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Photo: John Wessels
Health workers are seen inside the red zone in a recently built Ebola treatment center (ETC), which MSF is treating in Bunia.
By Rebecca Ratcliffe
While the health system is at the limit, uncertainty about the transmission of the virus raises fears that it is outside the DRC.
The number of Ebola cases recorded every day in the Democratic Republic of Congo is expected to more than double, as concerns about how the virus is transmitted could spread to neighboring countries.
On Thursday, the World Health Organization (WHO) reiterated its warning that the risk of an epidemic would spread not only in the DRC, but also in Uganda, Rwanda and even Southern Sudan. The increased danger of transmission is due to significant movement between affected areas.
Efforts to contain the epidemic in the DRC have been hampered by violence related to the December elections that disrupted prevention activities. Protesters have targeted about 30 health facilities in Beni, while efforts to trace anyone who has been in contact with the virus have been partially suspended for security reasons.
From October to December, six cases were recorded every day in all affected areas of the east of the country, but their numbers are increasing, said Jean-Philippe Marcoux, national director of Mercy Corps for the DRC.
"Now he doubles – it's very possible that he can still overtake," Marcoux said. "If we do not increase resources significantly, it will continue to increase. It will gradually spread to other health areas and remain there for a long time. "
Two health centers supported by Mercy Corps are being rebuilt after demolition by protesters during the Christmas period. The protesters were angry at the decision to postpone the presidential election in some parts of the country.
Although much of Mercy Corps' work resumed in January, its activities are still hampered by instability, the presence of armed groups and the shortage of qualified health professionals. In addition to the Ebola crisis, the DRC is also experiencing outbreaks of cholera, polio and malaria, according to the WHO, exacerbating the pressure on the country's overwhelmed health system.
In some regions, about half of recent cases recorded were nosocomial – which means that transmission has occurred in health centers – Marcoux said.
"This indicates that much more needs to be done at the health center level to prevent the spread of infection," he said.
Marcoux added that more funding is needed for training and monitoring health workers and for preventive prevention work with communities in areas where the disease may spread.
There is also concern that in some areas the source of transmission is unclear in almost half of recent cases.
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Since the beginning of the epidemic in August, the WHO has recorded 668 confirmed or probable cases and 410 deaths. Since 1 December, more than a third of cases have occurred in children under 15 years of age. Of these, 16 were infants under 12 months of age.
"If nothing is done, it will spread to other parts of the DRC and neighboring countries close to the affected areas – Uganda, Rwanda, and even South Sudan." "said Marcoux.
The disease is expected to be present for at least nine to twelve months, he added.
In a status report, the WHO warned that the epidemic was at a critical juncture: "The persistence of insecurity threatens to reverse recent advances made around disease hotspots such as Beni and Butembo. "
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