Ebola Virus DiseaseImagine traveling 1,316 kilometers from the Democratic Republic of the Congo (DRC) to Uganda seeking medical help for your nine-year-old daughter who seems to have been infected with the Ebola Virus Disease (EVD).

On August 29, 2019, a nine-year-old girl from the DRC was exposed and later developed symptoms of this rare and fatal disease. She was identified at the Mpondwe-Kasindi border point and then sent to an Ebola Treatment Centre (ETC) in Bwera, Uganda. Sadly, not too long after her arrival, the child passed away.

This sporadic epidemic has come back yet again and bigger than last time. This disease has infected the North Kivu Province and has caused more than 2,200 cases, along with 1,500 deaths just this year. Thus, making this the second-largest outbreak in history following behind the 2014-2016 outbreak that killed about 11,000 people. As of September 4, 2019, a total of 3,054 Ebola Virus Disease cases were reported. Out of that total number of cases, 2,945 of them were confirmed reports and the rest of the 109 were probable cases. Overall, 2,052 of those people died.

This disease has had a total of 25 outbreaks since its first flare-up in the Ebola River in 1967. It has plagued countries spanning from the West to sub-Saharan Africa and has a 25 to 90 percent fatality rate. Even though reports are coming from 29 different health zones, the majority of these cases are coming from the health zones of Beni, Kalunguta, Manima and Mambasa. About 17 of these 29 health zones have reported new cases stating that 58 percent of probable and confirmed cases are female (1,772), 28 percent are children under the age of 18 (865) and 5 percent (156) are health workers.

This 2019 case is different because of the way that Ebola Virus Disease is affecting an area of the country that is undergoing conflict and receiving an influx of immigrants. The nation’s “political instability,” random acts of violence and “limited infrastructure” also contribute to the restricted efforts to end the outbreak.  As of June 2019, the disease started its expansion to Uganda, with four cases confirmed near the eastern border shared with DRC, South Kivu Province and Rwanda borders. The World Health Organization (WHO) Country Representative of Uganda, Yonas Tegegn, stated that whoever came into contact with the nine-year-old patient had to be vaccinated.

Out of the five Congolese who had contact with the little girl, four of them have been sent back to their country for “proper follow-ups.” Another 8,000 people were vaccinated against Ebola due to “high-risk areas in the country.”  Overall, 200,000 people in DRC have been vaccinated against EVD along with “health workers in surrounding countries.” With this being said, there is no official vaccination that is known to effectively protect people from this disease. Therefore an “effective experimental vaccine” has been found suitable enough for use. Also, a therapeutic treatment has shown “great effectiveness” in the early stages of the virus.

Ugandan authorities have taken matters into their own hands, strengthened border controls and banned public gatherings in areas that have been affected by EVD. According to the August 5, 2019 risk assessment, the national and regional levels are at higher risk of contracting EVD while the global level risk is low.

The Solutions

The World Health Organization (WHO) is doing everything they can to prevent the international spread of this disease. They have implemented the International Health Regulations (2005) to “prevent, protect against, control and provide international responses” to the spread of EVD.

This operational concept includes “specific procedures for disease surveillance,” notifying and reporting public health events and risks to other WHO countries, fast risk assessments, acting as a determinant as to whether or not an event is considered to be a public health emergency and coordinating international responses.

WHO also partnered up with the Global Outbreak Alert and Response Network (GOARN) to ensure that proper “technical expertise” and skills are on the ground helping people that need it most. GOARN is a group of institutions and networks that use human and technical resources to “constantly alert” one another to rapidly identify, confirm and respond to “outbreaks of international importance.”  WHO and GOARN have responded to over 50 events around the world with 400 specialists “providing field support” to 40 countries.

– Isabella Gonzalez Montilla
Photo: Flickr

Fight Disease in the DRC
With 80 million hectares of arable land and over 1,100 precious metals and minerals, the Democratic Republic of the Congo has quickly established itself as a large exporter in the lucrative diamond industry. Despite this, the DRC ranks 176th out of 189 nations on the UN’s Human Development Index and over 60 percent of the 77 million DRC residents live on less than $2 a day. Internal and external war, coupled with political inefficacy and economic exploitation, has hindered the country’s ability to combat poverty and improve health outcomes. Listed below are some of the most deadly diseases that are currently affecting individuals in the DRC and the different strategies that governments and NGOs have taken to fight disease in the DRC.

