Today marks the one-year anniversary of the current Ebola epidemic in northeastern Democratic Republic of Congo (DRC)—the worst on record in the country and the second-largest outbreak recorded anywhere. Since last August, Ebola has infected over 2,600 people and killed more than 1,800, and the epidemic is still raging in the region.
The ongoing outbreak was declared last year just days after an earlier, separate outbreak in the northwest of the country was officially declared over.
Trish Newport, deputy manager of Doctors Without Borders/Médecins Sans Frontières’ (MSF) Ebola programs in DRC, reflects on the outbreak and the response over the past year.
I remember July 24, 2018, so clearly. It was the day the ninth Ebola outbreak in DRC was declared over. I had worked during the outbreak managing MSF's vaccination project. It was the first time that the experimental Ebola vaccine was used at the beginning of an outbreak to try and help control the outbreak. The outbreak lasted less than three months, and I remember crying with joy and hope on July 24 when it was declared over.
I naively thought that with this great vaccine the world would never have to face a large Ebola outbreak again. As has happened so many times in my humanitarian life, I was very wrong.
One week after the ninth Ebola outbreak in DRC was officially over, the start of the tenth Ebola outbreak in DRC was declared on August 1. Today marks the one-year anniversary of the start of the tenth outbreak, and it is not only still raging, it has become the world’s second-largest Ebola outbreak in history.
It has been a long, painful, deadly year for the people living in the Ebola-affected areas in DRC. Ebola treatment centers have been viciously attacked and destroyed, health workers have been murdered because they worked in the Ebola response, security forces "protecting" Ebola responders have killed civilians, and people continue to die of Ebola.
The "Ebola response" is made up of the Congolese Ministry of Health, the World Health Organization, and other international organizations. One of the biggest problems in the outbreak is that this response has never gained the trust of the local community. The outbreak is happening in an area that has been plagued in recent years by conflict and massacres of civilians.
I once asked one of our local staff why there was so much anger towards the Ebola response. She answered: “My husband was killed in a massacre in Beni. At that time, all I wanted was some organization to come protect us from the killings, but no international organization came. I have had three children die of malaria. No international organization has ever come to work in this area to make sure we have access to health care or clean water. But now Ebola arrives, and all the organizations come because Ebola gives them money. If you cared about us, you would ask us our priorities. My priority is security and making sure my children don't die from malaria or diarrhea. My priority is not Ebola. That is your priority.”
In July, the Ebola outbreak was declared a Public Health Emergency of International Concern. There are still many questions about what impact this will have on the actual response. What we do see is that even more money is being directed towards the Ebola response, but if there is no change in the way the Ebola outbreak is managed—if we don't gain the trust of the population—more money won't do anything. It will just create more problems.
One of the greatest frustrations about this whole situation is that there is not only an effective Ebola vaccine available, there are also experimental treatments for Ebola cases. These are tools that were much less readily available in the West African Ebola outbreak, but if the affected communities don't trust the Ebola response, these tools will never be able to be used to their full potential.
In February 2019, two of MSF's Ebola Treatment Centers in the epicenter of the outbreak were attacked. We didn't know who attacked the centers or why. As we could no longer ensure the security of our staff or our patients, MSF took the painful decision to stop all activities in that specific area.
We were forced to review the problems we had been facing and how we should change our response to the Ebola outbreak. We determined that we needed to work more closely with the communities, and that we needed to listen to and respond to their health priorities.
We began providing access to free health care for all illnesses that were affecting local communities, like malaria, measles, and diarrhea. We began building wells, so that when we told people they needed to wash their hands to prevent the spread of Ebola, they had water to do so. We set up centers for suspected Ebola cases in local health centers, so that patients [who were possibly infected] could be cared for in their community instead of having to travel to other areas for testing, where they would be completely isolated from their families and communities. By addressing the actual needs and health priorities of the population, we began gaining the trust of the community.
Sadly, this approach has still not been adopted by the overall Ebola response, and there remains overall mistrust as a result. In many areas people still refuse to go to Ebola treatment centers when they are sick, and other people still refuse the vaccine.
When I see families and communities ripped apart by Ebola, it makes me so sad. It didn't have to be like this. Unless a drastic change happens in the management of the Ebola response, the outbreak is not going to end anytime soon.
One year into the outbreak, more than 2,600 people have gotten sick with Ebola, and more than 1,700 people have died of the disease. Today, on the one-year anniversary of the outbreak, my thoughts are with all of those people that have been affected by the illness.