Fighting epidemics

Parents and children wait to receive measles vaccinations in Etebe health area, Mai-Ndombe province, Democratic Republic of Congo.
Democratic Republic of Congo 2019 © Franck Ngonga
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Every year, millions of people die from infectious diseases that are treatable or preventable. The people at highest risk often live in poverty or in countries affected by conflict, mass displacement, or political unrest. When living conditions are so precarious, access to health care is limited and vaccination coverage is low.

These factors converge in Democratic Republic of Congo (DRC), which has endured decades of multiple overlapping conflicts and crises. An ongoing Ebola outbreak has drawn international attention and resources. However, more people this year have died from a massive measles outbreak that demands greater support from the international community. Doctors Without Borders/Médecins Sans Frontières (MSF) teams are working on multiple fronts and calling for other humanitarian actors to respond to the urgent needs. 

2019:

2019: The year in photos

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Measles campaign in DRC
An MSF doctor listens to the heartbeat of a child hospitalized at a measles treatment center in Mayi-Munene, DRC. Measles mainly affects children under five years old. The spread of the disease in DRC is exacerbated by low rates of immunization and limited supplies of vaccines.
Democratic Republic of Congo 2019 © Pablo Garrigos/MSF

We are still fighting to contain the Ebola outbreak in eastern DRC, which was declared on August 1, 2018, and is not yet under control. This is the worst Ebola outbreak on record in the country and the second largest epidemic of the disease recorded anywhere. MSF is caring for people with confirmed and suspected cases of Ebola in treatment centers, transit centers, and isolation facilities. We’re also helping to shore up infection prevention and control measures in health structures and supporting efforts to vaccinate health workers against Ebola.

Emergency response in Ituri
An MSF nurse cares for a child suffering from measles during a consultation at a health post in a camp for displaced people in Bunia, capital of Ituri province.
Democratic Republic of Congo 2019 © Pablo Garrigos/MSF
Measles vaccination in Mai-Ndombe Province
An MSF team prepares materials for a measles vaccination campaign in Etebe, Mai-Ndombe province.
Democratic Republic of Congo 2019 © Franck Ngonga/MSF

None of our projects focus on Ebola alone—rather, our goal is to fight the spread of the disease with an integrated approach. Of the patients admitted to Ebola transit and treatment centers with worrisome symptoms, only 4 percent test positive for the disease. The rest require the kind of routine care that, for many in the region, has been out of reach for decades.

Beni ebola treatment center
In Beni, in DRC’s North Kivu province, outreach worker Joseph Mbokanil Kambale, part of the national Ebola response, answers questions about the disease and its treatment. Fears and misconceptions about Ebola have kept many eligible people from receiving vaccines. In 2019, MSF worked to adapt its response to the Ebola outbreak in northeast DRC to better involve the community.
Democratic Republic of Congo 2019 © Samuel Sieber/MSF

DRC is also reeling from a series of deadly outbreaks of measles that spread like wildfire across the country. With the international response remains largely focused on the Ebola outbreak, the measles epidemic has become DRC’s deadliest in nearly a decade: more than 4,000 people have died so far, nearly 90 percent of them children under the age of five. 

MSF supports the Ebola Transit Center in Bunia
Staff members dress in personal protective equipment to enter the high-risk zone at the Ebola transit center in Bunia.
Democratic Republic of Congo 2019 © Pablo Garrigos/MSF

No treatment currently exists for measles—the only way to prevent its spread is through inoculation. But DRC’s massive size and poor roads complicate the delivery of lifesaving vaccines. “Just getting vaccines to places where children need them is a huge task,” said Pierre Van Heddegem, field coordinator of MSF’s emergency measles team.

MSF teams are fighting measles in partnership with the Congolese Ministry of Health, vaccinating nearly 500,000 children in 13 of DRC’s 25 provinces in the first eight months of 2019 and treating more than 27,000 patients. But without a further massive mobilization of funding and resources to combat the spread of the disease, the outbreak could worsen.

Beni ebola treatment center
While the vaccine has proven effective, dose rationalization limits its use to a ring vaccination strategy which only targets direct and indirect contacts of Ebola cases. Only around 25 percent of contacts can currently be reached through this existing strategy.
Democratic Republic of Congo 2019 © Samuel Sieber/MSF