3 Deadly Diseases Currently Affecting Individuals in the DRC

  1. Malaria

The DRC has the second-highest number of malaria cases in the world, reporting 15.3 million of the WHO-estimated 219 million malaria cases in 2017. Of the more than 400 Congolese children that die every day, almost half of them die due to malaria, with 19 percent of fatalities under 5 years attributed to the disease. However, some are making to reduce malaria’s negative impact.  For example, the distribution of nearly 40 million insecticide-treated mosquito nets, or ITNs, has helped lower the incidence rate by 40 percent since 2010, with a 34 percent decrease in the mortality rate for children under 5. The DRC government procured and distributed the nets with international partners such as the Department for International Development, Global Fund and World Bank. In addition, the President’s Malaria Initiative, a program implemented in 2005 by President Bush and carried out by USAID, has distributed more than 17 million nets. UNICEF has also been a major contributor in the efforts to fight malaria and recently distributed 3 million ITNs in the DRC’s Kasaï Province. However, the country requires more work, as malaria remains its most frequent cause of death.

  1. HIV/AIDS

Among its efforts to fight disease in the DRC, the country has made significant progress recently in its fight against HIV/AIDS. As a cause of death, it has decreased significantly since 2007, and since 2010, there are 39 percent fewer total HIV infections.

This particular case illuminates the potential positive impact of American foreign aid. The DRC Ministry of Health started a partnership with the CDC in 2002, combining efforts to fight HIV/AIDS. PEPFAR, signed into U.S. law in 2003 to combat AIDS worldwide, has invested over $512 million since 2004, which has helped to fund antiretroviral treatment for 159,776 people. In 2017, it funded the provision of HIV testing services for 1.2 million people.

The country is also addressing mother-to-child transmissions. In the DRC, approximately 15 to 20 percent of mothers with HIV pass the virus onto their child. The strategy to end mother-to-child transmissions involves expanding coverage for HIV-positive pregnant women, diagnosing infants with HIV earlier and preventing new infections via antiretroviral drug treatment. UNAID, The Global Fund and the DRC Ministry of Health have undertaken significant work to accomplish these objectives and their efforts have resulted in the coverage of 70 percent of HIV-positive pregnant women.  However, much work remains to cover the remaining 30 percent of pregnant HIV-positive women.

Overall, there is still a lot of necessary work to undergo in the fight against HIV/AIDS in the DRC and around the world.  In total, UNAIDS estimated that HIV/AIDS was the cause of 17,000 deaths in the DRC in 2018.  While this is a decrease from previous years, it shows that the DRC still has a long way to go in order to fully control the spread of the disease.  Additionally, there must be more global funding. The U.N. announced on July 2019 that annual global funding for fighting HIV/AIDS decreased in 2018 by almost $1 billion.

  1. Ebola

Since 2018, the DRC has undergone one of the world’s largest Ebola outbreaks. On July 17, 2019, WHO declared the outbreak an international health emergency. Since August 2018, more than 2,500 cases have occurred, with over 1,800 deaths.

However, the country is making efforts to prevent the transmission and spread of Ebola in the DRC.  Recently, more than 110,000 Congolese received an experimental Ebola vaccine from Merck & Co. The vaccine is called rVSV-ZEBOV, and studies have shown the vaccine to have a 97.5 percent efficacy rate.  This vaccine provides hope that people will be able to control Ebola breakouts in the near future.

While there have been attempts to fight disease in the DRC in recent years, such as malaria, HIV/AIDS and Ebola, each disease remains a major issue. In the coming years, the country must continue its efforts.

– Drew Mekhail
Photo: Flickr

Ways to Fight Ebola in the DRCThe Democratic Repulic of the Congo (DRC) has been ravaged by violence and a deadly Ebola epidemic. Thousands have died, however, there may be hope on the horizon. A vaccine and cure for the terrible virus may soon end the years of pain and suffering caused by Ebola. Here are some ways to fight Ebola in the DRC.

Ebola in the DRC

The Congo has dealt with Ebola outbreaks before and managed to contain them before they grew out of control. The current outbreak, however, is proving to be difficult to contain as there have been more than 2,500 cases. Almost 1,800 people have died and the virus is spreading fast. With cases having been confirmed in neighboring Uganda, the World Health Organization says that there is a high risk that Ebola could spread into Rwanda and South Sudan as well. 

Challenges

The main obstacles to containment are a mistrust of doctors and violent conflict. Unfortunately, violent conflicts spill over into clinics where doctors are attacked for providing life-saving treatments for Ebola patients. In addition, a recent study found that almost 25 percent of Congolese people think Ebola is fake due to a lack of trust and the spread of misinformation. Some people even believe that Ebola is a money-making scheme and a way to suppress voters. Unfortunately, distrust means many Congolese avoid formal health care and decline vaccines.

