Milestones :: Perspectives
DRC – Ebola
Ebola Treatment Center in Congo Is Attacked Again; 1 Dead
March 9, 2019 By The Associated Press
KINSHASA, Congo — Heavily armed assailants again attacked an Ebola treatment center in the heart of eastern Congo’s deadly outbreak on Saturday, with one police officer killed and health workers injured, authorities said, while frightened patients waited in isolation rooms for the gunfire to end.
The early-morning attack in Butembo came less than a week after the treatment center reopened following an attack last month, which forced Doctors Without Borders to suspend operations in the city amid warnings that ending this outbreak is impossible if health workers aren’t protected.
Dozens of armed groups are active in mineral-rich eastern Congo, though some have allowed health workers access to administer Ebola vaccines and track contacts of infected people after delicate negotiations.
Security forces on Saturday repelled the attackers, one of whom was wounded, Butembo Mayor Sylvain Kanyamanda said. Congo’s health ministry in a statement said forces had surrounded the center after being tipped to a possible assault, “saving many lives.”
The attack occurred hours before the World Health Organization director-general and the Centers for Disease Control and Prevention director visited the center, which remained open. WHO chief Tedros Adhanom Ghebreyesus encouraged workers to continue their fight against the second-deadliest Ebola outbreak in history, which is spreading in a region compared to a war zone…
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WHO Director-General reiterates commitment to Ebola response despite another attack
9 March 2019 Statement
Butembo, Democratic Republic of the Congo
WHO Director-General, Dr Tedros Adhanom Ghebreyesus today visited an Ebola treatment centre in Butembo, in the Democratic Republic of the Congo, that was attacked by armed groups last week and again earlier today. He spoke with personnel in the centre and thanked them for their dedication.
The visit came as he concluded a three-day mission to the country, along with senior US officials and other WHO leadership. They met with the President, government officials, partner organizations and local responders involved in the outbreak response. He spoke to a group of partners, officials and staff in Butembo on Saturday morning.
“It breaks my heart to think of the health workers injured and police officer who died in today’s attack, as we continue to mourn those who died in previous attacks, while defending the right to health,” said Dr Tedros. “But we have no choice except to continue serving the people here, who are among the most vulnerable in the world.”
“These are not attacks BY the community, they are attacks ON the community. There are elements who are exploiting the desperation of the situation for their own purposes. The people of Katwa and Butembo, as in the other communities affected by Ebola, want and deserve a place to receive care and a chance of survival. They do not deserve to suffer in their homes while infecting their loved ones, they do not deserve to suffer in inadequately resourced health centers while infecting health workers,” he added.
WHO has requested and received further support from UN and local police forces to protect the treatment centres. To conquer Ebola, we must strike a delicate balance between providing accessible care, maintaining the neutrality of the response, and protecting patients and staff from attacks by armed groups. These are the dilemmas we face in conflict zones around the world. We are committed to ending the outbreak, and we are committed to improving the health of the people of DRC,” he concluded.
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31: Situation report on the Ebola outbreak in North Kivu 3 March 2019
[Excerpt]
Implementation of ring vaccination protocol
A total 585 community rings have been defined and vaccinated, including two targeted geographic zones. In total, 85,341 contacts and contacts of contacts have been vaccinated (including health workers and front-line workers). Of those who consented and were vaccinated, 21,511 are contacts and 63,615 are contacts of contacts. The total consented and vaccinated includes 26 601 health workers and front-line workers, while 21,135 are children between 1-17 years. In addition, vaccination of health workers and front-line workers is ongoing in the neighbouring areas where there is a possibility of spread. In Goma, 3896 health workers and front-line workers have been vaccinated. In Uganda, 4852 health workers and front-line workers have been vaccinated. In South Sudan 1138 health workers and front-line workers have been vaccinated. Vaccination is planned to start in a week’s time in Rwanda and preparations are underway in Burundi.
Risk communication, social mobilization and community engagement
Since the recent attack on the two ETCs in Katwa and Butembo, WHO, UNICEF and partners have been supporting the MoH in setting up platforms to directly dialogue with local politicians, key community leaders and influencers, and pressure groups at health area levels in Katwa, Vihovi and Kyondo health zones to better understand their needs and come up with a common understanding and joint action towards stopping the Ebola outbreak.
Risk communication and social anthropologist teams have strengthened community engagement activities in Katwa. Risk communication and community engagement orientation sessions were organized for different pillars of the response to enhance capacity of RECOs and other Ebola response personnel to address community concerns.
Risk communication and community engagement activities in other health zones, including Mangina, Bunia, Beni, Oicha and Komanda continues, with a focus on communicating about the current situation of the Ebola outbreak and the response.
