Ebola is a known disease in the Democratic Republic of the Congo (DRC). Since the discovery of the disease in 1976, The country has experienced 17 outbreaks, counting the latter, whose impact scales to 1,077 possible cases and 246 deaths. However, this virus is not the only threat to the Congolese population. The presence of armed groups, cuts in international aid, social stigma and the high mortality caused by other tropical diseases complicates the prevention and treatment of Ebola.
The initial focus of the outbreak was detected in the Mongbwalu mining townin the northeast of the country. There, the high population density, the concentration of workers in the mines and the constant movement linked to trade created the perfect scenario for the Bundibugyo variant of Ebola to spread rapidly. “It is a highly insecure region with significant population movements across borders with South Sudan and Ugandadriven by the ongoing armed conflict, as well as by mining and commercial activities,” he explains to EL PERIÓDICO Esperanza Santosemergency coordinator Doctors Without Borders (MSF).
The first patient, a resident of Mongbwalu, went to a medical center in Bunia, capital of the province of Ituriwith high fever, diarrhea and hemorrhages, symptoms similar to other common diseases in the region, so the case went unnoticed. After his death, the body was brought back to Mongbwalu to celebrate a traditional funerala ceremony in which family and friends maintain direct contact with the body. “One of the transmission routes is the handling of corpses of people who have died from the disease, which is why it is very important that burials are held in a controlled and safe manner,” says Santos.
Incidents in health centers
However, part of the population faces this new outbreak with mistrust and resistance to abandon traditions to follow prevention and isolation measures. Last Thursday, relatives of a deceased person at the Rwampara Hospital, in Ituri, They set fire to two tents used to treat Ebola patients, according to local sources. The NGO Alliance for International Medical Action, which operates at the center, confirmed the incident in a statement, although without providing further details.
In that same hospital, built by Doctors Without Borders, 18 patients being treated for or suspected of having Ebola fled last Saturday after a new incident in which a group broke into the isolation areas and set fire to the facilities again. “The lack of information about the disease, isolation, treatment and infection control measures can cause frustration that in some cases turns into violence against the agents in charge of the response,” explains Santos.
In the middle of an armed conflict
The World Health Organization (WHO) also insists on the need for the population’s collaboration, but warns that it is difficult to generate community trust in a context marked by violence and constant combat. “Eastern Democratic Republic of the Congo now faces a catastrophic collision of diseases and conflicts“wrote on Wednesday the director general of the WHO, Tedros Adhanom Ghebreyesuson their social networks. “We cannot build trust in the community or isolate the sick while bombs fall. We urge all parties to the conflict to agree to a Immediate ceasefire to contain this outbreak“he added.
In the northeast of the Congo, an area rich in gold and coltandozens of armed groups dispute control of resources. Although most are small and disorganized, others, such as the M23have managed to take control of part of the territory and have established a parallel administration in the provinces of North Kivu and South Kivuwhere they confront the Congolese Army and groups that support the Kinshasa Government. The fighting causes internal displacements and aggravate a situation of chronic poverty, insecurity and infrastructure deficit.
“Responding to a large Ebola outbreak is extremely difficult in a context marked by major humanitarian crisis and armed conflicts. All of this makes surveillance, contact tracing and timely treatment difficult,” says the MSF coordinator.
Cuts in international aid
One of the main differences of this outbreak compared to previous ones are the cuts in international aidnot only of the programs financed by the American agency USAIDalmost completely dismantled by the Trump administration, but also by other donors, both state and private foundations.
“Almost all Western countries have cut funds. Some of those resources were allocated to the analysis and treatment of samples. The reduction of resources has had a very negative impact on African countries to detect, analyze and report disease outbreaks,” stressed the director general of the African Centers for Disease Control and Prevention (Africa CDC), Jean Kaseya, in a virtual press conference this Thursday. “We no longer wait for our partners to act. In Africa we have understood that we must stand on our own,” he said.
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