Potential Cure

Scientists have been trialing two new antibody-based treatments. The success of these two treatments has been so great that Ebola may no longer be considered incurable. The two drugs, REGN-EB3 and mAb-114, have both increased survival rates to around 90 percent. REGN-EB3 is a drug invented by the pharmaceutical company Regeneron. mAb-114 is an antibody that was drawn from the blood of an Ebola survivor.

Recently, both treatments were involved in a study to test their effectiveness in comparison with the current drug Zmapp that has a mortality rate of 49 percent. The two new drugs, REGN-EB3 and mAb-114, were both found to have mortality rates under 35 percent. Even more encouraging, the mortality rates for the two drugs drops to below 15 percent when patients are treated as soon as they are infected. A major obstacle in the fight to control the epidemic is that patients wait a long time to seek medical attention. The new more effective treatments could convince people to seek help earlier since their mortality rates are better than the older treatments.

Possible Vaccine

American pharmaceutical company Merck has created an experimental vaccine that has proven to be very effective. Merck uses ring vaccination to vaccinate those who have come in contact with an Ebola patient. Using this method, almost 200,000 people in the DRC and its neighboring countries no longer have to worry about contracting Ebola. The vaccine has given 97 percent protection for those who have taken it. The United States Department of Health and Human Services recently announced that it will fund Merck’s vaccine production, with a $23 million investment signaling good news in the fight to contain (and prevent) Ebola in the DRC.

– Gaurav Shetty
Photo: Flickr

 

Dikembe Mutombo's Impact
Dikembe Mutombo is most famous for his basketball career as a player in the NBA for 18 years and a four-time Defensive Player of the Year award recipient, but he is also well-known for his humanitarian work. Mutombo, born in Kinshasa, the capital city of the Democratic Republic of the Congo, has spent the last 22 years contributing much of his time to helping his home country. Dikembe Mutombo’s impact has been significant due to creating the Dikembe Mutombo Foundation.

The Democratic Republic of the Congo’s Struggle With Poverty

The Democratic Republic of the Congo (DRC) has faced a long history of injustice due to political corruption and economic collapse which has affected the country in a multitude of ways. Approximately 70 percent of Congolese people have little or no health care, and many hospitals and clinics lack necessary components to keep them running smoothly. Many health care facilities have shortages of personnel and equipment and frequently run out of necessary medicine and supplies.

Some of the top causes of death in the DRC include preventable or treatable conditions such as malaria, lower respiratory infections, tuberculosis and diarrheal diseases. However, in the last 12 years, child vaccinations have increased from 31 to 45 percent, and the DRC has been free of polio for over three years. Still, because 64 percent of Congolese live under the poverty line, they often have to make the choice between food and medicine.

The Dikembe Mutombo Foundation

Mutombo founded the Dikembe Mutombo Foundation (DMF) in 1997, in honor of his mother. Due to civil unrest, she was unable to get to the hospital for treatment and died that year.

This inspired Mutombo to create a foundation focused on primary health care, disease prevention, health policy and research and access to health care education. Its mission is to improve the health, education and quality of life for the people in the DRC.

DMF opened its first hospital in 2007, the Biamba Marie Mutombo Hospital, named after Dikembe Mutombo’s mother. It commits to providing high-quality health care regardless of economic status. Dikembe Mutombo’s impact has allowed the hospital to treat over 30,000 patients and employ almost 400 doctors and nurses.

A future project of the foundation will be the building of a Welcome House next to the hospital. It also plans to construct an elementary school with an emphasis on science and technology outside of Kinshasa.

Mutombo on the Ebola Crisis

Mutombo and his foundation have recently joined with the U.S. Center for Disease Control and Prevention (CDC) to communicate with the Congolese about the Ebola crisis. Almost a year after the initial outbreak, reports mentioned 2,284 cases of infection and almost 1,500 probable deaths, making this the 10th and worst Ebola outbreak that the DRC has faced.

The CDC began posting the public service announcements to its YouTube channel and on the agency’s website on Monday in some of the native languages of the DRC, French and Swahili. In the video, Mutombo describes the early signs of Ebola, treatment, preventative measures and recommendations. Mutombo told the Associated Press, “When there’s something happening around the world, it should be a concern of everyone living on this planet, and I think the epidemic of Ebola is touching all of us.”

Mutombo’s philanthropy in his home country of the Democratic Republic of Congo will impact generations to come. Mutombo stated it best in the Ebola PSA: “I believe as a son of Congo, I think my voice can be heard. Because everyone in the country knows my commitment to humanity and health.”

