Battle against Ebola being lost amid militarized response, MSF says

FILE PHOTO: A mother of a child, suspected of dying from Ebola, cries outside a hospital during the funeral in Beni, North Kivu Province of Democratic Republic of Congo, December 17, 2018. REUTERS/Goran Tomasevic

By Tom Miles

GENEVA (Reuters) – The battle against Ebola in Democratic Republic of Congo is failing because ordinary people do not trust health workers and an overly militarized response is alienating patients and families, the medical charity MSF said on Thursday.

Last week Medecins Sans Frontres (Doctors Without Borders) suspended medical activities at the focal point of the epidemic after two of its facilities were torched by unidentified assailants.

MSF’s international president Joanne Liu said the outbreak, which has killed 569 people, would not be beaten unless the community trusted the authorities and were treated humanely.

“The existing atmosphere can only be described as toxic,” Liu told reporters in Geneva.

Ebola responders were increasingly seen as the enemy, with more than 30 attacks and incidents against the Ebola response in the past month alone, she said.

The epidemic is in a region of Congo that is prey to armed groups and violence where officials are prone to see threats through a security lens and to use force.

“There is a lot of militarization of the Ebola response,” she said. “Using police to force people into complying with health measures is not only unethical, it’s totally counterproductive. The communities are not the enemy.”

Involvement of security and police forces merely deepened suspicions that Ebola was being used as a political tool, she said.

A spokeswoman for Congo’s Health Ministry said there appeared to be confusion about the security forces’ role.

“The police and the army are not involved in Ebola response activities and their role has never been to enforce sanitary measures,” Jessica Ilunga said.

The Interior Ministry has been asked to guarantee security, as it is unacceptable for health officials to be threatened and attacked, or for the threat of violence to stop families burying their loved ones in a dignified and safe manner, she said.

MSF was insisting on security before it returned to its damaged facilities, she said. Local officials, unlike international staffers, did not have the privilege of being evacuated for security reasons, she said.

Liu said there were still signs the outbreak – the second worst ever – was not being brought under control.

Forty percent of deaths were outside medical centers, meaning patients had not sought care, and 35 percent of new patients were not linked to existing cases, meaning the spread of the disease was not being tracked.

“Ebola still has the upper hand,” Liu said.

Villagers saw fleets of cars racing to pick up a single sick person and vast amounts of money pouring in. Some were instructed to wash their hands but had no soap to do so.

“They see their relatives sprayed with chlorine and wrapped in plastic bags, buried without ceremony. Then they see their possessions burned,” she said.

 

(Reporting by Tom Miles, additional reporting by Giulia Paravicini in Kinshasa; Editing by Angus MacSwan)

Congo records one-day record for confirmed Ebola cases

FILE PHOTO: Healthcare worker carry a coffin with a baby suspected of dying of Ebola during the funeral in Beni, North Kivu Province of Democratic Republic of Congo, December 18, 2018. REUTERS/Goran Tomasevic/File Photo

KINSHASA (Reuters) – Democratic Republic of Congo on Wednesday confirmed 14 new cases of Ebola virus in its eastern borderlands, the largest one-day increase since the current outbreak was declared in August.

The outbreak of the haemorrhagic fever in the eastern provinces of North Kivu and Ituri is already the second-largest in history with 713 confirmed and probable cases and 439 deaths.

It is surpassed only by the 2013-2016 outbreak in West Africa, which involved over 28,000 cases and 11,000 deaths and led to substantial investments in a vaccine and treatments for the virus.

Health officials have struggled to bring the current outbreak, Congo’s tenth since 1976, under control, largely due to widespread militia violence in eastern Congo which has hampered the response.

The health ministry said in a daily bulletin that nine of the new cases were in the health zone of Katwa, just outside Butembo, a city of several hundred thousand people near the Ugandan border that has emerged as the outbreak’s new epicenter. One other case was in Butembo.

The ministry also announced six new deaths of confirmed cases as well as the recovery of one patient.

