Tackling Ebola in DRC: "We knew we had to act fast"

Veteran Ebola nurse Patient Muhindo Kamavu on the latest outbreak in DRC

Portrait of Patient Muhindo Kamavu, an experienced MSF nurse at MSF’s Ebola treatment center in Mangina, DRC.
DEMOCRATIC REPUBLIC OF CONGO 2018 © Caitlin Ryan/MSF
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Nurse Patient Muhindo Kamavu was one of four experienced Doctors Without Borders/Médecins Sans Frontières (MSF) health workers who were the first on the ground, alongside the Congolese Ministry of Health, to respond to the Ebola outbreak declared on August 1 in Mangina, North Kivu, Democratic Republic of Congo (DRC).

A veteran of this year’s previous Ebola outbreak in DRC’s Equateur province, Patient has now finished his work in Mangina and has headed to Butembo, where he is setting up the response for the positive cases diagnosed in the town of around one million people. Here, he describes his experience.

“On August 2, I received a call telling me Ebola had once again broken out in Congo and MSF were set to respond. Given that I have experience working with Ebola, they asked if I would be willing to come. ‘Sure,’ I said. ‘I’m available. Let’s go.’  I was on a plane less than 48 hours later.

Our team of four experienced nurses arrived in Beni on August 4, and we headed straight to Mangina that afternoon, to the local health center that was at the epicenter of the outbreak. We knew we had to act fast. When we arrived, we saw that the center was overwhelmed. They were doing their best, but the patients were all together in one ward of the hospital and they weren’t properly isolated. Staff and visitors were coming in and out. Inside there were bins and medical equipment on the floor. A number of health staff were ill, and the number of patients was increasing each day.

This would be bad in a normal clinic, but during an Ebola outbreak, it’s dangerous. Without proper hygiene, health staff can easily get infected and then spread the virus to patients who visit the center for other treatment.

Ebola health workers going through proper hygiene and infection protocols.
DEMOCRATIC REPUBLIC OF CONGO 2018 © Sylvie Michaud/MSF

From there, we immediately established a fixed circuit for staff and patients in the center. Having the right processes and patient flow in place is vital when you’re treating Ebola. It cuts down on the risk of cross-contamination and makes the work safer for everyone.

Part of that process is establishing a set order to the day. We organized regular ward rounds and made sure there were staff present day and night. We ensured there were three staff [members] at the triage out front of the hospital and taught them how to identify patients who might be infected with Ebola. Suspected Ebola patients must be isolated before they can enter the general wards and spread the infection to staff or other patients. 

Shift change at Ebola treatment center
Shift change in the Ebola treatment center where an exiting team briefs incoming staff.
DEMOCRATIC REPUBLIC OF CONGO 2018 © Karin Huster/MSF

We also tried to set up case investigation for everybody who came through the triage with Ebola-like symptoms. We made sure forms with contact details were filled out, so the teams working in the community could monitor contacts and understand how the virus was spreading.

Thankfully, after a few days, MSF reinforcements arrived. We could now focus on patient care while our logistics and water and sanitation teams worked day and night to complete the Ebola treatment center that could care for patients in a safe way. It was incredible. We’d make visits to the site (about 328 yards from the health center) just one day later and see a totally different hospital appearing.

Construction of the Ebola treatment center in Mangina
Construction of the Ebola treatment center in Mangina, the epicenter of the outbreak.
DEMOCRATIC REPUBLIC OF CONGO 2018 © Karin Huster/MSF

On the day we moved to the Ebola treatment center, we had 37 patients and in the days that followed we had many more. But last week there were eight patients, two days ago five, and today, only two. 

When we see patients walk out cured, we dance. We are just so happy. I’m very proud of the work that we have done. It’s been hard, but we’ve achieved good results. My Congo is full of people who are capable of doing amazing things. We just need the support. We started with four experienced nurses and now we have trained 44. They’re the fruits of our labor and I am very proud.”

Cured Ebola patient receives cheers
One of the first cured patients coming out of the treatment center.
DEMOCRATIC REPUBLIC OF CONGO 2018 © Karin Huster/MSF