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Lessons From Last Ebola Outbreak Guide Approach in DRC 


A teacher leads a class at the Wangata commune school during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of the Congo, May 23, 2018.

When Ebola broke out in West Africa in late 2013, no one was prepared. A potential vaccine had been in limbo since a previous outbreak a decade earlier. Governments dragged their feet while failing to recognize the risks the outbreak carried. Local health workers were quickly overwhelmed. And aid agencies were scrambling to catch up.

By the time the epidemic was brought under control in 2016, more than 11,300 people had died in Guinea, Liberia and Sierra Leone and the costs had risen to $4.3 billion.

Flash forward to May 8, when word emerged about a possible Ebola outbreak in a remote village in the Democratic Republic of the Congo. Within two days, the DRC had dispatched experts to the scene. International agencies shipped in personnel, mobile medical labs and a batch of vaccine that had been tested during the West African outbreak.

Painful lessons from the last Ebola outbreak are being applied in the current one, in hopes of limiting its scope.

'Quick and robust response'

"The coordinated action is essential," said Tarik Jasarevic, spokesman for the World Health Organization (WHO), which so far is reporting 27 deaths among 51 cases of hemorrhagic fever.

"We know how damaging Ebola can be in the communities," Jasarevic told VOA in a phone interview from Geneva. "And we have to mount a quick and robust response not to get to the point where a transmission chain would get out of control."

But concerns remain that the virus could elude containment efforts.

The aid group Medecins Sans Frontieres (MSF), or Doctors Without Borders, reported that three patients left an isolation ward at a treatment center in the port city of Mbandaka sometime between Sunday and Tuesday. Two of the patients died; a third had been scheduled for discharge.

"You can imagine having the Ebola virus in a community is a cause of concern for the local population," Jasarevic said. The city has roughly a million residents.

A laboratory worker uses a microscope at the health center in the commune of Wangata during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of the Congo, May 23, 2018.
A laboratory worker uses a microscope at the health center in the commune of Wangata during a vaccination campaign against the outbreak of Ebola, in Mbandaka, Democratic Republic of the Congo, May 23, 2018.

The Associated Press quoted MSF emergency coordinator Henry Gray as saying in a statement Wednesday, "One of the men died at home and his body was brought back to the hospital for safe burial with the help of the MSF teams; the other was brought back to the hospital yesterday morning and he died during the night."

Thursday brought an alarming new development: MSF said that the two patients who died first had attended a prayer meeting with 50 people, Reuters reported.

Every epidemic has its unique challenges. In this case, the villages initially affected were in remote locations. Land had to be cleared, first for helicopters and then planes.

With quick action came the need for funding. Last Friday, the WHO requested $26 million. More than half of that had been pledged as of Tuesday, with the United States committing $8 million of the amount.

Jasarevic said the requested amount was small, given the costs of the last outbreak.

"It's better to spend more today than to be forced to spend much, much more afterward, because we know what damage, economic damage, was done to the countries in West Africa in 2014," Jasarevic said.

One upside

The repeated outbreaks have had the positive side effect of developing a core of health workers whose experience is proving priceless, including those in the DRC, now dealing with its ninth outbreak.

"Obviously, they are leading the response," Jasarevic said of the Congolese.

The DRC's health minister, Dr. Oly Ilunga Kalenga, discussed the country's experience in responding to the current outbreak. In a separate phone interview Monday with VOA's French to Africa service, he confirmed that the first patient to test positive for Ebola in the northwestern Bikoro health zone had been discharged.

"From the start, the sick people were put in good conditions," Kalenga said. "All the complications they developed were correctly treated, and they were healed and discharged. It is not unusual. People survived Ebola in the past."

Jasarevic added that WHO also had created an international emergency medical team roster, which includes experts who've participated in previous outbreaks.

The experts include anthropologists, who can help explain how individuals can safeguard themselves and others. The experts can instruct that anyone showing symptoms consistent with the virus, such as flu-like symptoms, "should be brought to the treatment center so they don't affect other people," Jasarevic said.

Health experts also want to increase awareness of safe burial practices, limiting exposure to the body of someone who has died of the infectious disease. It can spread through direct contact with bodily fluids.

The bottom line now is to keep the outbreak from spreading.

Kalenga, the health minister, emphasized to VOA that "one must know that the virus is present in the forest, and cannot be easily eradicated. In fact, it is a challenge for world scientists.

"The measures taken by the DRC include always having strict monitoring guidelines, and when a case is detected, we want a very effective response," he said. "The most important thing is an effective response based on case detection, contacts monitoring, and implementation of hygiene measures in all public areas and homes, and the other aspect is burials, which must be secured."

The vaccine is being used first on health workers and the friends and relatives of those who already have been infected.

If these precautions and responses all work, the aid agencies and various governments soon will be looking for new lessons.

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