the health and public health staff. This is easier said than done and, in addition, the safety of the staff assigned to the outbreak has been a problem in recent months. Given the complexity of the political situation in the region, it is unlikely that the violence will end.
WHO says measures have been taken to improve the safety of health workers. More and more guards were deployed in treatment centers and in the premises used by health workers.
It is also crucial to ensure that sufficient resources are available to continue the fight against this epidemic. This includes sufficient and uninterrupted supplies of Ebola vaccine to enable the DRC to cross this epidemic and beyond. The WHO states that there has been no interruption in the supply of vaccines to date. But as the epidemic continues to worsen, one wonders if this situation will remain the same.
Read more:
The Ebola vaccine is key to ongoing efforts to contain the DRC epidemic
Jacqueline Weyer, Senior Medical Scientist, National Institute of Communicable Diseases
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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