Economy in the DRC
On June 25, 2020, the Ministry of Health of the Democratic Republic of Congo declared that the 10th Ebola outbreak was over in three provinces. With the rise of COVID-19 cases in the country, Ebola cases have also increased significantly as social distancing became difficult in medical facilities. As of August 13, 2020, there have been 86 confirmed Ebola cases in the northwest Equateur province. As of July 3, 2020, there were a total of 3,481 cases in the entire country. With Ebola and COVID-19 cases rising, medical costs, personnel and resources will heavily affect the economy as government officials scramble to contain the outbreaks. Here is some information about how Ebola has affected the economy in the DRC.

Keeping Inflation in Check

The recent outbreaks in the Equateur province are in remote areas, regions that are difficult for medical supplies to reach. The lack of access to these areas requires an increase in medical cost support, however, the DRC currently cannot shoulder the financial burden due to the COVID-19 pandemic. The economy in the DRC has been stressed because of COVID-19 costs and has been adjusting rates in order to control inflation. During the week of August 10, the Central Bank of DRC increased the key interest rate from 7.5% to 18.5% in order to prevent inflation. Despite the pandemic, Central Bank experts are expecting an increase in the economic growth of 2.4% at the end of 2020. This would be a downward trend from expectations at the beginning of 2020.

Tracking COVID-19 and Ebola

The DRC will only be able to contain both viruses if it can properly document progression and transmission. However, the DRC has more than 500 regions of difficult terrain that do not have access to basic resources. These remote, populous areas are unable to receive medical resources or be properly tracked. They have less access to electricity, medical personnel and resources. The economy in the DRC has exacerbated most funds in order to contain the COVID-19 outbreak. However, the World Health Organization (WHO) has reported that almost 13,000 people have received vaccinations since the 11th Ebola outbreak that started near the end of July 2020.

International Aid

The U.S. Agency for International Development (USAID) is delivering an additional $7.5 million in humanitarian assistance to the DRC for Ebola. With these funds and WHO’s vaccine distribution procedures, testing facilities and medical personnel volunteers, the DRC will be able to more efficiently combat these pandemics.

Additionally, the DRC is receiving a $363 million loan from the International Monetary fund, $47 million from the World Bank and $40 million in emergency funds from the United Nations to strengthen the economy. These monetary aids will go toward the COVID-19 medical response, 11th Ebola outbreak vaccinations and necessary medical facilities.

Conclusion

Despite battling two pandemics at once, the DRC has maintained its composure and enacted the proper medical responses with the resources it has. The economy in the DRC has suffered because of the new Ebola outbreak. However, the DRC’s mission and determination to wipe out the last of the Ebola infections are unparalleled by previous responses. The DRC is on track to declaring another Ebola outbreak over.

Aria Ma
Photo: Flickr

Ebola Outbreak Funding Gap
Amid efforts to suppress the coronavirus effects, the Democratic Republic of the Congo (DRC) is now facing its 11th outbreak of Ebola since the discovery of the disease in 1976. The current outbreak officially began on June 1, 2020 — causing 24 deaths and garnering the attention of government officials and international agencies, such as the World Health Organization. The start of this outbreak coincides with the end of the 10th outbreak, which finished just 25 days earlier. Further complicating the latest outbreak is the fact that it comes when much of the international world is focusing on protecting themselves against the spread of the new coronavirus. As a result, there is an Ebola outbreak funding gap for what is required to sufficiently protect citizens of the DRC from the further spread of Ebola.

The Gap

The WHO reports that the $1.75 million raised so far will not last long enough to end the current outbreak. The organization estimates that the money will only last a few more weeks and that the unique location of the outbreak (in a more forested part of the country) is too costly to regularly send health officials.

This lack of funding could be a step backward for the country’s progress in limiting the disease. An outbreak in 2018 killed only 33 people, but from 2014 to 2016, 11,000 people died as a result of the disease. The main difference between the two time periods was the level of preparation and emergency funds to rely on, both of which are now decreasing due to the estimated gap.

