• The Ebola outbreak in the northeast of the DRC, the second-largest in world history, claimed the lives of 2,287 of the 3,324 patients affected. The new outbreak, in Équateur province, has affected 13 of the province’s 18 health zones, with 130 confirmed cases and 55 deaths.
• 372,848 people have been vaccinated against Ebola (including 39,859 in Équateur province).
INTERNATIONAL MEDICAL CORPS’ RESPONSE
• International Medical Corps’ Rapid Response Teams (RRTs) have managed more than 900 patients at Ebola Treatment Centers (ETCs) in Bikoro, Mbandaka and Buburu, including 29 confirmed cases.
• On June 30, when the Mangina Ebola Treatment Center (RTC) was decommissioned, the facility had cared for 3,859 suspected and 422 confirmed Ebola patients.
• International Medical Corps is providing infection prevention and control (IPC) support to 196 health facilities to ensure that healthcare delivery is safe, including 20 new facilities in Équateur.
• Since August 21, 2018, screening and referral units (SRUs) supported by International Medical Corps have provided more than 2 million screenings for Ebola and 941,125 screenings for COVID-19
Mitigating new waves of COVID-19 in the DRC
The reopening of DRC borders on August 16, including international commercial flights, was followed by a spike in COVID-19 cases a few weeks later. This period coincided with the reopening of schools and places of worship, as well as lifting of the movement restrictions imposed by the president of the DRC in March, following the detection of the first case of COVID-19 in the country. Since the country’s reopening, the province of North Kivu—one of the three provinces supported by International Medical Corps’ COVID-19 programing—has experienced a flare up of the disease. As a result of this, North Kivu now ranks second in the country in terms of total cases, second only to the capital of Kinshasa.
International Medical Corps deployed two rapid response teams (RRTs) to support case management in the cities of Butembo and Goma, which registered the highest rise in new cases over this period. In addition to on-the-job training for infection prevention and control (IPC) and safe management of COVID-19 patients, International Medical Corps has provided personal protective equipment (PPE) and other essential supplies to the COVID-19 treatment center in the city of Butembo, enabling this facility to treat five suspect and one confirmed case of COVID-19. In Goma, our rapid response team is focused in the city’s central prison (Munzenze), where it has supported the management of 126 suspect and 38 confirmed cases. In addition to these RRT deployments, the support provided by International Medical Corps (including training and PPE) has enabled the screening of 383,666 people across 82 health facilities. Among those screened, 3,042 suspect cases of COVID-19 were identified, safely isolated and referred to holding centers for laboratory testing. Furthermore, we have reached 170,444 people with health messaging reminding people to adhere to COVID-19 protective measures despite the loosening of government restrictions. Two of every three persons were reached through remote measures such as bulk short text messages (SMS), radio spots and mobile mass informational caravans that move around neighborhoods and areas of public gathering. These messages emphasized the correct use of face masks, the need to protect high-risk populations and what to do when presenting symptoms of the disease. With the reopening of schools, International Medical Corps is planning in November to roll out the use of specially developed picture books that will provide children and youths with basic knowledge about COVID-19 and IPC protective measures, which they can share with their peers and family. This is considered to be the first COVID-related activity of its kind targeting children in the DRC.
We are currently working with the Ministry of Health (MoH) to finalize the development of awareness-raising messages that will be placed on billboards at public spaces throughout the month of November. International Medical Corps has been working to build the capacity of informal care providers (traditional doctors, roadside medicine vendors and prayer houses where people seek care) to refer suspect cases of COVID-19 to health facilities based on community case definitions. International Medical Corps has also provided training to 361 health personnel and community health workers on the basics of self-care and psychosocial support, essential skills in the context of COVID-19 that are needed both for treating patients and providing peer support. International Medical Corps is also preparing to provide community engagement and communication (RCCE) support to the MoH, which will be needed for the introduction of a potential COVID-19 vaccine.
Responding to the Outbreak of Ebola in Équateur Province
The outbreak of Ebola in Équateur province has progressively subsided over the past five weeks, with no new case being reported during the month of October. As of November 9, the province had reported zero positive cases for 34 days, edging closer toward the 42-day mark when the outbreak could officially be declared over. Between June 1 and September 28, 72% of the health zones in the province (13 of 18) reported a total of 130 confirmed cases, including 55 deaths and 75 recoveries. At 42% mortality, the Ebola mortality rate in this latest outbreak has been lower than the tenth Ebola outbreak in the northeast of the DRC, which recorded a mortality rate of 67%. The World Health Organization estimates that approximately 40,000 people have been vaccinated during this outbreak.
Since the beginning of the latest outbreak, International Medical Corps has worked alongside the MoH to isolate and manage 938 patients—29 of whom were confirmed—at two Ebola Treatment Centers, which were set up in the two health zones (Wangata and Bikoro) that registered the highest number of confirmed cases. A third treatment center that was integrated into an existing health center in the town of Buburu, in Bomongo health zone, helped reduce the risk of the disease spreading to the neighboring Republic of the Congo. A key driver of this success has been the deployment of an RRT, reinforcing the ability of local health providers to rapidly identify and isolate suspect cases while safely managing those confirmed. Furthermore, through mentoring and by providing basic PPE and WASH supplies, the RRT reinforced IPC measures at these treatment centers, as well as 20 other health facilities in the affected health zones, and helped to improve management of medical waste. With donor support, International Medical Corps would like to support the 90 days of heightened Ebola surveillance that will follow the end of the outbreak, which will begin on November 18 if no new cases are confirmed. This will require interventions to reinforce community-based surveillance, IPC at health facilities, rapid response deployment capacity of the local MoH RRT, facilitation of access to primary healthcare and Ebola survivor-care programs (including ring surveillance).