In Oicha’s Tenambo health area, women eligible for the Ebola vaccine (as contacts or contacts of contacts) were sensitized on the importance of vaccination. EVD awareness activities were carried out for women in the market in Bwanasura, and for teachers from the Vutsundo health area. A visit to Butembo ETC was organised for some community representatives to show them how patients are being cared for in the treatment centre…
DONS – Ebola virus disease – Democratic Republic of the Congo
7 March 2019
[Excerpt]
…Following the attacks on two ETCs in Katwa and Butembo, patients were temporarily transferred to the Katwa Transit Centre. On 2 March, the Butembo ETC was rehabilitated and resumed treatment of EVD patients. Response teams are progressively resuming activities in all affected areas with the exception of two health areas where security and community resistance remain a challenge…
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Ebola response failing to gain the upper hand on the epidemic – MSF
Democratic Republic of Congo
Press Release 7 Mar 2019
:: Despite a rapid and large outbreak response with new vaccines and treatments, the signs are that Ebola is not under control
:: Since the beginning of the year, more than 40 per cent of new Ebola cases are people who died of Ebola in the communities
:: Patients and communities must be treated as partners in the response; we must listen to their needs not preach to or coerce them
Seven months into the largest-ever Ebola outbreak in the Democratic Republic of the Congo (DRC), the Ebola response is failing to bring the epidemic under control in a climate of deepening community mistrust, Médecins Sans Frontières (MSF) said at a press conference in Geneva today.
Since the beginning of the year, more than 40 per cent of new cases are people who died of Ebola in the communities. At the epicentre of the epidemic, in Katwa and Butembo in North Kivu province, 43 per cent of patients in the last three weeks were still being infected without known links to other cases.
“We have a striking contradiction: on the one hand a rapid and large outbreak response with new medical tools such as vaccines and treatments that show promising outcomes when people come early – and on the other hand, people with Ebola are dying in their communities, and do not trust the Ebola response enough to come forward,” said International President of MSF, Dr Joanne Liu.
Last week, MSF suspended our Ebola activities in Katwa and Butembo, in North Kivu province, after successive attacks on the two treatment centres. While MSF does not know the motives or identities of the attackers, these incidents follow an escalation of tensions around the Ebola response. Dozens of security incidents occurred against the response as a whole in the month of February alone. While the causes of these acts are not all the same, it is clear that various political, social and economic grievances are increasingly crystallising around the response.
A range of issues have led to these tensions: from the massive deployment of financial resources focusing only on Ebola, in a neglected region suffering from conflict, violence and long-standing health needs; to elections being officially postponed due to the Ebola outbreak, exacerbating suspicions that Ebola is a political ploy.
The use of police and armed forces to compel people to comply with health measures against Ebola is leading to further alienation of the community and is counterproductive to controlling the epidemic. Using coercion for activities such as safe burials, tracking of contacts and admission into treatment centres discourages people from coming forward and pushes them into hiding.
The Ebola response must take a new turn. Choices must be given back to patients and their families on how to manage the disease. Vaccination for Ebola must reach more people, and more vaccines are needed for this. Other dire health needs of communities should be addressed. And coercion must not be used as a tactic to track and treat patients, enforce safe burials or decontaminate homes.
“Ebola is a brutal disease, bringing fear, and isolation to patients, families and health care providers,” said Dr Joanne Liu. “The Ebola response needs to become patient and community centred. Patients must be treated as patients, and not as some kind of biothreat.”
Seven months since the beginning of the current Ebola outbreak in the provinces of North Kivu and Ituri, there have been 907 cases of Ebola cases (841 confirmed and 66 probable) and 569 people have died. [source: World Health Organization (WHO) report week 9]
Further to the suspension of its activities in Katwa and Butembo, MSF has maintained its Ebola-related activities in the North Kivu towns of Kayna and Lubéru, as well as its management of two Ebola transit facilities in Ituri province, in the towns of Bwanasura and Bunia. In the city of Goma, MSF has been supporting emergency preparedness by reinforcing the surveillance system and ensuring there is adequate capacity to manage suspected cases.
It has almost been six years, since 11 July 2013, that three MSF staff remain missing after being abducted in Kamango, Nord Kivu, where they were carrying out a health assessment. MSF continues to search for them.
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Wellcome pledges new funds to tackle Ebola outbreak – but more is needed to prevent catastrophe
Wellcome is making £2 million available to the WHO and government of DRC, to support vaccine research as part of the emergency response to the Ebola outbreak.
News | 6 March 2019
The pledge comes after the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, called on donors to continue funding the response to the Ebola outbreak. There is a risk the response will slow down if current actions are not sustained and intensified.
Since the outbreak began in August 2018, there have been over 800 Ebola virus cases in the area, including 563 deaths.
Jeremy Farrar, Director of Wellcome, said: “The Ebola virus has taken hold in an incredibly challenging region and recent attacks on treatment centres show that the security situation is a very real concern which will impact on the epidemic. The outbreak is in danger of spreading within the DRC, and if the international community doesn’t step up their support, there is real risk that this outbreak will get out of control, cross borders and take off as it did in the West African epidemic where over 11,000 people died.”
“To prevent catastrophe, the international response must be significantly increased to support the incredible work led by DRC. The DRC, WHO and partner’s public health teams have provided an amazing response, but the situation is fragile and they need global support to ensure this outbreak is contained effectively. Wellcome is committed to helping the world tackle the Ebola threat and we have made £2 million available immediately to support the response. Further funds will be needed, and we are working with our global partners to address these needs.”
Wellcome’s £2m emergency funding is provided through the Joint Initiative on Epidemic Preparedness, a partnership with the UK Department for International Development (DFID) that is part of our work on vaccines…
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vaccines and global health :: ethics and policy 