Ebola in the DRC: ‘Second largest Ebola outbreak in history’

Ebola in the DRC: ‘Second largest Ebola outbreak in history’

There is seldom a thing that strikes fear into the heart of a community than an outbreak of disease and Ebola is no exception. It grew to global infamy in 2014 after a major outbreak claimed over 3,955 lives in Sierra Leone, Guinea, and Liberia. Now it is spreading in the Democratic Republic of Congo leaving the World Health Organisation to describe it as a “toxic mix of violence and community mistrust”. Ebola is being fought in a war zone.

The sources I’ve spoken to in Uganda, which borders the affected regions of the DRC, all reiterate the same thing, ‘it’s a matter of when, not if’.

They are talking about the potential for Ebola to spread into the more developed neighbour nations of Uganda and Rwanda, and Ebola is not something to take lightly. The development of major road networks between western regions and Kampala, the capital of Uganda, has ironically increased the danger of Ebola spreading.

Every day my Google alert email warns me ‘suspected Ebola case found in Hoima [west Uganda on lake victoria]‘, ‘suspected Ebola case in Fort Portal‘. So far none of these have proven positive, so Uganda remains safe, but there have been over 200 suspected cased in the last few weeks.

The more connected the country, the faster Ebola can move into larger populations. The disease has an incubation period of 2 to 21 days – this means there is ample time for someone to contract the illness and not suffer full-blown symptoms until they have travelled a long distance. Although this is rare, it is a scary thought. However, Uganda is the first country in the world to implement a vaccine that aims to protect those on the front-lines, fighting the outbreak and Uganda claims no positive cases of Ebola in the country so far.

This is vitally important, because if the research conducted by Oxford university that brought the vaccine into the market is valid, then the vaccine can protect health care workers and people living within affected regions for 12 months. It is the first time any nation has taken preventative steps against the outbreak of Ebola and the first health workers allegedly received the vaccine earlier this month (November 3rd 2018). So far, according to the New York Times, 36,000 health workers and contacts have been vaccinated.

A total of 422 cases (375 confirmed and 47 probable), 242 deaths and 125 people cured. This is the tenth and the most deadly outbreak of Ebola in the DRCs 40-year battle with the disease, and the second largest in history.

Containment is key, but a vaccine can’t protect against certain dangers – mainly the ongoing conflict in the North Kivu province of the DRC, and the thousands of people who cross porous border crossings between the DRC and Uganda. Many of these travellers are merchants, making their way to sell at local markets held during the week in various towns and villages.

The conflict is complicated, but nevertheless when health workers get attacked, which has happened frequently since the outbreak in August, this means the WHO, The Red Cross, and MSF are fighting Ebola in a war zone. This has never happened before on this scale.

Emergency relief organisations do not aim to takeover health and emergency infrastructure of a disaster torn country. However, due to natural disasters, warfare, and civil unrest, many end up operating in a country long after the disaster has passed until the affected areas rebuild their infrastructure.

With Ebola, like many dangerous communicable diseases, emergency relief organisations may have to consider replacing, or creating, preventative measures rather than relief measures, if they hope to starve further outbreaks. The DRC, in the middle of an ongoing, bitter, and complicated war, will not, and has never really had, the infrastructure to handle this crisis, now considered by the WHO as a ‘perfect storm’.

An article in the The England Journal of Medicine, recently stated that global efforts need to step up to fight Ebola completely, rather than just respond to an outbreak. Depsite the DRC having previous experience in dealing with an Ebola outbreak, the speed that relief organisations responded, and the control of the WHO in dealing with the crisis, since September the incidence of Ebola has doubled.

The WHO has not yet rated this outbreak as a Public Health Emergency of International Concern, but they have claimed that the disease spread to Uganda is “very likely”. Ebola is winning the battle in the DRC, and despite vaccines, experience, and personnel fighting back; the WHO has proposed an international Contingency Fund for Emergencies (CFE) to fund operations not just to respond to these outbreaks – but end them entirely.

In 2014 the world reacted to the Ebola crisis – the international community needs to act now: Ebola spreading again is a matter of “when, not if”.