Ebola in DR Congo: One month on, scaled up response remains insufficient
The DRC now has more than 780 confirmed cases and 180 deaths, while Uganda has recorded 19 confirmed cases, including two deaths. On the ground
The DRC now has more than 780 confirmed cases and 180 deaths, while Uganda has recorded 19 confirmed cases, including two deaths. On the ground, the response has expanded considerably. Some 400 beds are now available and four laboratories are operational. Two of them alone can process nearly 1,000 samples a day. Yet despite this scale-up, the World Health Organization (WHO) believes efforts remain far below what is needed to bring the outbreak under control. “On a scale of zero to ten, compared with where this response needs to be, I would say we are at about three or four,” said Dr. Rose Belizaire, Emergency Response Lead at WHO Africa, in an interview with UN News. “The outbreak is evolving rapidly, and all partners (...) need to step up their efforts on the ground in order to keep pace with the evolution of this epidemic.” © WHO/Josua Mulala Raymond Eleven pillars Today, when a person is reported as a suspected case in a community, an investigation team is immediately dispatched. If the alert is confirmed, the patient is referred to a transit centre, where they await laboratory results before being transferred, if necessary, to a treatment centre. But the Ebola response goes far beyond medical care. “The response is organized around 11 pillars in the field,” Dr. Belizaire explained. Community surveillance, investigation teams, transit centres for people awaiting diagnosis, laboratories, treatment centres, infection prevention and control, and data management are among the many components mobilized under the leadership of Congolese health authorities. The response also includes extensive support for patients, their families and people exposed to the virus. “We now have psychosocial support and nutritional support that provide assistance to confirmed patients, their families and the contacts we are monitoring, so that we can take a holistic approach to this outbreak,” said the WHO official.
On the ground, this approach takes very concrete forms. “Contacts receive food rations,” the epidemiologist noted. As for hospitalized patients, “they receive three hot meals a day.” The response also includes infection prevention and control measures aimed at limiting transmission. “This includes disinfection and the destruction of items contaminated by the virus,” Dr. Belizaire said. “It is an entire machinery that has to be put in place.” © WHO/Josua Mulala Raymond We have the expertise, resources must follow During a recent visit to Beni, one of the areas hardest hit by the outbreak, Dr. Belizaire said she was struck by the level of preparedness among local teams. “I was very satisfied with their technical capacity to implement the response. They know what needs to be done. They also have the technical expertise,” she said. What they lack, however, are the resources needed to match their capabilities. “What they were really missing were the means. They lacked human resources, and they also lacked the logistical support required to put in place a robust response.” Women on the frontline The outbreak is also evolving demographically. At the start of the outbreak, men aged 20 to 49 were the group most affected. Today, women represent the most affected category, while cases among children are increasing. For Dr. Belizaire, this shift is not surprising. “In outbreaks of infectious diseases, women are generally the most affected. They are the ones who care for family members, their husbands, their parents and their children.” A listening response For WHO, adapting the response to realities on the ground has become an essential part of the fight against Ebola. “We are trying to meet with all segments of the population in order to understand their needs and adapt the response to their reality,” Dr. Belizaire explained.
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