(Reporting By Stanis Bujakera and Fiston Mahamba; Writing by Aaron Ross; Editing by William Maclean and Peter Graff)

Ebola outbreak in east Congo now world’s second biggest

FILE PHOTO: A medical worker wears a protective suit as he prepares to administer Ebola patient care at The Alliance for International Medical Action (ALIMA) treatment center in Beni, North Kivu province of the Democratic Republic of Congo September 6, 2018. REUTERS/Fiston Mahamba/File Photo

KINSHASA (Reuters) – The Ebola outbreak in eastern Congo is now the second biggest in history, with 426 confirmed and probable cases, the health ministry said late on Thursday.

The epidemic in a volatile part of Democratic Republic of Congo is now only surpassed by the 2013-2016 outbreak in West Africa, where more than 28,000 cases where confirmed, and is bigger than an outbreak in 2000 in Uganda involving 425 cases.

Ebola is believed to have killed 245 people in North Kivu and Ituri provinces where attacks by armed groups and community resistance to health officials have hampered the response.

Congo has suffered 10 Ebola outbreaks since the virus was discovered there in 1976. It spreads through contact with bodily fluids and causes hemorrhagic fever with severe vomiting, diarrhea and bleeding, and in many flare-ups, more than half of cases are fatal.

“This tragic milestone clearly demonstrates the complexity and severity of the outbreak,” Michelle Gayer, Senior Director of Emergency Health at the International Rescue Committee said in a statement. “The dynamics of conflict (mean) … a protracted outbreak is … likely, and the end is not in sight.”

(Reporting by Giulia Paravicini; Editing by Tim Cocks and Andrew Heavens)

Current Ebola outbreak is worst in Congo’s history: ministry

FILE PHOTO - Workers fix an Ebola awareness poster in Tchomia, Democratic Republic of Congo, to raise awareness about Ebola in the local community, on October 9, 2018. Picture taken October 9, 2018. WHO/Aboulaye Cisse/Handout via REUTERS

KINSHASA (Reuters) – The current Ebola outbreak in the Democratic Republic of Congo is the most severe in the country’s history with 319 confirmed and probable cases, the health ministry said late on Friday.

The hemorrhagic fever is believed to have killed 198 people in North Kivu and Ituri provinces, where attacks by armed groups and community resistance to health officials have complicated the response.

FILE PHOTO: A Congolese health worker prepares to administer Ebola vaccine, outside the house of a victim who died from Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. REUTERS/Olivia Acland/File Photo

FILE PHOTO: A Congolese health worker prepares to administer Ebola vaccine, outside the house of a victim who died from Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. REUTERS/Olivia Acland/File Photo

Congo has suffered 10 Ebola outbreaks since the virus was discovered near the eponymous Ebola River in 1976.

“The current epidemic is the worst in the history of DRC,” Jessica Ilunga, a spokeswoman for the ministry told Reuters.

With over 300 cases the epidemic also ranks as third worst in the history of the continent, following the 2013-2016 outbreak in West Africa where over 28,000 cases were confirmed and an outbreak in Uganda in 2000 involving 425 cases.

World Health Organization Director-General Tedros Adhanom Ghebreyesus said on Thursday that security represented the primary challenge in the current epidemic, followed by community mistrust.

“When there is an attack, the operation actually freezes. So we hold the operation. And when the operation stops, the virus gets advantage and it affects us in two ways,” he told reporters in Kinshasa.

“And one is catching up on the backload. Because when operations are stopped, there is always a backload of vaccinations or contact tracing. And the other, the second problem, is that more cases are generated because we can’t vaccinate them,” he said.

The confirmation of new cases has accelerated in the last month and an emergency committee of World Health Organization experts said in October that the outbreak was likely to worsen significantly unless the response was stepped up.

