DR Congo

Eight months pregnant and infected with Ebola in conflict-affected DRC - a mother's story

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Beni, DEMOCRATIC REPUBLIC OF THE CONGO—Baby Sylvana’s life hung in the balance. Her mother, Josephine Kakule, 28, became infected with the Ebola virus when she was eight months pregnant and was quickly isolated.

Ms. Kakule lives in a village about 100 kilometres from Beni, situated in the heart of the country’s tenth outbreak of Ebola. The region is also an active conflict zone, which has serious implications for the national Ebola response, launched after the outbreak was declared by the government in August last year.

The future for both mother and baby looked bleak.

When an expectant mother is infected with the virus, her pregnancy is likely to end in premature labour, miscarriage or intra-uterine death (stillbirth). That is, if the mother survives. And even if she is cured, she may give birth to a baby infected with the virus.

These were the odds facing unborn Sylvana.

Sick, isolated and awaiting birth

As soon as Ms. Kakule was diagnosed with Ebola, she was isolated at a treatment centre in Beni to avoid transmitting the virus to her family and community.

The loss of contact with her loved ones was hard for the mum-to-be.

"It was painful to separate from my family and my children but I had to do it," she said. She was aware that her life could only be saved with medical intervention at the Ebola treatment centre.

While she was in hospital, concerted efforts were underway to prevent the spread of the disease in both the maternity section of the hospital and in her village.

UNFPA provided support to coordination and monitoring efforts, and follow-up with all of the people Ms. Kakule had been in contact with. This includes risk communication, community engagement, and infection prevention and control, with a special focus on reducing the risk of transmission via reproductive health services.

Halting the spread of Ebola

Because Ebola is highly contagious and deadly, stringent steps are needed to stop the virus in its tracks.

Since the beginning of the new outbreak, more than 500 of the 800 plus people who contracted the virus have died. Of those infected in North Kivu and Ituri, 65 per cent were women – 64 per cent of whom were women of childbearing age – and 12 per cent were children under five.

But prevention and treatment efforts in the DRC were being hindered by communities’ behaviour towards the disease. Fear and misinformation regarding burials and other social activities abound in Ebola-affected communities. This is why UNFPA and partners remain committed to the response efforts, including provision of information and training.

To aid the Ministry of Health, UNFPA supported the production of more than 600 modules on prevention and care of the sick. These seek to strengthen skills in hand washing, waste management, disinfection of equipment and premises, secure burial, and infection prevention and control in routine care and in the fight against Ebola.

“These serve as a reference for students, including medical and paramedical students, and community-based mobilizers," said Sennen Hounton, UNFPA Representative for the DRC.

The information in the modules is passed down to communities through the community-based mobilizers. It also helps prevent infection and death among medical staff, a critical loss that would cripple services.

These prevention efforts help ensure that treatment can be provided to those infected, including Ms. Kakule.

Declared Ebola free

After days of pain and uncertainty, the health of the expectant mother began to improve until finally, lab tests confirmed that she was no longer positive for Ebola.

The treatment centre's medical team, including midwives, could now focus on preparing her for delivery.

Ms. Kakule was discharged but remained close to the treatment centre during the waiting period. She stayed at a nearby nursery, where care is being provided for babies and infants whose parents are being treated for the virus.

Training of those providing care for those affected by Ebola is critical. UNFPA has supported the training of 2,500 people – including midwives, women leaders and young leaders – on hand washing and how to wear and remove personal protective equipment. Two vehicles have been donated to the local government’s communication committee in support of outreach activities.

UNFPA also funded the rehabilitation of and equipment for the maternity wards of the reference hospital of Beni, and the reference health centre of Mangina.

The moment arrives as contractions begin

Two weeks after being declared Ebola free, Ms. Kakule felt her first contractions. She was thrilled that her baby had survived thus far, but was also nervous of this moment because during delivery, her baby was at high risk of infection.

At this moment, staff training and experience in handling the risks are crucial. This is why UNFPA supported the training of 108 midwives in emergency obstetric and newborn care, and family planning. The Fund also donated 10 tons of emergency reproductive health medicines and supplies, and equipped health facilities with infection prevention and control kits.

Without this kind of support, babies are unlikely to survive.

A miracle baby

Baby Sylvana is one of the lucky ones. She was welcomed into the world, her safe and healthy birth nothing short of a miracle.

“Despite the odds, Sylvana was born in good health,” said Sister Clarisse Baraka, a midwife who was part of the team that delivered the little girl. "This is the first baby born negative to a mother who tested positive for Ebola during pregnancy. It's a double success!”

Since that day, Sylvana has become a symbol of hope in a battle tainted by insecurity, communities’ myths and misinformation, and poor infrastructure. She is admired by all, especially the midwives who named her.

Ms. Kakule is relieved to have given birth to a healthy baby. She is looking forward to returning to her village to introduce Sylvana to her father and siblings.

“Together, Sylvana and her mother overcame the Ebola virus. That encourages us to redouble our efforts to put an end to this epidemic,” rejoiced Sister Baraka.

- Brigitte Kiaku and Aimee Manimani