– Alexia Carvajalino
Photo: Flickr

Ebola in the Democratic Republic of Congo
With a population of more than 85 million people, the Democratic Republic of the Congo (DRC) has struggled with political and social instability since the Belgian conquest in the early 20th century. More than 100 armed groups are active in the DRC to this day. The second-deadliest Ebola outbreak in history, where more than 1,600 people have died, rages against this backdrop of violence. Since the virus’s discovery in 1976, the DRC has had 10 documented Ebola outbreaks, including this most recent one.  Despite these grim circumstances, a group of Congolese tech-savvy youth has developed an unlikely weapon against Ebola in the Democratic Republic of the Congo; an app called Lokole.

Ebola is a virus that causes fever, sore throat and muscle weakness and later progresses to vomiting, diarrhea and internal and external bleeding. Patients die due to dehydration and multiple organ failure. Developed during the West African epidemic of 2014-2016 where more than 11,000 people died, the investigational vaccine called rVSV-ZEBOV is currently in use to fight the outbreak in the DRC under the Compassionate Use Clause since no one has commercially licensed it to date.

What is Lokole?

In addition to medical interventions, the Congolese Ministry of Health is seeking technological tools. Through collaboration with Internews and Kinshasa Digital, it organized a hackathon in March 2019 which brought 50 students in communications, medicine, journalism and computer science together. These students divided into teams of approximately seven members, and each team sought to answer the question: “How can Ebola response teams leverage new technologies to achieve their communication goals at the local, national and international level?” Thrown together for the first time, Emmanuel, Ursula, Aurore, Joel, David, Israël and Maria worked for 24 hours and emerged with Lokole, the winning technology.

Lokole is an Unstructured Supplementary Service Data (USSD) mobile application that is “designed to facilitate the real-time transmission of data and information between communities and the Ebola response teams” despite poor internet connectivity in rural areas. This team of seven chose the name Lokole because it is the name of a traditional Congolese drum Congolese people use to transmit messages over long distances. With this app, they hope to increase communication about the spread of Ebola in the Democratic Republic of Congo.

USSD technology is a text-based communication system used by Global System for Mobile Communication (GSM) cellphones, which are used in most countries except for the U.S. and Russia. Even though text-based communication might seem outdated with smartphones in the picture, smartphone use across Africa is less than 35 percent and even those with smartphones might not have access to data plans. As such, a real-time mobile to mobile communication platform based on USSD technology is inherently more inclusive, cheaper and more useful.

How Will Lokole Help?

The Lokole app allows community workers to note and document Ebola symptoms through questionnaires, which are then relayed to Ebola response teams and the Ministry of Health.

“Real-time management of information by the different components of the Ebola response will help detect and provide treatment to patients more quickly and deploy resources on the ground more swiftly, which will help lower Ebola mortality rates,” David Malaba, one of the app’s developers, said.

While analog in comparison to smartphone technology, Lokole’s USSD platform offers the potential for real-time communication without having to invest in widespread expensive improvements in its internet connectivity infrastructure. Lokole empowers the everyday Congolese person with the tools to fight Ebola. It is a democratic grassroots health care model. In fact, similar USSD technology which connects the average citizen with a nurse or physician in a matter of minutes powers large-scale telemedicine platforms, such as BabylRwanda in neighboring Rwanda.

The development of the Lokole app is exciting in its fight against Ebola in the Democratic Republic of the Congo, but the galvanization of local Congolese talent is a game-changer. Hackathons that bring disparate youth together to problem solve big, often overwhelming, issues inspire others to pursue change. Lokole is just the beginning.

– Sarah Boyer
Photo: Flickr

Ebola Prevention in Rwanda

In August 2018, the World Health Organization confirmed an Ebola virus outbreak in the Democratic Republic of the Congo. Since then, the Rwandan government has taken a proactive stance with a rigorous system to promote Ebola prevention in Rwanda. So far, the system has been successful. Despite constant traffic across the borders between the DRC and Rwanda, there have been no cases of Ebola in Rwanda.

Threat of Transmission from the DRC

Since the outbreak of Ebola in the DRC, there have been more than 2,600 confirmed cases of the virus and 1,800 deaths. According to the WHO, the DRC Ebola outbreak is one of the worst outbreaks in history, second only to the 2014 West Africa Ebola epidemic. The WHO recently designated the outbreak as a global health emergency. With approximately 12 cases of Ebola arising every day in the DRC, the threat of transmission to other countries is still high, especially Rwanda. Since the Ebola threat is just across their border, Rwanda’s government has been proactive in preventing it.