(Reporting by Giulia Paravicini; Additional reporting by Fiston Mahamba; Editing by Alessandra Prentice and Hugh Lawson)

Congo Ebola outbreak poses high regional risk, says WHO

An ambulance from the Medecins Sans Frontieres (MSF) drives through a street in the town of Beni in North Kivu province of the Democratic Republic of Congo, August 2, 2018. REUTERS/Samuel Mambo

By Tom Miles and Fiston Mahamba

GENEVA/GOMA, Democratic Republic of Congo (Reuters) – An Ebola outbreak in eastern Democratic Republic of Congo is likely spread over tens of kilometers and poses a high regional risk given its proximity to borders, a World Health Organization (WHO) official said on Thursday.

Four people have tested positive for Ebola in and around Mangina, a town of about 60,000 people in North Kivu province, 100 km (62 miles) from the Ugandan border, the health ministry said. Another 20 people died from unidentified haemorrhagic fevers in the area, mostly in the second half of July.

Just last week, a previous outbreak on the other side of the Central African country was declared over after killing 33 people.

“It would appear that the risk, as we can surmise for DRC, is high. For the region it’s high given the proximity to borders, particularly Uganda,” said WHO’s emergency response chief Peter Salama.

“We are talking about tens of kilometers but I stress that this is very preliminary information at this stage.”

Ebola is believed to be transported long distances by bats and can find its way into bushmeat sold at local markets and eaten. Once present in humans, it causes haemorrhagic fever, vomiting, and diarrhea and is spread through direct contact with body fluids. Over 11,300 people died of an epidemic in West Africa from 2013 to 2016.

This is the vast, forested central African country’s 10th outbreak since 1976 when the virus was discovered near Congo’s Ebola river in the north. That is more than twice as many epidemics as any other country.

The response to Congo’s previous outbreak was considered a success despite the 33 deaths, as the use of a vaccine made by Merck helped contain the virus.

The kind of Ebola in the latest outbreak has been confirmed as the Zaire strain that the Merck vaccine protects against, Congo’s health ministry said late on Thursday. This should allow health officials to again use what has become the greatest weapon against Ebola epidemics to date.

Still, this outbreak poses new challenges. Eastern Congo is a tinderbox of conflicts over land and ethnicity stoked by decades of on-off war and this could hamper efforts to contain the virus.

About 1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over 1 million displaced people.

“FAST AS POSSIBLE”

Officials in Mangina rushed on Thursday to educate people about the risks of spreading the virus in a town that one local nurse told Reuters had no ambulance service.

Agents were deployed to warn people about the need for strict hygiene and the local radio station passed on messages about how to act, a local journalist said by phone.

“There is a great panic among the local population following the appearance of the Ebola epidemic,” said a nurse by phone, who asked not to be named.

The hospital where she works has already seen three people die recently of haemorrhagic fever. The hospital was awaiting help from the Red Cross to bury the bodies properly, she said.

Meanwhile, Uganda has set up screening at the land border it shares with Congo and at its Entebbe international airport.

“Ebola is highly infectious so we have put in place measures,” Uganda’s Junior Health Minister Sarah Achieng Opendi told Reuters.

An international delegation including officials from the United Nations, the World Bank and the WHO is in Beni, 30 km from Mangina.

(Reporting by Tom Miles in Geneva and Fiston Mahamba in Goma, Additional reporting by Elias Biryabarema in Kampala, Writing by Edward McAllister and Tim Cocks, editing by William Maclean and Rosalba O’Brien)

Seventeen deaths reported in Congo as Ebola outbreak confirmed

FILE PHOTO: A health worker sprays a colleague with disinfectant during a training session for Congolese health workers to deal with Ebola virus in Kinshasa October 21, 2014. REUTERS/Media Coulibaly

By Benoit Nyemba and Fiston Mahamba

KINSHASA (Reuters) – At least 17 people have died in an area of northwestern Democratic Republic of Congo where health officials have now confirmed an outbreak of Ebola, the health ministry said on Tuesday.

It is the ninth time Ebola has been recorded in the central African nation, whose eastern Ebola river gave the deadly virus its name when it was discovered there in the 1970s, and comes less than a year after its last outbreak during which eight people were infected, four of whom died.

“Our country is facing another epidemic of the Ebola virus, which constitutes an international public health emergency,” the ministry said in a statement.

