100 days on: Ebola response in DR Congo must reach communities faster

This outbreak has become the largest and deadliest in the country’s history, and it continues to spread at an alarming rate in communities already facing conflict, violence, displacement, food insecurity, and other health emergencies.

Communities affected by the outbreak urgently need a scale-up in training for health workers and community leaders on case detection, referral of suspected cases, and infection prevention and control measures.

Over the past week, approximately one person has died from Ebola disease every 30 minutes. As of August 16, more than 5,000 people have been confirmed to have the disease, and over 2,400 deaths have been reported since the beginning of the outbreak, according to national authorities. 

“This epidemic continues to spread faster than the response can keep up,” says Dr. Javid Abdelmoneim, international president of MSF. “Treatment centers remain essential for saving lives, but this response needs more than extra beds. It needs better detection, safe isolation for sick people and their contacts, and support for health workers. People seeking care in existing health facilities also need to be protected from infection. Crucially, the response must be built with communities, not around them.”

Community engagement is critical to the Ebola disease response

In Rho displacement camp, near Drodro, Ituri province, community leaders have worked with MSF to encourage people with symptoms to seek testing, isolation, and treatment early. They also promote infection prevention and control measures to reduce the risk of community transmission. The overcrowded camp hosts nearly 50,000 people, and collaboration with community leaders has helped limit the spread of Ebola disease and reduce mortality.

“We know our communities and how to reach our people,” says Ezrome Kiza Lumani, a community leader living in the camp. “When Ebola arrived, we did not wait. We spoke with families, listened to their fears, and encouraged people with symptoms to seek care. We have a crucial role to play in stopping this outbreak.”

Since the outbreak was officially declared, more than 60 percent of Ebola disease deaths have occurred in the community, often far away from Ebola treatment centers. This means many people are dying without receiving medical care, and the virus is spreading undetected. Worryingly, case numbers are rising rapidly outside Ituri province, the epicenter of the outbreak. Neighboring North Kivu province is experiencing particularly high levels of mortality. Mistrust of the response is also widespread.

“With cases emerging in new areas with little or no previous experience managing Ebola disease, Ebola-trained health care workers are urgently needed not only inside treatment centers, but also directly in affected communities,” says Trish Newport, MSF’s emergency program manager in Ituri province. 

How MSF is responding to the Ebola disease outbreak

MSF is currently responding to the outbreak across Ituri, North Kivu, South Kivu, Tshopo, and Haut-Uélé provinces. In affected areas, MSF teams operate six Ebola treatment centers as well as isolation units, with more than 400 beds available — one-third of all beds available in the response. Since the start of the outbreak, MSF teams have admitted more than 1,900 patients into these facilities, 720 of whom were confirmed to have Ebola disease. More than 1,400 MSF staff are supporting the response.

In Beni, North Kivu province, we have adapted our response to work in the community. Part of that work includes supporting existing health facilities that also offer general health care services, which is crucial to saving lives and helps patients with symptoms of Ebola disease access treatment earlier. But more must be done to ensure people can receive the care they need closer to home in all affected areas.

“Health care workers and community leaders need training to help detect cases early, refer people safely, reinforce infection prevention and control, and protect themselves and others from infection,” says Newport. “The World Health Organization, other UN agencies, humanitarian organizations — including MSF — and the Congolese Ministry of Health must urgently expand this training and support.”

Community members encourage one another to seek care

Community leaders like Emery Guba Mateso, who lives in Rho displacement camp, are sharing their experiences with their communities to encourage people to seek care. He lost his son to the disease and later survived an infection himself.

“As a person who has recovered from Ebola disease, the message I would like to share with the community is that as soon as the first symptoms appear, it is important to seek medical care promptly, because early access to appropriate treatment increases the chances of recovery,” says Guba Mateso.