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DR Congo

Ebola came quietly to the village of Chowe

But WHO's response was rapid

13 September 2019

Chowe village is a string of houses, nestling along a road cutting into the sides of seemingly vertical hills. This is spectacular country. Conical peaks brushing the clouds, coated with green, red soil tracks seaming the green.

What is not so spectacular is the arrival of Ebola virus disease in Chowe. Ebola came quietly to Chowe, in a local woman, who had travelled to the North Kivu hotspot, Beni, to spend time with family there, and came into contact with several people infected with Ebola. After a time, she travelled home with her two young children to join her husband in Chowe.

That quiet homecoming has now extended the massive geography of the Ebola outbreak in North Kivu and parts of Ituri, in the eastern side of the Democratic Republic of the Congo (DRC), to another province, South Kivu.

By the time this young mother had returned home -- it is a 700-kilometre journey by bus, boat and taxi -- she was weak and ill. She went to the local health care post, where, on August 14, soon after seeking care, she died. Aware that a death like this should be reported, the local health care worker alerted the authorities and a test was done on August 15.

Even before the results were known, WHO and the Ministry of Public Health sent responders to the site to identify people who had become infected with or who could have come into contact with the Ebola virus, to organise vaccination, to conduct awareness raising, and to provide medical care.

“This rapid response is only possible because we have trained people who are ready and able to move as soon as we know a new area has become infected,” says Dr Socé Fall, WHO Assistant Director-General for Emergencies who is overseeing the Ebola response in the DRC. “It is hard work, difficult and expensive but it is what we have to do, and will continue to do, until we have found every last case and shut down every chain of transmission in the DRC.”

The rapid response team arrived on the evening of August 15 ready to begin work immediately, and Ebola was confirmed as the cause of death that same day. The woman's son, just six months old, was showing signs of infection. With nowhere safe to isolate and care for him, one room of the family home was set aside.

Equipment flown down by helicopter was used to provide treatment and also protect the medical staff caring for the child.

‘We used bamboo sticks to set up a fence around the hut to isolate the space," said Dr Janet Diaz, lead for Clinical Case Management in the WHO Health Emergencies programme, and a member of the team sent to provide medical care for people in Chowe. “It was a struggle finding everything we needed, but we were still able to treat the baby for Ebola.”

Since those early days, the baby and his father -- who also developed symptoms and has been confirmed positive for Ebola virus disease --have been moved to the local health post which has been turned into a temporary treatment centre.

Dr Patrice Kabongo from the Ministry of Public Health, trained alongside Ebola veterans in Goma and Mangina, is now leading the fight to save their lives. “It’s very difficult. We don’t have much water, no light, we sleep on the floor but, we are here to do all that we can do to stop virus.”

At the same time, a kilometre or so down the road, a vaccination team have set up their tables and are vaccinating not only those who came into contact with people confirmed to have Ebola, but also the entire village.

“It’s an adaptation of the strategy,” says Alhassane Toure, WHO lead for vaccination. “We have vaccinated all the contacts and contacts of contacts but because it’s a small village, we are able to widen it to the whole village.”

Overall, 35 WHO staff are now working in Chowe alongside many partners, including Medecins Sans Frontieres, UNICEF, the World Food Programme and the US Centres for Disease Control, to ensure that every person at risk is identified, followed up, that everyone is being vaccinated, that the people in the area understand the disease and why stopping transmission is essential to protect their lives and their communities, and that the best possible medical care is available to those who do develop Ebola virus disease.