Congo Ebola response strained a month after WHO declares international emergency
Written by: Emma Farge, Jennifer Rigby and Clement Bonnerot
NAIROBI/LONDON/DAKAR, June 17 (Reuters) – Health workers fighting an Ebola outbreak in eastern Democratic Republic of Congo lack the personnel to detect suspected cases, ambulances to transport them and even construction materials to build isolation wards, officials and aid workers told Reuters.
A month after the World Health Organization declared an international emergency, an outbreak of the rare Bundibugyo strain has reached more than 800 confirmed cases, raising warnings that it could be the worst on record, surpassing the 2014-16 West African outbreak that killed more than 11,000 people.
Jean Kaseya, director general of the Africa Centers for Disease Control and Prevention, told Reuters that medical teams were so stretched that tens of thousands of contacts of those cases could not be traced, pointing to insecurity and the epidemic’s urban, mining-heavy environment as central obstacles.
“Four weeks later, we had an outbreak in an urban area where there was insecurity, where there was mining and trading activities, and also where we couldn’t reach all the people who needed to be on the contact list,” he said late Tuesday.
“We can’t say we can win with this pandemic if we can’t reach these people.”
PATIENTS ARE RUNING AWAY, WAITING
Even detected cases, which may represent only a fraction of the total due to insufficient testing and data gaps, are not always isolated and dealt with, he said.
“We have people who were accepted and decided to run for many reasons. We have people who were positive but were not accepted. We also saw a large number of people who were accepted, but we believe they did not receive the appropriate support,” Kaseya said. he added.
A WHO report showed that roughly a third of 241 alerts about new suspected cases in Ituri, the worst-hit province, had not been followed up as of June 14.
Oxfam Ebola Response Coordinator Manel Rebordosa in the city of Bunia told Reuters that a woman with symptoms such as fever and bleeding was kept waiting for hours at the Rwampara medical center she visited this week.
“They were calling the surveillance system, but they didn’t show up because they covered so many health districts and didn’t have enough ambulances,” he said.
The Africa CDC said teams handling safe burials and decontamination in Ituri had only 15% of the necessary personnel and 7% of the necessary vehicles.
Congo’s health minister, Samuel-Roger Kamba, rejected suggestions that the outbreak had outpaced the response, saying at a government briefing on Monday that the ministry had trained 1,200 community protection officers and deployed 1,000 of them to follow contacts and suspected cases door-to-door, and that contact tracing was now running at 63%.
However, response teams faced a number of challenges in the field. In documents shared with Ebola response teams in Ituri on Wednesday, the ministry highlighted problems such as missing contact cases, patients moving between health zones and a lack of fuel for mobile units.
RESOURCES FOR ‘EVERYTHING’
Professor Salim Abdool Karim, who advises the Africa CDC and visited Ituri last week, said the biggest challenge was supply.
“More resources are needed for almost everything from PPE (Personal Protective Equipment) to gravel,” he said in a report he will present at an emergency meeting soon.
Gravel shortages have delayed the construction of isolation wards, he said, adding that prefabricated panels for walls, floors and roofs are missing and that USAID, which was dismantled by US President Donald Trump last year, is notable for its absence.
The United States says it is the largest donor to the intervention and is asking others to contribute as well.
Medics have no masks and dozens of people have contracted the Bundibugyo strain, which has no proven vaccine or treatment.
Kaseya of the Africa CDC said the materials needed sometimes “just sit somewhere in a warehouse.”
The African Union says it has received only a fifth of funding for its $518 million response plan, and aid workers say donor support has fallen compared to previous Ebola outbreaks.
Asked whether Western governments need to do more, Kaseya said: “I think they’re starting to understand that this is serious.”
(Reporting by Emma Farge, Jennifer Rigby and Clement Bonnerot; Editing by Hugh Lawson and Deepa Babington)