Strategies for Ebola Prevention in Rwanda

The Rwandan National EVD Preparedness Plan is the basis of Ebola prevention, with key strategies, including early detection and response training, Ebola education, vaccinating health workers, outfitting health facilities, and carrying out simulation drills.

Early detection and response training help prepare medical staff, from Red Cross volunteers to health care centers. Rwanda’s efforts to educate its citizens, also contribute to early detection and response training. Through radio, television, billboards and community meeting, the public has learned the signs and symptoms of Ebola, so citizens are better prepared.

Vaccinating health workers in high-risk areas is also critical to controlling transmission, should health workers encounter a patient with Ebola. Approximately 3,000 health workers have received vaccinations so far. Beyond health care officials, Rwanda set up an Ebola treatment center and 23 isolation units. These measures, paired with simulation exercises to maximize response efficiency, go beyond proactive, by preparing for potential Ebola transmission.

In addition to all these measures, health officials check for Ebola symptoms at points of entry to Rwanda. Officials check travelers’ temperatures and make them wash their hands, while Ebola awareness messages play in the background. So far, these measures have kept Ebola out of Rwanda. Even so, the threat of Ebola spreading to Rwanda remains critical.

Increasing Threat of Ebola Transmission

In early August 2019, Rwanda briefly closed its borders, after the third confirmed Ebola death in the Congolese border city of Goma. According to a joint statement from the WHO and the United Nations, the latest case of Ebola in the highly populated, border city of Goma increases the risk of the virus spreading to other countries.

The government closed the border to cut down on traffic between the two countries, due to concerns of transmission between Goma and the Rwandan city of Gisenyi. Though Rwandan officials shortly reopened the border in response to international criticism, they have also increased cross-border monitoring between the two countries.

Moving Forward

As WHO Director-General, Dr. Tedros Adhanom Ghebreyesus noted, “Rwanda has made a significant investment in Ebola preparedness.” These investments and prevention strategies have stopped the spread of Ebola into Rwanda thus far. However, the threat of Ebola transmission will remain significant, until the outbreak is controlled in the DRC. Therefore, it is crucial that the Rwandan government, as well as health organizations worldwide, keep encouraging Ebola prevention in Rwanda.

– Morgan Harden
Photo: Flickr

Children with Ebola

In July 2019, there were 750 reported cases of Ebola among children. This is in comparison to 20 percent dating back to prior epidemics. Children are particularly vulnerable to contracting Ebola and require special care to treat the disease. Also in July 2019, about one-third of children have accounted for the nearly 1,700 people who lost their lives to Ebola since August 2018 in The Democratic Republic of Congo. Additionally this month, over 2,500 individuals have been diagnosed with the illness. The nation has begun working with the World Health Organization (WHO) along with other health advocacy organizations such as UNICEF to help cure Ebola.

Children and Ebola: The Numbers

Children under age five are at the highest risk and often suffer the worst symptoms. Out of the 750 cases reported, 40 percent of children under age five were diagnosed with Ebola. Young children are also most likely to die from this disease, as their fatality rate is 77 percent. This is in comparison to 67 percent for other age groups.

Symptoms and Treatments

Manifestations of Ebola encompass fever, headache, diarrhea, and sometimes blood vessel discharges. Prompt detection and sufficient medication are effective in curing the disease.

Because children are more susceptible to contracting Ebola and due to the difference in symptoms in comparison to adults, children with Ebola require differentiated medical care.

Medical personnel has articulated that special treatments are necessary for children suffering from Ebola. They require different and exclusive treatments to focus on children’s individual psychological and social requirements.

Treatments for children with Ebola consist of the same drugs that are used to treat other age groups. Of course, distinct quantities differ. Young children also receive zinc to cure diarrhea and intestinal parasite infections as well. Undernourished children must receive different medication. For example, they are given food that is precisely manufactured for their needs.

Orphaned and Abandoned Children

Hundreds of children are either orphaned or abandoned due to their parents becoming infected with Ebola. UNICEF has organized nursery settings in conjunction with treatment centers. Survivors even serve as caregivers.

Children whose parents have been diagnosed or die from Ebola are at an increased risk of being condemned and forsaken, as their chances are much higher of contracting the disease. Within the treatment centers, all patients undergo examinations on a daily basis.

For orphan children, The Democratic Republic of Congo works to set up arrangements with other family members for the child to live. Additionally, the country is providing nutrient guidelines and covering the cost of fees to allow children to attend school.