The funding gap could have a direct impact on the current outbreak and may become a significant factor in the potential for new outbreaks. E.g., the recurrence of outbreaks is due to the virus’s presence in animals across the country. Therefore, there will most likely be another outbreak for which the WHO needs to be prepared.

Help from the United States?

The United States has donated more than $600 million to prevent the spread and minimize the devastation of previous outbreaks of the disease, in the DRC. This money has gone to building and managing health facilities, tracking the spread of the disease and evolving several safety measures for the country’s citizens. Those funds also went toward developing the two effective vaccines for Ebola and for transferring the dosages to citizens in need. Only a fraction of this money could make up for the lack of funding that the western part of the DRC needs today. Still, with most efforts and donations going toward coronavirus relief — very little attention has been placed on the current outbreak. This lack of attention contributes to the existing Ebola outbreak funding gap.

Looming Threats and Remaining Vigilant

A great challenge with this disease is that it could spread rapidly in the absence of a vaccine. Health officials typically vaccinate using a ring method — meaning they treat people that are near the center of the disease. Without the funds needed to disseminate the vaccine, the country’s infection rates could go up dramatically.

Officials are aware of this potential future, as the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus states, “This is a reminder that COVID-19 is not the only health threat people face. Although much of the world’s attention is on the pandemic, the WHO is continuing to monitor and respond to many other health emergencies.” Some are urging other countries and organizations to take on this mindset. Aid from the United States could prove a significant help in preventing loss of life in the DRC by closing the Ebola outbreak funding gap.

Aiden Farr
Photo: Pixabay

Education in Sierra LeoneMany important improvements in educational outcomes have occurred in Sierra Leone since 2015, especially for women and children. The country is bouncing back from the civil war, Ebola crisis and other serious challenges. This progress is partially owed to organizations that help children go to school. Several NGOs and community-based actors support education in Sierra Leone. Here is a small glimpse into the work of many.

4 Organizations Improving Education in Sierra Leone

  1. Street Child: Street Child’s goal is to improve the educational prospects of the world’s poorest and most marginalized children. Since its founding, the organization has helped more than 250,000 children escape poverty and go to school.  It originally started by improving education in Sierra Leone, where it began a project for 100 children in a small northern village. It has since expanded to serve children in ten other countries. Some of its work involves providing young girls with school supplies and giving families financial support. The organization also trains teachers and supplies classroom materials.
  2. Mother’s Club: After setbacks and challenges from the Ebola outbreak, mothers in Sierra Leone began organizing to ensure their children would receive a full education. Mother’s Clubs are village and community-based networks that sell products to fund their children’s schooling. Profits from farming, tye-dyeing, gardening and soap making pay for school supplies, books and uniforms. Thanks to these self-starters, with aid from international partners like UNICEF, communities can help drive positive educational outcomes.
  3. Girls Access to Education (GATE): Funded by U.K. Aid and its partners, Girl’s Access to Education (GATE) aims to help girls from disadvantaged households go to school and enables out-of-school girls to resume their education. Importantly, it also empowers communities to create their own solutions. The net enrollment rates in both primary and secondary education have consistently increased since 2013, due in part to their work. Where the literacy rate for girls ages 15-24 was less than 40% in 2005, that figure rose to 62.7% in 2018. The gap between male and female literacy rates continues to drastically decrease as well. This speaks to an overwhelmingly positive impact on Sierra Leone’s children and youth.
  4. Teach for All: Teach for All is a network of education partners and nonprofits who work together to help inspire change on a global scale. The organization announced Teach for Sierra Leone as its latest partner in July 2020. Similarly to other actors, Teach for Sierra Leone is community-driven and recognizes educational disparities in the country as an urgent issue. They aim to bridge education gaps by recruiting women and teachers from under-resourced schools whose efforts will help break the cycle of global poverty.

