RokStories Congo Starts 2019 Still Battling Ebola
By P.J. Heller
Efforts to battle the second worst outbreak of Ebola in the Democratic Republic of the Congo were being hampered at year’s end by a deterioration in the security situation, leading the head of the World Health Organization to warn that recent gains in fighting the deadly virus could be lost.

“We have reached a critical point in the Ebola response,” said Dr. Tedros Adhanom Ghebreyesus, director-general at WHO. “After an intensification of field activities, we were seeing hopeful signs in many areas, including a recent decrease in cases in Beni.

“These gains could be lost if we suffer a period of prolonged insecurity, resulting in increased transmission. That would be a tragedy for the local population, who have already suffered too much,” he said.

Raphael Mbuyi, acting country director for Oxfam, sounded an even more ominous tone in describing the situation, where pre-election violence forced the nonprofit, as well as WHO teams, to suspend their work in the Ebola ravaged areas of Beni and Butembo in eastern DRC.

“This is an extremely worrying situation, as every time the Ebola response has been suspended before, we’ve seen a big spike in the number of new cases,” Mbuyi said. “This could mean Ebola spreading to even more people and potentially other countries in the region, putting many more lives at risk.”

WHO reported that since the latest Ebola outbreak was declared on Aug. 1, more than 350 people have died out of nearly 600 people infected. Some 20 percent of the cases were reported in the last month.

So far, more than 50,000 Congolese have been vaccinated with an experimental drug designed to protect them from the virus, according to the Ministry of Health. Ebola is a deadly disease spread through direct contact with body fluids of people infected with it. It is also spread by touching things that have been contaminated with these fluids. It first appeared in 1976 near the Ebola River in what is now the DRC.

Officials worry that national elections scheduled for Dec. 30 will result in more people traveling to polling places and coming into contact with others, which could further spread the disease. There was also concern about people traveling for the holidays, not only within DRC but to Uganda, Rwanda and South Sudan which border Congo areas with Ebola outbreaks.

“As the risk of national and regional spread is very high, it is important for neighboring provinces and countries to enhance surveillance and preparedness activities.” WHO said. “The International Health Regulations Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread.”

The DRC elections, which have been delayed for years, have prompted dozens of local militia groups to step up their attacks, forcing health workers to suspend their work tracking cases and isolating people with Ebola. Protestors allegedly broke into an isolation center for Ebola patients in Beni, prompting two dozen of them to flee; 17 had already tested negative for Ebola and seven others had yet to be tested.

Concern about the spread of Ebola and the ongoing violence prompted the DRC’s national election commission (CENI) to delay voting in Beni, Butembo and Yumbi and surrounding rural areas until March, long after a new president is sworn in. It was not clear what would happen with those subsequent votes. More than 1.2 million of the Congo’s 40 million registered voters live in that region, which opposes outgoing President Joseph Kabila, who has ruled since 2001. Some saw the move to delay the vote as an effort to shore up support for Emmanuel Ramazani Shadary, who Kabila favors as his successor.

“Elections lead to important movements of voters toward polling places, thus leading to concentrations of people . . . raising the risk of propagation of this disease and providing the conditions for terrorist attacks,” CENI said in a statement.

Mbuyi of Oxfam said he understands why people are protesting.

“. . . it’s not surprising that people who have had their votes taken away at the last minute are frustrated and going to the streets. These people deserve to have their say as well,” he said. “All parties need to find a way for people who have been devastated by Ebola and have lived through decades of violent conflict, to cast their vote.

“Whatever the outcome, there needs to be an end to the years of misery people in this country have had to endure. Just because elections are being held does not mean there will be peace,” he said.

The pre-election violence prompted Ebola experts from the Centers for Disease Control and Prevention to be pulled out of the outbreak zones in northeastern Congo. They initially went to Kinshasa, the capital, about 1,000 miles away. Staff with the U.S. Agency for International Development were also there.

On Dec. 14, the U.S. State Department ordered all non-emergency personnel and their families to leave the DRC, ahead of the elections, which had been scheduled for Dec. 23 but were pushed back one week due to the ongoing violence and a reported delay in deploying voting materials.

“The U.S. Embassy’s ability to provide emergency services to U.S. citizens in the DRC is severely limited, particularly outside of Kinshasa,” the State Department said. “Elections are scheduled to take place on Dec. 23 and could trigger large-scale demonstrations which could further limit the services of consular staff even in Kinshasa.”

Health officials, meantime, are hoping to resume their battle against the disease in the new year. There have, however, been varying statements about the road ahead.

The New York Times reported that the “biggest worry is that, unchecked, the epidemic could reach Goma, the regional capital.”

“If it hits Goma, we’re done for,” Dr. Jean-Christophe Shako, a director of a local Ebola response team, told the Times.

Robert Redfield, director of the Centers for Disease Control and Prevention, suggested in November that public health experts needed to consider the possibility that the Ebola outbreak in DRC could not be brought under control and instead would become entrenched.

WHO’s Ghebreyesus said that the priority was to end the outbreak.

“We hope to return to full operations as soon as possible while remaining committed to ensuring the safety of all staff deployed. We cannot afford to take a step back at this critical point in the response,” he said.

He said teams in Beni and Butembo were doing everything possible to continue responding despite the challenging security environment.

“In general, the communities in affected areas have been supportive of the response,” Ghebreyesus said. “We ask for everyone to protect health facilities and provide access for responders to the affected populations so that we can stop this outbreak. The population must also have safe access to transit and treatment centers that save lives and stop the spread of Ebola.”

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