Specialized Care for Children

Pediatricians work with children within the Ebola Treatment Centers to deliver focused treatments for children with Ebola. Treatment is based on the patients’ individual needs. Every child that has lost parents to Ebola, or has been separated as a result of their illness, receives specialized care. They are cared for by Ebola survivors who provide comfort. They also transport the child to visit their parents receiving medical care at the Ebola Treatment Centers. In addition, counselors are also present to provide support to families throughout the duration of their treatment.

Nutritionists are also present in the treatment centers to deliver personalized nutrient guidelines to those who are likely to have the disease, as well as those who have been diagnosed already. As a result of these health innovations, these types of care have proven to improve sufferers’ conditions.

International Intervention to Eliminate Ebola

Save the Children is a nonprofit organization that began in the United Kingdom in 1919. Their goal is to advance children’s lives in various aspects, such as education, healthcare and employment. Additionally, the organization supplies relief in response to natural disasters and war.

WHO, in conjunction with Save the Children has declared the current Ebola epidemic in the Democratic Republic of Congo to be a public health emergency of international concern. Due to the outbreak duration of nearly one year, further actions are being implemented to eliminate further cases of Ebola and to provide treatment for children with Ebola. It is predicted that if the outbreak of Ebola continues, the surrounding countries will be affected as well.

Several hundreds of government officials and health personnel are working to cure those infected by the disease and prevent further cases. Save the Children is promoting advocacy efforts in curing Ebola through communal action and informational sessions. These efforts are to ensure that all age groups are informed of prevention practices.

Since the beginning of the current epidemic, Save the Children has provided one million individuals with advice relating to symptom detection and how to prevent the spread of Ebola. Health workers receive training on how to treat those infected with Ebola.  Patients are separated and the disease is then traced. Save the Children also educates the public about the disease.

Save the Children has also delivered various supplies to health practices and border crossings in addition to establishing sanitation facilities in order to decrease further infections and to provide treatments for children with Ebola.

Bringing Hope to Children in the Democratic Republic of the Congo

Thanks to international intervention and specialized care, children in the Democratic Republic of the Congo are receiving the treatment they need to fight against Ebola. There is still much to be done, but as long as aid efforts continue, there is hope for these children’s futures.

– Diana Dopheide
Photo: Flickr

Ebola in the Democratic Republic of the CongoIn August of 2018 the Democratic Republic of Congo declared an Ebola outbreak. The first case of the virus erupted in the city of Goma, located on the border of Rwanda. As the tenth Ebola outbreak in Congo within 40 years, the virus became a public health concern for the over 1 million people that call Goma home. Goma also acts as a popular transit hub for many people crossing the border into Rwanda putting the population at a heightened risk for the disease to spread. The International Health Regulations Emergency Committee has met four times following this initial Ebola case.

  1. A Widespread Disease: Congo’s ongoing Ebola outbreak is now the world’s second-largest. According to The World Health Organization (WHO), the virus has infected 2,512 people and killed 1,676. The largest Ebola outbreak on record took place in West Africa killing more than 11,300 people. WHO continues its efforts to stop the spread of the disease in Congo with its team of medical specialists. In the worst cases, death and uncontrollable bleeding have resulted from the viral hemorrhagic fevers of the disease.
  2. A Global Issue: On July 17, 2019 the World Health Organization (WHO) declared the Ebola outbreak in Congo a global health emergency. Following the first case of Ebola, intensive training for the prevention and control of the virus heightened for more than six months. News of a female traveller from Beni that contracted the virus, and then visited Uganda sparked growing concern in Uganda and Congo. Between June and July of 2019 an estimated 245 confirmed cases of Ebola were reported in the North Kivu and Ituri provinces of Congo. WHO makes the continuous effort to monitor the cases of those infected, as well as travel and trade measures in relation to the virus.
  3. Dangerous Territory: The Ebola response teams in the Democratic Republic of Congo face violent attacks. David Gressley, the United Nations’ secretary-general, became the deputy of the U.N. missions in Congo and witnessed it firsthand. Gressley requested a force of peacekeepers along with the health officials to assist him amid the attacks. The violent attacks often hinder the Ebola responders from treating people with the virus, and still no one knows the reasoning or people behind the attacks. The U.N. estimates that due to the attacks about 1,200 have been shot or slashed to death with machetes. One popular theory points to Congolese politicians orchestrating the attacks in order to undermine political rivals. On the other hand, the Congolese government blames the Mai Mai militia. Rumors continue to swirl that the U.N. responders fail to treat Ebola patients, and intentionally spread the virus which makes them even more susceptible to these attacks.
  4. Catching Ebola: Common diseases such as measles and malaria share initial symptoms of Ebola. Many medical specialists in Congo believe that to put a stop to this epidemic they first must isolate the disease. Most Ebola patients receive a diagnosis too late, and go through multiple health facilities before getting treatment. Response teams understand that controlling the transmission of Ebola, and catching the disease in its early stages has the potential to save an entire community.
  5. The Ebola Vaccination: More than 111,000 people have received the Ebola vaccination. Developed by Canadian scientists, the Ebola vaccine (also known as the rVSV-ZEBOV vaccine) consists of an animal virus that can wear a non-lethal Ebola virus protein, which results in the human immune system developing a pre-emotive defense to the disease. Health care professionals, and family members of Ebola patients are the majority of those vaccinated. Health care responders in Congo ensure that all the contacts of Ebola patients receive a vaccine to stop the epidemic. Reports show no deaths from individuals that developed Ebola symptoms more than 10 days after receiving the vaccination.
  6. Promoting a Disease-Free Environment: Medecins Sans Frontieres/Doctors Without Borders (MSF) promotes healthcare and community engagement in Congo. This organization sends teams to determine and assist the medical needs of populations in crisis with exclusion from healthcare. Among the Ebola outbreak in Congo, MSF continues to provide free healthcare for non-Ebola needs, such as malaria and urinary tract infections. First starting in the city Goma, the MSF has now shifted aid to the Ituri province to limit infections with sanitation activities, and provide access to clean water.