A Brighter Future

Overall, these organizations play a critical role in improving access to education in Sierra Leone. Currently, many schools have been disrupted due to COVID-19, but now radio lessons bridge the learning gap until reopening. So long as outside actors continue to provide foreign aid, assist in educational outcomes and empower communities, children in Sierra Leone will be able to reach their fullest potential.

Rachel Moloney
Photo: Flickr

Psychosocial Recovery from Ebola in Sierra LeoneCommunity healing dialogues are proving effective in providing psychosocial recovery from Ebola in Sierra Leone by addressing the trauma and stigma that survivors face. These sessions give community members a forum to raise and address their concerns about problems in the community, promoting health, wellness and prosperity in both psychosocial, emotional and economic senses. The dialogues seek to erase the stigma and promote economic recovery via micro-enterprise groups.

Poverty and Public Health Challenges

Sierra Leone is a West African country with a population of 7.5 million. Life expectancy is approximately 52 years for women and 51 years for men. The top ten causes of death include malaria, neonatal disorders, diarrheal diseases, tuberculosis and HIV/AIDS. Sierra Leone has the highest maternal mortality rate in the world (women have a one in 17 chance of dying from pregnancy or childbirth), in addition to one of the highest mortality rates for children under five. The country lacks a centralized public health system, and most people cannot access health care due to extreme poverty.

Support and Strides Amid Ebola

Sierra Leone had the highest number of fatal Ebola cases in the 2014-2016 outbreak. The disease’s severity prompted the CDC and NGOs like Partners in Health to provide resources and support. The CDC mounted its largest ever response to an outbreak in an individual country, providing services that included:

  • Epidemiological/strategical support
  • Infection prevention and control
  • Case management
  • Health promotion
  • Laboratory/diagnostic support
  • Emergency management
  • Border health
  • Research support

Partners in Health also provided emergency Ebola care and stayed in Sierra Leone after the outbreak to help strengthen the country’s public health system, staff, supplies and infrastructure. It has provided prenatal care, community health services, tuberculosis treatment, mental health care, blood banking and emergency medical services. The organization also established ongoing support systems for Ebola survivors. Strengthening Sierra Leone’s health system is an important means of both alleviating poverty and helping the country heal from Ebola. However, much work remains to be done.

Returning to Communities Through Healing Dialogues

Ebola is a disease with severe physical manifestations, but its social and psychological aftereffects can also be devastating and can help ensure that those affected remain in poverty.

In the words of one lifelong resident of Sierra Leone, “The Ebola outbreak in West Africa had the same psychological effects on individuals as war.”

Often, Ebola survivors are grieving for the deaths of their loved ones. At the same time, they face stigma and discrimination when trying to return to their communities because people fear that they still carry Ebola.

To address these complex and multifaceted issues, USAID’s Advancing Partners & Communities project introduced community healing dialogues. These meetings, which are conducted by trained facilitators, give community members space to talk through and resolve their concerns. These sessions are having positive effects on psychosocial recovery from Ebola in Sierra Leone for both survivors and their communities. Some survivors have been able to rejoin their communities free of stigma. In addition, the sessions serve as a forum for the community-based resolution of economic problems. For example, the forum led to a micro-enterprise group helping pay for a young woman’s school fee.

Sierra Leone’s Ebola outbreak was devastating on medical, economic and psychosocial levels. Support from governmental and non-governmental organizations have helped the country face these issues. Community healing dialogues have been extremely beneficial in aiding psychosocial recovery from Ebola in Sierra Leone.

– Isabelle Breier
Photo: USAID

Ebola Survivors
The Ebola epidemic that ravaged the Democratic Republic of the Congo (DRC) in 2018 claimed more than 2,250 lives. Doctors and nurses worked vigorously for months to treat patients and stop the spread of the deadly disease. Finally, in early March 2020, the DRC was able to announce that it had discharged its last Ebola patient. After the country’s lengthy battle with the virus, citizens are seeing that the end of the outbreak is finally within reach. With this new horizon in sight, here’s how Ebola survivors in Congo are giving back to their communities.

