Rwanda

Rwanda: Ebola Preparedness Emergency Plan of Action (EPoA) - DREF Operation n° MDRRW017

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Description of the disaster

Following the declaration of the 9th Ebola Disease Outbreak (EVD) on 8th May 2018 by the Democratic Republic of Congo (DRC) Ministry of Health, the WHO has raised the alert for neighbouring countries of the Democratic Republic of the Congo (DRC) which share extensive borders, hosting DRC refugees and are used as corridors for DRC population movement. 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.

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 crossborder 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. Based on this context, the public health risk is considered high at the national and regional levels.

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 other 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 the government’s 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.

North Kivu (Beni), the affected area in DRC, is just 370 kms from Rubavu in Rwanda, which borders DRC through the town of Goma. Population movement is remarkable in that border specific area with approximately 45,000 to 60,000 people reported to cross daily for trading and private business. Rwanda is a highly populated country with a population of around 12 million and this population density is at threat to a possible Ebola outbreak from across the border in DRC. Indeed, as per WHO risk profile, four countries have been categorized as Priority 1 – this includes Rwanda, Uganda, South Sudan, and Burundi.

Eleven districts are considered most at risk of the outbreak. These are Rusizi, Nyamasheke, Karongi, Rutsiro, Rubavu (bordering DRC), Nyabihu, Musanze, Burera, Gicumbi and Nyagatare (bordering Uganda) and Kigali city (comprised of 3 localities). Kigali is also at risk because of the Kigali international airport and high population density of the city

As such, the emergency preparedness operation focuses on community-based surveillance and contact tracing, safe and dignified burials (SDB), risk communication, social mobilization and community engagement, disinfection of households and psychosocial support. The planned response reflects the current situation and information available at this time and will be revised based on further developments and more detailed assessments.

Considering Rwanda Red Cross`s experience and skill in EVD preparedness, the government has identified a key partner risk communication, social mobilization and community engagement and PSS. Therefore, the proposed DREF operation seeks CHF 93,625 to support 1,250,000 people in preventing an EVD outbreak for 3 months.