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A. SITUATION ANALYSIS
Description of the disaster On 1 June 2020, the Ministry of Public Health of the Democratic Republic of Congo (DRC) declared the 11th outbreak of Ebola Virus Disease (EVD) in Equateur province, which shares a river border and significant trade and social links with the Republic of Congo (RoC). In preparedness, this DREF Operation was launched on 29 June 2020 for CHF 156,587 to support the Congolese Red Cross actions in the event of an outbreak in the country.
The intensification of the epidemic in the DRC along the bordering areas with RoC from 7 to 13 September 2020 led WHO to indicate that RoC was at very high risk of EVD outbreak spillover. Considering that RoC RC was the only actor having the mandate for safe and dignified burials (SDB), on 15 September, WHO requested IFRC to inform on the level of SDB preparedness of the National Society, in case of an imminent outbreak.
As of 24 September 2020, a total of 124 confirmed and probable cases had been registered in the DRC since the beginning of the epidemic, of which 50 had died (40%) with 62 people having recovered. The majority of cases were not registered contacts and most did not have documented epidemiological links to other cases, indicating very poor surveillance and case detection capacity, and increasing the risk of spillover to new communities and countries.
There was sustained transmission of EVD in DRC areas bordering on and sharing significant social and trade links with neighbouring communities in ROC. Contacts of known cases had crossed into ROC, and not all of them had been accounted for. These factors significantly increased the risk of an EVD outbreak in ROC. Therefore, readiness had to be increased rapidly and significantly for an appropriate response to suspected cases, to reduce the risk of onwards transmission and to avoid that a larger outbreak resulted from first imported cases. As such, an Operation Update was published on 5 October 2020, approving a second allocation of CHF 53,729 for a total grant of CHF 210,316. The Operation Update also allowed for a timeframe extension of three months, to allow completion of preparedness activities, in line with WHO recommendations. This DREF operation thus ended on 31 December 2020 after six months implementation period.
Summary of response
Overview of Operating National Society
Red Cross is the only actor with the mandate to conduct safe and dignified burials (SDB) in the Republic of Congo and WHO requested information regarding the level of SDB preparedness in case of an imminent outbreak and the role of CRC. Thanks to this DREF operation and the close cooperation with IFRC, MoH, WHO and partners, the Congolese RC was able to:
• Participate in the emergency weekly coordination meetings from the month of June, hence, contributing to developing the National EVD Prevention Action Plan with the lead of the MoH and partners in August. This plan was developed based on previous responses, lessons learned from the prevention operation of 2018 and in accordance with the roadmap of the Ministry of Health and partners.
• Red Cross department committees participated in the MoH coordinated rapid assessment of the level of preparedness to respond to a possible Ebola epidemic from 23 June to 7 July 2020.
• From 11 to 23 September, a joint mission of the Congolese Red Cross with MoH, WHO, Médecins d’Afrique in the departments of Likouala and Cuvette Centrale for community awareness, surveillance and monitoring of the EVD situation at the borders areas.
• Some 122 volunteers from 4 geographic departments (21 in Brazzaville, 41 in Likouala, 28 in Cuvette and 32 in Plateaux) were deployed on this operation and trained on all relevant thematic areas as stated below:
Health: In health, the National Society carried out screening in Brazzaville from the last week of August and in Liranga in early September following the gradual reopening of the borders with two volunteers positioned per gateway, three times a week. Screening included taking temperatures and registering people. The temperature of all passengers was systematically checked.
Sensitization and disinfection activities were carried out in public places in collaboration with health districts in the neighbourhoods including the four health districts of Brazzaville, four health districts of Liranga, one health district in Ndzondou village, eight districts of the health district of Mossaka and eight districts of the health district of Makotimpoko. These activities are ongoing in these localities and will continue in Impfondo.
As concerns to SDB, all the 122 volunteers were briefed on the management of dead bodies according to MoH and WHO guidelines. Yet, more in-depth training on SDB was carried out by the proposed SDB/CEA teams. Management of Mortal Remains (MMR) equipment that was available to the NS thanks to an ICRC grant in the past years was used for this briefing. Cascade simulations on the donning and doffing of PPE, the solution of disinfectant products and the handling and maintenance of sprayers and cleaning of objects recoverable within the framework of SDB were also carried out by the hygienists of the CRC.
The volunteers were also trained on community-based surveillance and epidemic control. Those trainings were harmonized with MoH.
Community Engagement and Accountability (CEA): In regards to CEA, volunteers collected rumours and feedback through awareness-raising meetings with community leaders, mayors and neighbourhood chiefs, facilitated by volunteers, in Liranga, Brazzaville, Makotipoko and Mossaka.
All the 122 volunteers engaged in this operation were trained on CEA, Risk Communication and Community Engagement, Protection, Gender and Inclusion.
All the volunteers deployed in the operation were insured and equipped with PPE throughout the operation.
Overview of Red Cross Red Crescent Movement in country
• IFRC: The IFRC Central Africa Cluster Delegation team, based in Yaoundé, assisted the Congolese Red Cross in coordinating all emergency operations activities, including financial management, logistics, volunteer insurance, planning, monitoring, evaluation and reporting (PMER), and participation in field supervision missions with the technical support. The Cluster's team organised weekly online exchanges with the National Society to follow up on activities in order to give the necessary support and guidance on the implementation of this operation (technical support, logistical and financial process, etc). The same applies to the Regional Office, which closely monitored the progress of the implementation of activities. Some six surge personnel were deployed by the IFRC including three CEA (Community Engagement and Accountability), two SDB (Safe and dignified burials), and one WASH specialists. In addition, a security delegate was deployed for two weeks to Brazzaville to review with the National Society, all security aspects of this operation.
• ICRC: provided support by ensuring safe access to the Surge personnel and accommodation in Brazzaville and during his missions in the target areas.
• French Red Cross: As the only participating partner present in Congo, French Red Cross supports health and water, sanitation and hygiene projects but was not involved in this operation.
Overview of other actors in country
The Government of the Republic of Congo (RoC) and its partners set up a coordination structure supported by the United Nations System which was coordinated at the highest level by the government of the Republic through the CNLSE (National Committee for Epidemiological Control and Surveillance).
The Ministry of Health and the WHO ensured continuous monitoring of the situation in the field. In parallel, WHO,
Médecins d’Afrique and Terre Sans Frontières supported the Government with handwashing kits at the department levels, organised meetings to raise awareness among the population, production and distribution of posters and picture boxes for these awareness-raising events.
The government equally set up temporary isolation sites and trained health workers and community relays on surveillance, Risk Communication and Community Engagement (RCCE), screening at entry points, Infection Prevention and Control (IPC) and Department of Health Service with the support of WHO, UNICEF and WFP.
Technical coordination was ensured at national, departmental, and local levels by the national committee for the coordination and management of the Ebola epidemic with decentralised technical sub-committees at the national level departmental and village coordinating committees at local level.