Interacting with Patients

There are more than 1,000 Ebola survivors in the DRC. These survivors have developed antibodies that can last up to a decade, allowing them protective immunity against Ebola. Essentially, if survivors come into contact with someone infected, they are not at risk of contracting the disease again.

This allows them to interact with sufferers who may feel isolated and alone during their treatment. Members of the Ebola Survivors Association were able to talk with and provide companionship to patients suffering from Ebola without making them feel alienated.

Spreading Awareness One Home at a Time

Members of the Ebola Survivors Association have been serving their community in Beni, a northeastern city in the DRC, by visiting homes to educate families on Ebola prevention strategies. One member, Gemima Landa, goes above and beyond as a way to thank the healthcare team that saved her life when she was infected.

Landa spends her week visiting countless neighborhoods in Beni. She shares her own story to enlighten families on how to stay healthy. She also makes regular visits to health centers to meet with mothers and pregnant women to explain to them how they have a crucial role in protecting their children against the deadly disease. Landa has been able to spread Ebola awareness and share life-saving information with hundreds of Congolese, and she isn’t the only survivor who’s making a difference.

Caring for Orphans of Ebola

With Ebola having taken so many lives across the country, it also left hundreds of children parentless as a result. Fortunately, survivors were quick to volunteer their time to step in and care for these orphans by providing love, attention and other necessities children desperately need during such a difficult time.

UNICEF also stepped in to help by partnering with survivors and opening nurseries close to Ebola treatment facilities. This is so that the caregivers would have a separate space to tend to the children. These nurseries provide daily screenings and checkups. Additionally, children who may have the disease can be cared for by survivors, who don’t have to risk being infected because they have developed an immunity.

There are now more Ebola survivors in the world than ever. The survivors in the Democratic Republic of the Congo have proven how valuable their help can be to impacted communities. If volunteers continue to band together and share their experiences, the world could be on its way to a healthier, Ebola-free future.

Hadley West
Photo: Flickr

New Ebola and Malaria Vaccines
In December 2019, the Gavi Board, an organization that improves the accessibility of immunizations to vulnerable children, approved a new program that will allocate new Ebola vaccines. A new funding initiative will invest about $178 million by 2025 for a new program to develop the vaccines. The decision is monumental in leading global health emergency stockpiles, which will grow to 500,000 doses.

Ebola’s Effect on Poverty

A study in December 2014 in Liberia indicated that the infectious disease hits poorer neighborhoods most. People in poverty are 3.5 times more likely to contract the disease than those in wealthier areas. Due to the dense population and lack of sanitation and health care facilities, the people in these communities are more susceptible to the virus. Ebola first appeared on an epidemic level in West Africa in 2014. While it existed prior to that, those cases were more contained. Crowded urban areas resulted in higher transference, further developing the outbreak.

Malaria Vaccines

In addition to the Ebola vaccine, Gavi approved continued steps in curating an implementation program for new malaria vaccines. The routine distribution of these vaccines will reduce child death significantly. Malaria is the primary cause of death of children under 5-years-old, with a reported 228 million cases and 405,000 deaths in 2018 alone. Malaria is also one of the top four causes of poverty, according to the United Nations. Its lack of affordable measures has strained many African economies, costing an estimated $30 billion a year. Many people cannot afford efficient medication and 20 percent often die due to poorly distributed drugs.

Countries affected by poverty and low income will have access to these vaccination campaigns free of charge, which will help boost economies. Countries such as the Democratic Republic of the Congo (DRC) have continually experienced rash Ebola outbreaks, with the latest one being in August 2018. Since then, the DRC has grappled with over 2,200 lives lost and 3,421 more reported cases in January 2020. In July 2019, the World Health Organization declared the Ebola outbreak a public health emergency that called for international concern.