“We still dispose of the well trained human resources that were able to rapidly control previous epidemics,” it said.

Ebola is believed to be spread over long distances by bats, which can host the virus without dying, as it infects other animals it shares trees with such as monkeys. It often spreads to humans via infected bushmeat.

Before the outbreak was confirmed, local health officials reported 21 patients showing signs of hemorrhagic fever around the village of Ikoko Impenge, near the town of Bikoro. Seventeen of those later died.

Medical teams supported by the World Health Organization and medical charity Medecins Sans Frontieres were dispatched to the zone on Saturday and took five samples from suspected active cases.

Two of those samples tested positive for the Zaire strain of the Ebola virus, the ministry said.

“Since notification of the cases on May 3, no deaths have been reported either among the hospitalized cases or the healthcare personnel,” the statement said.

After Congo’s last Ebola flare-up, authorities there approved the use of a new experimental vaccine but in the end did not deploy it owing to logistical challenges and the relatively minor nature of the outbreak.

The worst Ebola epidemic in history ended in West Africa just two years ago after killing more than 11,300 people and infected some 28,600 as it rolled through Guinea, Sierra Leone and Liberia.

Despite regular outbreaks every few years, death tolls in Congo have been significantly lower.

“Our top priority is to get to Bikoro to work alongside the Government of the Democratic Republic of the Congo and partners to reduce the loss of life and suffering related to this new Ebola virus disease outbreak,” said Dr Peter Salama, WHO Deputy Director-General, Emergency Preparedness and Response.

“Working with partners and responding early and in a coordinated way will be vital to containing this deadly disease.”

Health experts credit an awareness of the disease among the population and local medical staff’s experience treating for past successes containing its spread.

Congo’s vast, remote geography also gives it an advantage, as outbreaks are often localized and relatively easy to isolate.

Ikoko Impenge and Bikoro, however, lie not far from the banks of the Congo River, an essential waterway for transport and commerce.

Further downstream the river flows past Democratic Republic of Congo’s capital Kinshasa and Brazzaville, capital of neighboring Congo Republic – two cities with a combined population of over 12 million people.

(Writing by Tim Cocks and Joe Bavier; Editing by Richard Balmforth)

Two million children in Congo at risk of starvation, U.N. warns

GENEVA (Reuters) – More than 2 million children in the Democratic Republic of Congo are estimated to be at risk of dying from severe acute malnutrition if they do not get the aid they need, the United Nations warned on Friday.

U.N. humanitarian chief Mark Lowcock will meet donors next week in the country where conditions in many areas are worsening, U.N. spokesman Jens Laerke told a Geneva briefing.

“We have a great responsibility in the DRC…now is the time to stay the course,” Laerke said.

The 2 million children at risk of starvation include some 300,000 children in the Kasai region, Bettina Luescher of the U.N.’s World Food Programme (WFP) said.

(Reporting by Stephanie Nebehay, editing by Tom Miles)

Mass graves in central Congo bear witness to growing violence

A red headband, worn by Kamuina Nsapu militia fighters, is seen at a mass grave discovered by villagers in Tshimbulu near Kananga, the capital of Kasai-central province of the Democratic Republic of Congo, March 11, 2017.

TSHIMBULU, Democratic Republic of Congo (Reuters) – The increasingly brutal nature of fighting in central Congo between the army and local militia is on vivid display in the village of Tshienke, where the bodies of rebel fighters were dumped into a mass grave last month following intense clashes.

A visit to this site this month was the first time that journalists including Reuters have been able to see the toll that the Congolese military has exacted on fighters of the Kamuina Nsapu militia, whose insurgency poses the most serious threat to the rule of President Joseph Kabila.

Reuters was unable to determine the exact number of bodies in eight mass graves dug in January and February in Congo’s Kasai-Central province. The graves were also confirmed by nine local witnesses.

The United Nations said it suspects that Congolese forces killed 84 militia members close to the town of Tshimbulu between Feb. 9-13.