These six facts about the Ebola outbreak in Congo demonstrate global organization’s enthusiasm to assemble in times of crisis. Countless organizations continue to lend support to the Democratic Republic of Congo, and in due time the country will be at its best with a healthy population.

– Nia Coleman
Photo: Flickr

Ebola in the Democratic Republic of the CongoBoasting over 85 million people, Congo has struggled with political and social instability since the Belgian conquest in the early 20th century. To this day over 100 armed groups, including the Allied Democratic Forces, the Mai Mai and the Forces of the Liberation of Rwanda, are active in Congo. Against this backdrop of factionalism and violence quietly rages the second most deadly Ebola outbreak in history. Over 1,600 people have died. Despite these grim circumstances, a group of Congolese tech-savvy youth have developed an unlikely weapon against Ebola: an app they’ve called Lokole.

Fighting Ebola in Congo

Ebola is a virus that first causes fever, sore throat and muscle weakness and later progresses to vomiting, diarrhea as well as internal and external bleeding. Patients die due to dehydration and multiple organ failure. During the West African epidemic of 2014 to 2016, over 11,000 people died. During this epidemic, the investigational vaccine called rVSV-ZEBOV was used to fight the outbreak in Congo. However, it was used under the compassionate use clause because the vaccine had not been commercially licensed.

In addition, the Congolese Ministry of Health is seeking medical interventions through technological tools . Through collaboration with Internews and Kinshasa Digital, it organized a hackathon in March 2019, bringing 50 students in communications, medicine, journalism and computer science together. These students were sorted into teams of approximately seven.

Each team sought to answer the question: “How can Ebola response teams leverage new technologies to achieve their communication goals at the local, national and international level?” Thrown together for the first time, Emmanuel, Ursula, Aurore, Joel, David, Israël, and Maria worked for 24 hours. There, they came up with Lokole, the winning technology.

Introducing the Lokole App

Lokole is an Unstructured Supplementary Service Data (USSD) mobile application which “is designed to facilitate the real-time transmission of data and information between communities and the Ebola response teams,” despite poor internet connectivity in rural areas. This team of seven chose the name Lokole because a lokole is a traditional Congolese drum used to transmit messages over long distances. With this app, they hope to increase communication about the spread of Ebola in Congo.

USSD technology is a text-based communication system used by Global System for Mobile Communication (GSM) cellphones. Even though text-based communication might seem outdated with smartphones in the picture, smartphone use across Africa is at less than 35 percent. Plus, those with smartphones might not have access to data plans. As such, a real-time mobile to mobile communication platform based on USSD technology is inherently more inclusive, useful and cheaper.

The Lokole app allows community workers to note and document Ebola symptoms through questionnaires which are then relayed to Ebola response teams and the Ministry of Health. David Malaba, one of the app’s developers, says “Real-time management of information by the different components of the Ebola response will help detect and provide treatment to patients more quickly and deploy resources on the ground more swiftly, which will help lower Ebola mortality rates.”

While analog in comparison to smartphone technology, Lokole’s USSD platform offers the potential for real-time communication without having to invest in widespread expensive improvements in Congo’s internet connectivity infrastructure.