The US Fights Against Ebola

The U.S. Food and Drug Administration (FDA) will also participate in close efforts to fight the Ebola outbreak in the DRC. The FDA granted programs in order to advance the development of new drugs that will lead to the prevention of tropical diseases. People primarily contract Ebola through direct contact with bodily fluids, blood and infected wild animals or people. Limiting these factors is difficult, but with proper medication and programs, along with the investments in sanitation and health care facilities, outbreaks will significantly reduce. These types of decisions are paramount in shifting the United States’ focus to a more global standpoint in regards to large-scale poverty.

The development of Ebola and malaria vaccination pilots is essential to the sustainability of areas affected by extreme poverty. Preventable measures will reduce the risk of contracting infectious diseases among these low-income communities. These comprehensive overviews will scale back the rate of Ebola outbreaks in African regions, which will also cut back on excessive government spending. Vaccination programs will help prevent 24 million people from facing extreme poverty by 2030. People could prevent a quarter of deaths that the outbreaks caused through simple vaccination, which makes these programs all the more noteworthy. The Gavi Board and the FDA’s efforts in launching new malaria and Ebola vaccines will contribute to the positive impact.

Brittany Adames
Photo: Wikimedia Commons

Limit the Spread of Epidemics
In the past, there has been some difficulty in tracking and containing epidemics. In 2014, the Ebola virus killed thousands in West Africa. At the time, many national health systems had trouble properly addressing and controlling its spread. With aid agencies not knowing where to dedicate their attention, more people fell to Ebola. Determining where to distribute a vaccine is critical for the future of any region. It is often difficult to make the correct decision when there is not enough information on human mobility, the spread of an epidemic and its lethality in certain areas. People could have better contained Ebola had newer technology been available to help aid agencies track its spread. The Global Epidemic Prevention Platform (GEPP) may be able to limit the spread of epidemics.

A Solution for Limiting the Spread of Epidemics

The Global Epidemic Prevention Platform (GEPP) is a project that Korea Telecom (KT) Corporation and the Ghanaian government created to improve Ghana’s health information system and limit the spread of epidemics. The project employs information and communications technology (ICT) to gather data on epidemics. It works by gathering existing data and by incorporating newer input from its users. It analyzes Call Detail Record (CRD) data to determine the spread of people such as cross-border movement. Its main goal is to prepare its users for possible epidemics, whether its users consist of the general public or the Ghanaian government. Its existence helps detect the early spread of an epidemic, allowing governments more time to respond and giving humanitarian agencies and NGOs the opportunity to identify possible relationships and trends.

GEPP Explained

There are three parts to the GEPP: GEPP Public, GEPP Clinic and GEPP Gov. The GEPP Public’s intention is to inform Ghanaians of epidemic-prone areas. When someone is nearing one such area, they receive a notification and warning of its status. If a user is in an area that may become contaminated soon, the app provides disease information and prevention measures for pre-response during their stay. They also receive a list of nearby hospitals.

The GEPP Clinic is for the public to make real-time reports to nearby health centers in the event of an epidemic outbreak. Users can fill out a report for either themselves or another individual with their symptoms. This report goes into the GEPP Clinic’s database and gives the government a better idea of what is happening in a particular region.

The government uses GEPP Gov, which allows it to access the data gathered from GEPP Public and GEPP Clinic to monitor any possible health crises. As a result of the digitization of airport immigration information, the government can consider immigration levels when monitoring. This also takes away the need to manually compile this information. All of this aims to help developing countries and their governments prepare for and reduce the impact of epidemics.

If a disease has already spread and it is too late to prevent infection, the GEPP can also address the aftermath of disease by conducting communications in the area. Not only can it address health crises, but it can also apply to natural disasters and their control. In the event of a natural disaster, the GEPP can help aid workers provide shelter, food and health care to victims. If an area does not have a working mobile network, as a result of a natural disaster or not, the GEPP can use its collected data to contact them via satellites and Geographical Information Systems (GIS).

