Six months after The first case of Ebola was confirmed in the Democratic Republic of Congo's conflicts border province of North Kivu, the outbreak still raging and leaving a trace of broken families and hundreds of orphans.
Pr. On December 20, more than 512 cases have been confirmed and 288 people have been subjected to the lethal virus, making it the second largest eruption in history. Twenty percent of new cases have been reported in the last month alone. Now an upcoming election and holiday travel mobilized the population, making a hard situation even harder to control.
Efforts to keep outbreak have faced enormous obstacles. Local militia groups have intensified their attacks as the country leads to a long delayed national election on 30 December. That's when the electorate elects a successor to President Joseph Kabila, the only ruler known to the DRC since the bloody civil war ended in 2003. It also means that more people will travel to ballot papers, share polling equipment and get in touch with strangers.
The country's relief is understaffed. Due to the security threats posed by the militia, the US Department of Medicine withdrawed centers of disease control and preventive personnel from the eruption zones earlier in the fall. CDC employs some of the world's leading Ebola experts. On December 14, the US Embassy in Kinshasa announced that it had ordered all non-acute state and family members out of the country.
According to an official in the state department, some Ebola respondents will remain at the Kinshasa embassy as part of the essential staff. "The United States remains strongly committed to supporting the Congolese government's efforts to keep the ongoing ebola outbreak," said the official while falling to offer specifications. The CDC referred questions about its current Ebola efforts to the State Department.
Ibrahima Socce Fall, World Health Organization's Regional Emergency Director for Africa, says that CDC staff have continued to provide data analysis and advisory support from Kinshasa and Geneva, where the WHO has its headquarters. With 300 employees currently deployed in the DRC, the organization has worked with the DRC's Ministry of Health at pop-up Ebola treatment centers. Teams from these centers are sent to track and vaccinate people who have come into contact with the infected, and volunteers go door-to-door and village-to-village to educate locals about the disease.
Despite a battery of powerful new drugs, the virus continues to exceed the available human resources, confusing projections. Since August, the WHO has vaccinated close to 50,000 people with an experimental Ebola vaccine that has helped stop transmission to the transmission. But the first hope that the vaccine would be sufficient to contain the eruption has faded as new disease clusters have appeared in new places. "At the beginning of the outbreak we thought we would have this under control in January," says Fall. "Now we think we will continue to fight through the end of April, at least."
One of the new hot zones is Butembo, home to one million people – three times the size of the outbreak's former epicenter in Beni – and has registered 30 cases since the beginning of November.
Bad registration in the Beni network of 300 informal health facilities means that people often share rooms or even hospitals with Ebola patients without knowing it. WHO spent months retraining staff for better trace infections, an effort that helped stabilize the situation there. Now the organization is switching to new treatment centers under construction in Butembo and two villages-Katwa and Komanda.
Each of these new areas has experienced "societies" in recent weeks, which means that they occurred outside a treatment center or other health setting, increasing the risk of more people coming into contact with a body. If the outbreak spread more widely in Butembo, the number of vulnerable persons could quickly tighten the supply of vaccines.
The vaccines are given to frontline workers in a ring vaccination strategy – to their contacts and the people they interact with. Vaccine manufacturer Merck has committed to maintaining a global stock of 300,000 doses. Much of it is currently being stored in bulk, and it takes four to five months to prepare it for use in the field. New parties require a year to produce. "We work closely with the supplier to ensure that the outbreak will be under control when we are close to using most of the warehouse," says Fall.
Health professionals are also worried that the coming Christian holiday when many people travel to their families will spread the infection to new areas. International workers help set up sanitation stations and track people traveling between districts and across international borders. From December 9, more than 19 million travelers have been screened at the DRC border. So far, only two confirmed cases have been marked.
With regard to Sunday's election, the DRC's Ministry of Health plans to install health checkpoints with contact-free temperature sensor at the entrance to all polling stations in the areas affected by the outbreak. This year, the first time DRC will use electronic voting machines, and the touch screen terminals present an additional risk of spreading the disease.
It is unclear whether the choice will continue with the machines after nearly 8,000 were destroyed in a stock fire in Kinshasa last week. The vote was originally scheduled for December 23, but was postponed one week due to increasing violence and uncertainty in the delivery of ballot papers. It was the last within a number of delays. In 2016, President Kabila refused to leave the office at the end of his constitutionally limited second term. With 40 million Congolese expected to appear next Sunday to cast their voices in the long-awaited election, efforts for the future of the country have never been higher.
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