The government denies its soldiers used disproportionate force and says they have recovered automatic weapons from militia fighters after clashes.

Government spokesman Lambert Mende told Reuters that the bodies in the mass graves were those of Kamuina Nsapu fighters and it was the group who had buried them, not the army.

“I don’t see why the soldiers would hide the fact, that after clashing with the terrorists, the terrorists died,” he said, confirming that the army killed militia fighters in the clashes.

Leaders of Kamuina Nsapu could not be reached for comment.

BONE SHARDS

At one grave site at Tshimbulu, a human femur poked out of the dirt and shards of bone dotted the perimeter.

“We saw arms and legs. There were … people who were entirely exposed because they hadn’t been buried well,” said one man who found the mass grave last month with fellow farmers.

He, like about a dozen witnesses Reuters interviewed, spoke on condition of anonymity for fear of reprisals from the army.

Two km (1 mile) away in Tshienke, another farmer pointed out two more mass graves she said contained bodies dumped by an army truck between 8 p.m. and 11 p.m. on the night of Feb. 12, following intense clashes on Feb. 9 and 10.

A red headband of the kind worn by members of the Kamuina Nsapu militia was wedged in the grass near the graves.

In a statement to Reuters, the U.N. peacekeeping mission in Congo said it informed the government earlier this month of three alleged mass grave sites in Tshimbulu and, in December, of seven more in the village of Nkoto, about 150 km (90 miles) northwest. The government says the graves were dug by the militia.

Kabila’s decision not to step down when his presidential mandate expired in December was followed by a wave of killings and lawlessness across the vast central African nation.

Kabila has said he is committed to respecting the constitution but an election to choose his successor cannot take place until a lengthy voter registration process is completed.

However, the rebellion that began in Kasai-Central has spread to five of Congo’s 26 provinces and resulted in hundreds of deaths.

VIOLENCE

Kabila’s opponents have used violence to exploit the uncertainty caused by his decision to stay on. Last August, a local chief known as Kamuina Nsapu after his native village, was killed in a clash with soldiers.

He had rejected the authority of the central government in Kasai-Central and demanded that government forces leave. Since then, Kamuina Nsapu militants do not appear to have a leader and some of the latest violence appears to be ethnic score-settling.

But they have also demanded that the government move to implement a deal signed on Dec. 31 requiring Kabila to step down after an election this year.

“It has taken on a political dimension because the aim is now to see Kabila no longer at the head of the country,” said Alphonse Mukendi, a human rights activist in the provincial capital Kananga.

More than 60 local leaders connected to the militia, including Kamuina Nsapu’s brother, began arriving in Kananga on Sunday for negotiations with the government, provincial vice governor Justin Milonga told Reuters.

The government hopes that conciliatory gestures, including suggestions it is prepared to return Kamuina Nsapu’s body to his family, can ease tensions, though Milonga cautioned that many in the decentralized rebellion hope to see it continue.

Kamuina Nsapu’s tactics have alienated many, according to local residents, who say it uses child soldiers, some as young as 10.

It has attacked schools and churches, institutions it sees as oppressive, and executed police officers, soldiers and rival chiefs.

Mende, the government spokesman, said Congolese forces also suffered casualties at the hands of the group, including about 30 police officers killed last August.

But in battles with the military, the militia has faced machine gun fire while its fighters are armed with machetes, batons and home-made rifles.

After a video appearing to show soldiers massacring militia members was posted on social media, the United Nations called on Congo’s government to end “human rights violations, including apparent summary executions, by the … armed forces”.

The military’s top prosecutor, Major General Joseph Ponde, announced on Saturday that seven soldiers had been charged in connection with the video, including for the war crimes of murder and mutilation.

Ponde also said investigators plan to exhume two graves discovered near where the video was shot in neighboring Kasai-Oriental province.

(Editing by Tim Cocks and Giles Elgood)

Congo almost runs out of yellow fever vaccine amid epidemic

Residents read newspapers with reports on Yellow Fever

By Aaron Ross

KINSHASA (Reuters) – Democratic Republic of Congo has almost run out of yellow fever vaccine in Kinshasa, in the same week that the government declared an epidemic of the disease in the packed capital and two other provinces.