GEPP Support

The Ghana Health Service, KT, Mobile Network Operators (MNOs), Resolution 202, Resolution 136, Resolution 36 and WTDC Resolution 34 support the Global Epidemic Prevention Platform. While all of these play a large role in assisting the GEPP in its goal to limit the spread of epidemics, MNOs arguably do the most. MNOs provide the app with its official data. It gathers data from around the world and its software anonymizes it to protect privacy. This data then stays on a server or an International Telecommunication Union (ITU) cloud and can go towards creating a dynamic map for the ITU. Humanitarian actors and NGOs can, with permission, view this data through MNOs.

– Nyssa Jordan
Photo: Flickr

Global Health News
The start of 2020 is the time to look back and see global health news for 2019. From new drug recommendations and global vaccination efforts to ongoing diseases and funding to eliminate them, health agencies and national governments are working tirelessly to keep everything in place. They are making sure the general public, especially those in affected countries, get the right information and the best resources to address these health issues. They are gathering enough funding to implement different health programs for treatment and prevention. Finally, they are continually conducting research to find new treatments to make the world a healthier place.

Global Health News Updates for 2019

  1. Tafenoquine use for malaria is under new guidance: According to the World Health Organization (WHO), there were about 219 million malaria cases around the world in 2017. People can use Arakoda (tafenoquine 300 mg) and Krintafel (tafenoquine 150 mg) to treat malaria. The government of Kenya joined Ghana and Malawi to test the malaria vaccine for children. Results of clinical trials show that vaccinated children do not contract malaria as often as unvaccinated children.
  2. Poliovirus outbreaks increase sharply: Poliovirus (cVDVP) outbreaks have increased worldwide. Twenty-nine outbreaks occurred in 15 countries within a one-and-a-half-year period (2018-2019). The 29 outbreaks also tripled the number of outbreaks in the year prior (2017-2018) among six different countries. The Center for Disease Control (CDC) has send staff to the affected areas to provide treatment and prevention efforts.
  3. Measles numbers increased: Measles cases have increased tremendously in the last three years. In 2018, there were approximately 10 million measles cases with 140,000 deaths. The number of deaths has increased from 90,000 in 2016. People are not receiving immunizations due to different vaccination beliefs and the availability of vaccines. UNICEF is trying to address the issue; however, Xavier Crespin, UNICEF’s chief of health in the Democratic Republic of Congo, said it has been difficult.
  4. Global vaccination coverage has stayed the same since 2010: The global vaccination rate has stayed between 85 percent to 86 percent for the past eight years. This is due to the low availability of vaccines reaching areas of countries that are experiencing high poverty and warfare. False vaccination beliefs are also a factor in holding back coverage. The Global Vaccine Action Plan (GVAP) is working to address the issue by setting up vaccination stations in these countries as well as solving any vaccination challenges that stand in the way of vaccinating people. 
  5. New Respiratory Syndrome from Wuhan, China: Chinese health authorities have confirmed a case of new coronavirus in January 2020. The number of deaths has reached 80 with more cases expected. The virus has spread to Malaysia, Vietnam, Hong Kong, Korea and the United States, and the situation is on its way to becoming a global epidemic. WHO is closely monitoring the situation and issuing health advisories to affected countries.
  6. Preparing for Ebola in South Sudan: South Sudan is preparing for Ebola as its neighbor, the Democratic Republic of the Congo, had an outbreak. Warfare has devastated the country’s health system; health experts are suggesting ways to prevent and treat diseases. The country’s health governance deployed fully-immunized health workers to support prevention efforts with 32 outposts for screening and care along the border.
  7. Antiretroviral treatment (ART) reduces HIV mortality in Kenya: The use of antiretrovirals to treat HIV has reduced HIV-related death rates in Kenya as one researcher at the CDC Zielinski-Gutierrez confirmed. The CDC is leading the AIDS-control effort as part of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) all over the world including Kenya (PEPFAR Kenya).
  8. Shigella developed resistance to azithromycin and ciprofloxacin: In a research study, the virus that causes Shigella in men who have sex with men (MSM) has developed resistance to azithromycin, trimethoprim-sulfamethoxazole and ciprofloxacin. WHO put preventative measures in place like the Water and Sanitation Decade Development Project to promote water sanitation and hand-washing education.
  9. Tuberculosis (TB) is low in the U.S. but not globally: Residents who were born outside of the U.S. are much more likely to contract tuberculosis and carry latent TB infection. The CDC stated that 69.5 percent of newly diagnosed TB cases are of those who were born outside of the U.S. compared to 29.5 percent of those who were born in the U.S. Furthermore, countries other than the U.S. have higher TB death rates. The United Nations and WHO are targeting to end TB in 2030 and 2050 respectively.
  10. Donors pledge to donate $2.6 billion to end polio: Donors pledged to donate $2.6 billion at the Polio Conference in Abu Dhabi to help put an end to world polio. Donations come from the Gates Foundation, the U.K., the U.S., Pakistan and Rotary International. WHO will use the funding to vaccinate 450 million children each year.

