Goma (DR Congo) (AFP)
Health crisis, security threats, border anxieties, political battles, pharmaceutical issues: declared just one year ago on Thursday, the epidemic of Ebola haemorrhagic fever in the eastern Democratic Republic of Congo presents challenges to professionals in the field. public health, which does not see the end.
The tenth epidemic in the DRC is well beyond the borders of the provinces of North Kivu and Ituri where it killed more than 1,800 people (1,803 according to the latest figures) in twelve months, mainly in the areas of Beni and Butembo .
Saudi Arabia has closed the doors of Mecca to Muslims living in the DRC to prevent any risk of spread during the next pilgrimage. In Morocco, a pamphlet of advice and information on Ebola is handed to the Casablanca airport to passengers from Kinshasa.
"The economic and human exchanges are very intense," warned Pierre Somse, Minister of Health of the neighboring Central African Republic. "Our ranchers sell their cattle in the DRC, rebel groups and poachers come and go across the border, the risks are high."
No case has been recorded in the Congolese capital, which is two hours away from the main centers of infection.
In Goma, the capital of North Kivu on the border with Rwanda, frustration and despair are at the rendezvous for the two million inhabitants.
"We are sensitized, we respect the rules (hand washing and temperature control), but what we want is that this epidemic will quickly end," says Jonas Shukuru, motorcycle taxi in the city. "The government must make it a priority because we must not die at the same time because of insecurity and this epidemic".
The World Health Organization (WHO) has made the Ebola outbreak a "public health emergency of international concern" after the discovery of a first case in mid-July in Goma. A second case was recorded on July 30 and died a few hours later, reinforcing concerns.
WHO has, however, advised against the closure of the DRC's borders with neighboring countries, including Uganda, where two deaths were recorded in June.
- Tourbillon of violence -
Fifteen days later, the organization welcomed an increase in foreign aid to help the DRC and its almost non-existent public health system. The World Bank has announced $ 300 million in additional assistance.
After the 11,000 deaths in West Africa in 2014, the Congolese epidemic is the most serious in the history of the disease in Africa where it appeared in 1976 in the former Zaire (now the DRC), near the Ebola River.
The epidemic is mainly affecting the areas of Beni and Butembo-Katwa, caught in the whirlwind of violence by armed groups for 25 years.
The presence of the very bloody Allied Democratic Forces (ADF) has complicated prevention efforts north of Beni, in Oicha, a marginal focus of the epidemic. The deadly incursions of ADFs in Beni even suspended health activities for a few days.
But the teams in the field have mostly encountered the "reluctance" and "resistance" of the inhabitants: denial of the disease, refusal of vaccination, hospitalization of relatives, burials "dignified and secure" led by the Cross -Red to avoid any contact with the fluids of the deceased particularly contagious.
These "resistances" were violent, with the assassination of a WHO epidemiologist in the attack on a hospital in Butembo in April, and the attack on Ebola treatment centers (ETCs) in Butembo. and Katwa.
- "A year is enough!" -
The epidemic also had several political consequences. Congolese Health Minister Oly Ilunga resigned in late July, saying he was disavowed by President Etienne Tshisekedi who decided to take direct control of the fight against Ebola.
Mr. Tshisekedi entrusted responsibility for the "response" to Professor Jean-Jacques Muyembe, who was already working with WHO in 1976 on the first Ebola epidemic in the former Zaire.
Mr. Ilunga, an expatriate doctor in Belgium, was opposed to the introduction of a second vaccine, repeating every day his confidence in the current injection of Merck laboratories. He also referred to the risks of introducing a new product in communities where distrust of health care workers was already high.
Recommended by the WHO, this second product is manufactured by the company Johnson & Johnson and is at the stage of investigations on its effectiveness. The Merck vaccine has been tested but is not licensed.
The civil society of North Kivu invited "the authorities to make an evaluation of the results of the response against Ebola", declared to AFP its president, John Banyene: "A year is too much!".
bur-st / mbb / stb / jhd / jlb
© 2019 AFP