Some local people have complained they were denied immunization due to the shortage, despite queueing for a shot. More supplies have been promised, but health officials in the impoverished country say they have to choose between the high cost of flying them in, or a long wait for shipment by sea.

The mosquito-borne hemorrhagic virus is a major concern in Kinshasa, a city of about 12 million people which has poor health services, a humid climate beloved of the insects and much stagnant water where they can breed owing to pour drainage.

Health minister Felix Kabange said on Monday that 67 cases had been confirmed in Kinshasa, Kongo Central and Kwango provinces and that over 1,000 more suspected cases are being monitored. Five people have died from the disease.

The government and international health organizations vaccinated more than 2 million people, about half of them in Kinshasa, between May 26 and June 4.

But there is no more vaccine left, aside from a small number of doses left in reserve in Kongo Central and some being administered by a government agency at Kinshasa’s central hospital, airport and river crossing with neighboring Congo Republic, health officials said.

The agency is charging $35 for the doses it administers, a hefty sum in a country whose gross national income per person is estimated by the World Bank at $380 a year.

Eugene Kabambi, the World Health Organization (WHO) spokesman in Congo, said that the International Coordinating Group on vaccine provision has promised Congo more than a million more doses.

“That requires either a cargo flight, in which case it would come very quickly but cost a lot, or if it’s by boat, it could take a few weeks,” he told Reuters.

The Coordinating Group brings together the WHO and United Nations Children’s Fund (UNICEF) with the International Federation of Red Cross and Red Crescent Societies plus the medical charity Médecins sans Frontières.

The global stockpile of yellow fever vaccine has already been depleted twice this year to immunize people in Angola, Uganda and Congo. It stands at 6 million doses, but this may not be enough if there are simultaneous outbreaks in a number of highly-populated areas, experts warn.

Almost 18 million doses have been distributed for emergency vaccination campaigns so far in the three African countries.

QUEUES FOR VACCINES

Congo has extensive experience of dealing with outbreaks of tropical diseases and the Ebola virus was first identified in the central African country.

It earned plaudits in 2014 for quickly containing a local Ebola outbreak that killed 49 people in the country. By contrast an Ebola epidemic killed more than 11,300 as it swept through West Africa from 2013.

Of the cases confirmed in the latest yellow fever outbreak, seven were locally transmitted in Congo. Another 58 were imported from Angola, where it began, and two came from remote forested areas not linked to the current outbreak.

Symptoms of the disease include fever, body aches and nausea, although most people recover.

In Kinshasa’s Ndjili commune, a maze of narrow alleys and one of the health zones in the city targeted for vaccination in late May, many residents were unable to receive an injection before stocks ran out.

“Everyone started coming, even from other districts. Near the end we realized that the vaccine was insufficient,” said Murphy Nzuzi, a doctor at a dimly-lit health center in Ndjili with only a few small treatment rooms. He added that fights had broken out among people waiting in line.

In a nearby market where trash collected in a small stream, residents said that some people had received vaccination papers while waiting in line but never got a shot.

“When you present yourself, they give you the card that gives you access to the vaccine, but then there wasn’t enough vaccine for everyone,” said local resident Mama Mavungu.

The current method for making vaccines, using chicken eggs, takes a year. Health authorities are considering using a fifth of the standard dose of vaccine – enough to immunize temporarily but not to give lifelong immunity – to maximize its availability, but no final decision has been made.

(Editing by Tim Cocks and David Stamp)

Congo Rebels Kill Children Who Refuse To Fight

Human Rights Watch has released a report detailing atrocities committed by M23 rebels in the Democratic Republic of Congo including execution of children who refuse to serve in their ranks.

A spokesperson for Human Rights Watch told the BBC that the rebels have forced 137 young men and boys to join their army and have executed 33 young men and children who tried to escape from serving their troops. Continue reading