Global health challenges are ongoing; however, many are working to address these challenges. Global health efforts will not go unnoticed as the world will become a healthier, happier and safer place for all. Finally, global health news updates are an excellent way to communicate all global health trends, challenges and ongoing projects. 

– Hung Minh Le
Photo: Flickr

Infection Prevention and Control in Sierra Leone
Sierra Leone did not have an existing infection prevention and control program before its 2014-2016 Ebola epidemic. However, infection prevention and control is an essential element aiding in eradicating and preventing cross-infection among the community, patients, health care providers and hospital visitors.

The Current Course of Action

The Ministry of Health and Sanitation, with the help of the Centers for Disease Control and Prevention (CDC), has made significant strides in an attempt to get Sierra Leone’s health sector back on the right track. This partnership involves the implementation of the National Infection Prevention and Control Action Plan (IPC) to prevent future infection and disease. The IPC will enable the equipping of health facilities and open up conditions for the resources required for standard and transmission-based precautions. Further, the goal of the IPC aims to prevent and contain health care-associated infections.

The CDC’s Involvement

Disease threats are spreading faster than ever before but the CDC’s efforts in Sierra Leone have helped improve the country’s prevention, detection and ability to respond to infectious disease outbreaks. These abilities remain especially key before outbreaks become epidemics with the potential to affect global populations.

The CDC has played an important role in infection control in Sierra Leone, even establishing a country office in 2015 to focus on global health security. The CDC has been diligently working with Sierra Leone on surveillance, emergency management, strengthening laboratory and the workforce capacity to respond to disease outbreaks.

More than 700 CDC staff members served on over 1,000 deployments to Sierra Leone after the Ebola outbreak. Further, this makes it the CDC’s largest outbreak response ever in a single country. Sierra Leone, as of November 2015, is Ebola-free.

Keeping Infection and Disease Under Control in Sierra Leone

Sierra Leone has taken a different approach to sustain the infection prevention and control. The country has invested in ongoing training for its health care workers. These efforts have helped ensure a safe working environment for all, with lower health care-associated infection risks. Health care workers and hospitals have improved their disposal of waste practices, hiring individuals to clean, along with disposing of the waste.

In addition, Sierra Leone has heightened awareness of infection prevention and control with the aid of supported sanitation and hand hygiene campaigns. These campaigns aid in the creation of a culture of hand-washing and have drastically reduced cross-infection among patients, thus eradicating Ebola.

As Dr. Keiji Fukuda, the WHO Assistant-Director General, states, “When health workers are infected at work, this puts other health care workers at risk. Understanding where the breach in these measures is occurring and taking the steps needed to fully implement infection prevention and control measures can put an end to these infections.”

