One week after the Ebola outbreak in the Equateur Province was declared over, a new outbreak of the deadly virus hit DR Congo. This time it emerged in the country’s conflict-ridden north-east. In North Kivu Province, Cordaid started a joint healthcare and humanitarian aid operation to address medical and sanitary needs and help contain the outbreak.
(Ebola first responders in Beni, North Kivu, DR Congo. © Cordaid)
So far, health officials have reported 16 confirmed cases out of 74 suspected Ebola cases cases and 4 confirmed deaths. All cases are clustered in and around the health zones of Beni and Mabalako. 30 deaths appear to be Ebola-related but haven’t been confirmed.
Our main aim is to make sure the health system in the area continues to be operational, that people seek proper healthcare assistance and that all suspect cases are swiftly referred to specialized Ebola hospitals.
Paula Mommers, Cordaid healthcare expert
“People are very concerned”, Cordaid’s humanitarian coordinator Paul Kinenwa reports from Beni. “A no-touching policy rules in the streets and extra public hand washing facilities pop up everywhere. Authorities and first responders are on top of the situation, which is reassuring people. So far, no movement restrictions are being imposed.”
Emergency response for 280.000 people
When Congolese authorities confirmed the outbreak, on August 1st, a Cordaid crisis team of 2 doctors and 1 humanitarian coordinator settled in Beni and Mangina, the epicentre of the new outbreak. Here, they assessed the situation and coordinate our intervention, in close collaboration with national and provincial Congolese health authorities. Meanwhile, Cordaid’s Global Office in The Hague secured funds to carry out a 3 month healthcare and emergency response for 270.000 people.
Paula Mommers, Cordaid health expert currently in Kinshasa, explains: “Our main aim is to make sure the health system in the area continues to be operational, that people seek proper healthcare assistance and that all suspect cases are swiftly referred to specialized Ebola hospitals in Beni and Mabalako.”
Cordaid contracted all health centres in the crisis area and finances a full package of primary healthcare services.
Parallel to our healthcare operations, humanitarian efforts focus on awareness raising, hygiene and rehabilitation of water and sanitation infrastructure in Beni and Mabalako health zones.
North Kivu has not seen an Ebola outbreak before. “That is a major risk in itself”, says Mommers. “People do not easily recognize symptoms and don’t know what measures to take. Besides that people now refrain from seeking healthcare even more than before. There’s the financial burden of medical care. Now, on top of that, fear of the virus keeps them from going to places.”
To make matters worse, during the weeks when the fist Ebola cases emerged, the local health system was crippled by a major strike of nursing staff.
Providing free healthcare and improving the Ebola referral system
To address these problems Cordaid has contracted all 30 health centres in the crisis area (13 in Mabalako and 17 in Beni). In the coming 3 months Cordaid will finance a full package of primary healthcare services. The contracted health centres are also being trained to identify Ebola cases and refer them immediately. This means free healthcare and a better Ebola referral system for 270.000 people. It also provides short term financial security – and motivation – for medical staff. Cordaid’s results-based financing approach means that we pay them for the services they provide, according to previously agreed indicators.
Our hygiene kits contain everything from soap, towels, to disinfecting gel, water purifiers and personal protection gear like gloves and masks.
Paul Kinenwa, Cordaid humanitarian coordinator
“Parallel to that we will also set up mobile clinics in both health zones”, Mommers continues. “These will provide care to patients who cannot or are afraid to go to health facilities. Mobile clinic staff can also play an important role in detecting and referring possible Ebola cases.”
HIV/AIDS alarm line used in the Ebola response
And lastly, Cordaid is going to use the Ligne Verte – the nationwide HIV/AIDS telephone alarm line which is part of our Global Fund supported program that fights HIV and TB – to respond to the Ebola crisis. “Call centre staff have had proper Ebola-trainings. Throughout the country people can now use the well-known Ligne Verte to ask anything they need to know about the virus.”
Humanitarian response: water, sanitation and hygiene
In the same areas of Beni and Mabalako, Cordaid’s humanitarian response focuses on water and sanitation, as well as hygiene campaigns. Paul Kinenwa: “Good hygiene practices save lives and help prevent contamination. That’s why we are promoting hygiene in village communities. And through local health centres we distribute hygiene kits among 350.000 people. These kits contain everything from soap, towels, to disinfecting gel and water purifiers. And we will provide personal protection gear to paramedics who are acting as first responders.”
We will provide fast and accurate no-contact thermometers to health centers in the crisis area.
To improve sanitation infrastructure, Cordaid’s humanitarian team will also create 360 hand washing facilities in public hot spots, like schools, markets and youth friendly spaces. They will also install or repair water supplies, tanks, latrines, showers in much visited public sites. And rehabilitate dysfunctional waste disposal facilities in health centres. “And lastly”, Paul Kinenwa says, “we will provide fast and accurate no-contact thermometers to health centers in the crisis area. They offer precision reading, eliminate contamination risk and need no disinfection after use. Which is important when fighting Ebola.”
Ebola response in conflict-zone
North Kivu is a border area with Uganda and Rwanda – with intense cross border traffic that complicates viral outbreak control – as well as a scene of protracted conflict. Armed violence not only created major humanitarian crises, but also severely hinders humanitarian responses. “When travelling to communities, health centres and suspected Ebola cases in isolated places, we need to be constantly on our guard. For example when passing check points”, Paul Kinenwa explains. “It’s difficult to find partners who are willing to work in the so-called red zones, the conflict-prone areas. Then there’s the risk of being robbed or looted. We carry around valuable aid items, like medicines and healthcare equipment.”
“Our work comes with a lot of extra precautions. But without taking risks, you cannot reach out those who are most in need of support”, Kinenwa concludes.