ReliefWeb

A. Situation analysis

Description of the disaster

On 1 August 2018, just one week after the declaration of the end of the Ebola outbreak in Equator province, the 10th Ebola epidemic of the DRC was declared in the provinces of North Kivu and Ituri, which are among the most populated provinces in the DRC that also share borders with Uganda and Rwanda. Latest numbers as of 29 September are as seen below:

Total cases: 159
• Confirmed cases: 127
• Probable cases: 32

Deaths: 104
• Confirmed: 72
• Probable: 32

The provinces have been experiencing intense insecurity and a worsening humanitarian crisis with over one million internally displaced people (IDPs) and a continuous efflux of refugees to neighbouring countries, including Uganda, Burundi and Tanzania. Population mobility, including cross-border movements, were identified as a significant risk for disease transmission in this outbreak due to the high number of traders and miners, displaced populations and insecurity caused by rebels and militias in the area (Source IOM, 15 August 2018). Additionally, the security situation in North Kivu may hinder the implementation of response activities. Potential risk factors for a further EVD expansion exist not only at national level, but also at regional level, among which:
• transport links between the affected areas, the rest of the country, and neighbouring countries;
• internal displacement of populations;
• low level of knowledge around Ebola modes of transmission, especially among women (according to a KAP survey done in North-Kivu);
• displacement of Congolese refugees to neighbouring countries, including Uganda.

Since EVD outbreak in DRC continues to spread, WHO has been sending Preparation Support Team (PST) missions to neighbouring countries of DRC to review EVD readiness and support preparedness strategies with government and other stakeholders including RC/RC National Societies. According to their risk profiles, the WHO has categorized four countries i.e. Rwanda, Uganda, South Sudan, and Burundi as Priority-1 and remaining five countries -- Angola, Congo, Central African Republic, Tanzania, and Zambia are Priority-2. The prioritization was done based on their capacity to manage EVD and viral haemorrhagic fever (VHF) outbreaks, and their connections and proximity to the areas currently reporting EVD cases.

The RC/RC National Societies have been supporting government efforts in updating EVD contingency plans and strategies in the early detection/surveillance of cross border population movement, training of volunteers to undertake typical EVD response activities related to infection, prevention and control(IPC), risk communication, social mobilization and community engagement, Safe and Dignified Burials (SDB), Psychosocial support and National Society capacity building and preparing for future outbreaks.

The Government of Burundi does not have an EVD prevention policy and the Burundi Red Cross has reached out to the IFRC for support to develop its Ebola preparedness and prevention strategy. BRCS requested for DREF support late as the government was yet to finalize the National Ebola Contingency Plan which outlined the roles and areas in which BRCS was mandated. The plan was finally approved in September, after which BRCS could request support from the DREF.

The highest risk of a possible EVD outbreak will be through entry points (by road) in the north western provinces of the country, or possibly by maritime transportation on Lake Tanganyika.