Na’Keevia Brown
Photo: Flickr

Burundi's Health Care
Burundi is a Central African nation, bordering the Democratic Republic of the Congo, Tanzania and Rwanda. Those living within the nation face a plethora of challenges from civil wars to disease and a general state of civil unrest. On top of this, Burundi‘s health care requires efforts to reduce the spread of disease and provide better care to those affected.

The State of Burundi’s Health Care

The fear of communicable diseases grew exponentially following the multiple Ebola outbreaks in the neighboring Democratic Republic of the Congo. This illuminated the glaring flaws in Burundi’s health care system and an overall lack of preparedness for such a potentially deadly epidemic.

USAID has stated that Burundi’s health care system faces a “lack of adequate infrastructure and human resources to meet urgent community health needs.” Although the inadequacies are plentiful and debilitating, with relentless efforts, some are providing hope by way of ingenuity in Burundi’s health care system

Malaria

There were reports of over 7 million malaria cases in Burundi within the first 10 months of 2019. This is roughly 64 percent higher than the total recorded cases for 2018. The cause of this spike is a subject of debate, with experts citing climate change and an unequipped health care system as possible culprits.

A protozoan parasite causes malaria. After a bite from an infected mosquito, the protozoan parasite invades the red blood cells. People infected with malaria often experience flu-like symptoms. In 2017, there were records of 219 million cases of malaria, along with approximately 435,000 deaths. The vast majority of these cases were in Africa.

Many Burundians have taken refuge from the malaria epidemic in neighboring Rwanda. Although advances in fighting the disease remain somewhat stagnant in Burundi, Rwanda is succeeding in limiting the outbreak. Rwanda began coating refugee camps and homes with indoor residual spray. Since then, Rwanda experienced 430,000 fewer cases after just one year utilizing this method. Burundi, with a similar socioeconomic state as Rwanda, leads many to believe these methods could be beneficial for great success in both countries.

Cholera

Beginning in June 2019, a cholera outbreak overcame the city of Bujumbura, the most densely populated city in Burundi. With over 1,000 cases recorded, this far exceeds the national yearly average of about 200 to 250.

Cholera is a highly contagious bacterial infection caused by coming into contact with fecal matter, which is commonplace in bodies of still water. The disease causes severe diarrhea, which almost inevitably leads to dehydration. It can progress exceptionally fast, necessitating medical care within hours of infection.

Even with cholera’s endemic level in the city of Bujumbura, there have been minimal deaths. This is in large part due to the development of three cholera treatment facilities within the area. Many of the medical facilities face the incapability of treating the disease. However, with minimal investment, the country could make drastic changes for the better.

Ebola

Although the Ebola outbreak in the Democratic Republic of the Congo has not moved into Burundi as of yet, the risk is high. This is largely due to the fact that many Burundians work and trade in the neighboring DRC. The border town of Gatumba, for instance, averages 6,000 border crossings every weekday and 3,000 border crossings on the weekends.

Ebola, a contagious virus, spreads through contact with bodily fluids (such as blood, urine, breast milk, semen and fecal matter). Ebola is classified as a hemorrhagic fever virus. This is due to the fact that Ebola causes issues with the clotting of blood. The issues with clotting often lead to blood leaking from blood vessels within the body, causing internal bleeding.

In an attempt to spread awareness, a fleet of vans equipped with speakers and filled with UNICEF workers are traveling around Burundi and educating on ways to prevent the spread of Ebola. Many of those living in Burundi are unaware that things such as proper hand-washing techniques can be the difference between life and death. Through education and increased communication within the community, many are optimistic regarding Burundi’s fight against the spread of Ebola.

Although Burundi faces much to overcome, through proper allocation of resources and help from an international audience, Burundi’s health care system can flourish, saving countless lives.

Austin Brown
Photo: Flickr