WHO fears Ebola virus in DRC becomes uncontrollable due to political violence

The flow Ebola outbreak In the Democratic Republic of Congo, which is already the seventh largest in history, the World Health Organization announced Tuesday

While Ebola cases have slowed from 40 to about 10 a week in recent months, political instability has provoked riots and suspicions about government forces, which has put health workers in the dark. l & # 39; gap.

At a press conference, the WHO warned of a "perfect storm" of factors likely to aggravate the generalized epidemic: about 100 people died and 150 were infected in the province of North Kivu.

Ebola, a haemorrhagic fever, is spread by exposure to body fluids, which are becoming more prevalent as the disease progresses, making immediate quarantine and ongoing treatment paramount to stopping an epidemic. As new political violence and the recent campaign of misinformation make the region increasingly difficult for medical staff, the risk of Ebola-infected people staying in the community and spreading the epidemic further increases.

Dr. Peter Salama, WHO's Chief of Emergency Response, told HuffPost that the escalation of violence in the region was limiting health professionals' access to Beni, a city of some less than a quarter of a million people.

Salama pointed out that the WHO now estimates that several months may be needed to contain the epidemic, well beyond the initial three projections. More financial and international support would be needed to sustain response efforts.

The most recent and most violent attack by the Allied Democratic Forces (ADF) rebel group killed 17 civilians on Saturday, Salama said. Since then, Beni has entered a state called Salama "dead city", which means "dead city" and refers to public mourning. This mourning has turned into anger directed against the DRC government for its inability to protect its citizens not only against this violence, but also against scary epidemics such as Ebola, he said.

Public demonstrations of this anger include riots on police-controlled streets with tear gas, HuffPost told Hassan Coulibaly, a field director in Beni's field for the International Rescue Committee.

This has led intervention teams from the government, the WHO and various NGOs to lead the efforts in Beni, to hang since Monday, pending the end of the protests Friday .

"It's exactly the scenario that people have long dreaded with this outbreak," Jeremy Konyndyk, a senior official with the Washington-based Center for Global Development, told HuffPost. "Losing a week or more of confinement efforts is a big handicap and will likely result in more cases."

Salama warned that groups of young people in other parts of North Kivu were planning to hold their own "dead city" to express their solidarity with Beni, which could trigger a lockout in the affected areas.

Every day, health workers are not allowed to follow the contacts of infected people looking for signs of the disease.

"Over the days, if we see dangerous burials that we can not answer, if we see symptomatic people inaccessible, we can see this situation deteriorate very quickly," said Salama in a Geneva press. Tuesday briefing. Health teams were able to track only one-fifth of contacts in the last 48 hours in the Beni region.

"It's a very scary scenario, where 80% of the contacts we know simply do not know what happened to them today and yesterday," Salama said.

Salama added that there had been three suspicious cases in the last two days, which the intervention teams were unable to access during the lockdown.

He also told HuffPost that at least one confirmed case of Ebola, a person who has actively resisted treatment, is now in a red zone – an area to which health workers can not access. because of the security risk. Health workers have been unable to treat or track this case and the potential infection of other people.

"The epidemic is growing steadily," Coulibaly told HuffPost. "People could die in their homes [during this lockdown] and if it happens and it is linked to the Ebola virus and people are touching the body, it will probably lead to the spread of the disease, Coulibaly added.

Ron Klain, Obama's Ebola Tsar, echoed the need for an international approach and investment to tackle such dangerous epidemics. While commending the WHO for its prompt and transparent response, he stressed that insecurity in the region was highlighting its limitations as an international organization.

"[The WHO] There is no security force to allow him to operate in a conflict zone or when the responders could be in danger. And it lacks the political aspect to try to prevent local leaders from playing politics with a dangerous disease, "he said.

In addition to the violence in the region and the logistical complications it presents, Salama highlighted the rise of political misinformation in light of the upcoming December elections in the DRC.

Local politicians have taken advantage of the combination of rebel attacks and the Ebola outbreak to blame the government and increase tensions between the population and public health stakeholders, contributing to growing resistance from communities treatment and awareness. Salama pointed to a rise in social media on conspiracy theories about the epidemic that ignited such resistance and inhibited response efforts.

"This resistance, fueled by a completely natural fear of this terrifying disease, is starting to be exploited by local politicians and we are very worried … that exploitation of this very natural fear will take hold. scale and will make even more difficult the rooting of the latest cases of Ebola, "said Salama.This" scary high-risk pathogen will exploit these community and political loopholes and will not respect borders, whether provincial " or international ".

In any Ebola outbreak, there will usually be resistance from the community, with outside forces imposing themselves in an unknown area, imposing quarantines and forcing safe burials that are not the usual tradition, Coulibaly said. . Those in hazardous material combinations can sometimes be seen as warning signs of death.

A spokeswoman for the DRC Ministry of Health pointed out that years of rebel attacks "have created a clear defiance of all foreigners, especially public authorities and international organizations" .

Coulibaly further argued that there was a lack of deployed people from the affected communities – partly because of the fragility of the conflict-ridden region.

"A crisis is the wrong time to build trust," said Dr. Ashish Jha, director of Harvard Global Health Institute, HuffPost. "You want to have built that trust for years before the crisis."

This lack of confidence has caused some members of the community who are ill to resist treatment and run for miles in the bush to escape detection, Salama said. And this has helped to make this epidemic incredibly widespread geographically – more than 200 kilometers from north to south. Such a spread makes it extremely difficult to access suspected cases in less than 24 hours – which is preferable for containing and controlling such an outbreak.

And whenever a patient tries to actively hide Ebola for any reason, they compromise the safety of the community, Coulibaly said.

"They do not save their lives and they also kill other lives," he said.

The epidemic, which according to the Ministry of Health began after a man from Mabalako found an infected dead cat and took him home to eat with his family, continued to grow.

International authorities are particularly concerned because a case has been discovered on the shores of Lake Albert, DRC, on the border with Uganda.

Doses from an experimental vaccine, of which more than 11,000 were deployed in the DRC during this outbreak, are expected to arrive in Uganda on Thursday, Salama told HuffPost.

WHO must still consider the current situation as a public health emergency of international concern – an urgent declaration for the most serious public health crises – although Salama said the organization was considering or not to convene a meeting for the international broadcast.

While WHO, IRC and MSF all told HuffPost that they were not considering retiring, the increasing security risks are being raised. active surveillance. A withdrawal of international assistance would be devastating to control the outbreak, Salama said.

The DRC is tackling public health crises all year long – this is the second Ebola outbreak in 2018, and the country is also facing a polio epidemic and a yellow fever threat. For Salama and Jha, this is just a reminder of the increasing risks of the growing number of dangerous epidemics that accompany population growth, climate change and new patterns of migration.

"The number of homes that the DRC has experienced this year is unprecedented, not only for the DRC, but for all countries of the world," said a spokesman for the Ministry of Health in HuffPost. "The whole system is doing its best to provide an appropriate response to these outbreaks. But this shows the importance of investing more in improving and strengthening the overall health system.

But for now, public health experts are waiting to see the evolution of the epidemic at this time of crisis.

"It reminds us that we are just an epidemic on a global scale," said Jha.