Changing the Future of Grassroots Healthcare

Since the virus’s discovery in 1976, Congo has had 10 documented Ebola outbreaks. Years of consistent violence has led to great mistrust of government and health authorities. Such widespread mistrust of health systems makes epidemics like Ebola even harder to combat.

However, Lokole empowers the everyday Congolese with the tools to fight Ebola. It is a democratic grassroots healthcare model. In fact, large-scale telemedicine platforms, such as BabylRwanda in Rwanda, are powered by similar USSD technology. This connects the average citizen with a nurse or physician in a matter of minutes.

The development of the Lokole app is exciting in its fight against Ebola in Congo, but the galvanization of local Congolese talent is a game-changer. Hackathons that bring disparate youth together to problem solve big and often overwhelming issues inspire others to pursue change. Lokole is just the beginning.

Sarah Boyer
Photo: Flickr

Ebola VaccineThe Democratic Republic of the Congo (DRC) is currently facing its worst outbreak of Ebola in the country’s northeastern regions, with over 2,000 declared cases, but in cooperation with the DRC’s government, the World Health Organization (WHO) has worked to provide Ebola vaccine for those who are at risk of contracting the virus.

First declared by the DRC’s government in June 2018, the Ebola outbreak has resulted in the death of over 1,000 people, and cases have also spread into neighboring Uganda. This outbreak is the second largest ever Ebola epidemic, after the outbreak that took place in West Africa from 2014-2016. There is worry that the virus could spread across the nation’s eastern borders or into major cities.

How the WHO is Combatting Ebola with Vaccines

The Ebola vaccine that the WHO uses is known as Merck’s V920, and was first employed in the early stages of an outbreak in the DRC’s Equateur province. The WHO was able to contain the virus and put an end to the epidemic in that province in under three months, although 33 people unfortunately still fell victim to the Ebola virus. When the DRC officially declared an outbreak, the Ebola vaccine, although still unlicensed, was employed on the grounds of compassionate use. The Ebola vaccine was highly effective, achieving a nearly 100 percent protection rate for more than 119,000 people living in the eastern provinces of Ituri and North Kivu.

The WHO is following a “ring vaccination” strategy, which proved successful in fighting the epidemic in Equateur. In this strategy, all those who are known contacts of people who contracted Ebola are offered the Ebola vaccine. Then, the WHO offers the vaccine to any contacts of those, as well as to anyone classified as at particularly high risk of contracting the virus, such as healthcare workers. By forming a ring of immunity around someone that is confirmed to have Ebola, they are able to reduce the chance that the virus will spread.

However, the ring vaccination strategy is quite time consuming, as it requires what is known as “contact tracing” in which every single person diagnosed with Ebola must disclose every single person that they might have been in contact with. By following this ring vaccination strategy, the WHO was able to vaccinate more than 119,000 people from August 2018 to May 2019. However, despite the vaccine’s high success rate, the number of cases continued to grow. Due to increased occurrences of violence in the country, it is more difficult for aid workers to build these vaccination rings around those who are at risk.

Modifying the Vaccination Strategy

On May 7, 2019, the WHO’s Strategic Board of Experts (SAGE) announced new recommendations that would significantly modify the vaccination strategy in order to strengthen their fight against the virus. These new recommendations focus on adjusting the dosage of the vaccine, offering an alternative vaccine for those that are at a lower risk of contracting Ebola, expanding the scope of people that are eligible for one and working to accelerate the vaccination process. In addition, SAGE recommends that the WHO provide a different vaccine to those in affected areas that are at a low risk. Johnson & Johnson have developed a MVA-BN vaccine that is currently being investigated and is at an advanced stage in moving towards deployment.

In order to expand the scope of people that can receive the vaccine, the WHO will begin to establish “pop up” vaccination sites in villages so that everyone in an area who consents to the vaccine can receive it (the WHO says that 90 percent of people consent to the Ebola vaccine). SAGE recommends that the WHO also work to vaccinate members of neighborhoods and villages where a case has been reported within the last three weeks. Vaccinating entire villages will ensure that the virus’s movement is limited, and will definitely make it much easier to contain.

Together with the DRC’s government, WHO has made great strides in fighting against the Ebola outbreak and working to contain the virus. In establishing the ring strategy that focuses on vaccinating individuals that may have been in contact with the virus, the WHO has been successfully able to build rings of immunity. The WHO has used the highly efficacious Merck’s V920 vaccine to vaccinate over 119,000 people and continues to research additional vaccines and strategies. The WHO continues to refine their approach so they can contain the Ebola epidemic as soon as possible and save as many lives as they can.

– Nicholas Bykov
Photo: Boston University