SEATTLE — This past week, the World Health Organization declared an Ebola outbreak in the Democratic Republic of Congo. Since the end of April, three people have died and more than 20 cases of Ebola were confirmed in the province of Bas-Uele, a very remote and isolated area with no telecommunications and poor road access. Rebel group the Lord’s Resistance Army is active in this area, resulting in increased levels of insecurity and displacement. These factors present a unique challenge to tackling this most recent Ebola outbreak.
This is not the first Ebola outbreak in the Democratic Republic of Congo. In fact, the Congo has had eight Ebola outbreaks, the most of any country. Bas-Uele’s remoteness led the World Health Organization (WHO) to declare a low risk at a global level. That said, the high levels of displacement and a proximity to bordering countries — particularly the Central African Republic — led the WHO to state that the Ebola outbreak in the Democratic Republic of Congo has a moderate risk level regionally.
The WHO was critiqued for not responding quickly enough to the 2014 Ebola outbreak in West Africa, which ultimately resulted in more than 11,000 deaths. One of the major contributing factors to the 2014 outbreak was remote areas with poor access to communication, aid workers and health care services. This challenge will also face the outbreak in Congo.
A key component is addressing the outbreak quickly. Unlike in West Africa, clinicians in the Congo are more likely to recognize Ebola due to the high number of previous outbreaks. In more populated areas of the country, there are trained staff and isolation wards in healthcare facilities. While the current outbreak is in a remote area, the familiarity of Ebola in the Congo and the early action from the WHO and Ministry of Health bodes well for addressing this Ebola outbreak.
The Red Cross has mobilized approximately 70 volunteers to the area, and the government has set up coordination committees at the national, provincial and local levels. These coordination committees were instrumental in establishing potential contacts lists and identifying potential cases, with over 400 contacts already identified. In addition to surveillance, awareness campaigns are a top priority for the Congolese government and their partners. Psychosocial support is being provided in the form of a sensitization campaign, which raises awareness of Ebola and teaches how to disinfect houses and safely manage the disposal of infected bodies while still respecting local tradition and culture.
Unlike in previous outbreaks, there is a newly developed vaccine for Ebola. While this vaccine is still in the trial stages of development, testing has so far resulted in 100 percent protection. The GAVI global vaccine alliance estimates that 300,000 doses are available for usage if needed, and while the WHO is preparing for vaccine delivery, there is not an official decision on whether or not to use this new vaccine.
Early detection and awareness are vital for curbing the Ebola outbreak in the Democratic Republic of Congo. The area’s remoteness serves as both a challenge and a potential natural defense, but the quick and thorough response from the Ministry of Health, WHO, and partner organizations has been a positive first step.
– Nicole Toomey