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Description of the disaster
On 8 May 2018, the 9th Ebola Virus Disease (EVD) outbreak in the Democratic Republic of Congo (DRC) was declared by the Ministry of Health. 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. Both provinces are among the most populated areas in the DRC and bordering with Uganda and Rwanda.
In light of the intense insecurity and worsening humanitarian crisis affecting the provinces of North Kivu and Ituri, over one million internally displaced people (IDPs) and a continuous influx of refugees to neighbouring countries, including Uganda, Burundi and Tanzania has been reported. Population mobility in the area is high, including cross-border movements, due to the high number of traders and miners, displaced populations and insecurity caused by rebels and militias in the area. This has been identified as a significant risk for disease transmission in the EVD outbreak, including cross border transmission. Additionally, the security situation in North Kivu has hindered the implementation of response activities to control the EVD outbreak. In this context, the public health risk is considered very high at both national and regional level.
In response, IFRC launched this DREF Operation on 12 September 2018 for CHF 152,685 to assist Uganda Red cross to reach approximately 149,300 people (or approximately 29,860 households) at risk in Ebola preparedness activities. In the meantime, WHO risk level of the outbreak spreading to Uganda increased from high to very high following the confirmation of Ebola cases in Kashenyi, at the shores of Lake Albert in DRC (40km from the landing site in Uganda), and the continued conflict in Beni which hampered the Ebola control effort. As such, WHO initiated preparations for safe and dignified burial (SDB) by training teams. On the basis of the Red Cross Movement expertise in SDB in the Ebola outbreaks in West Africa, URCS started exploring possibilities for leading SDB services in Uganda and on 05 November 2018, was allocated additional CHF 17,040 for the deployment of Surge capacities to support the National Society (NS) with the development of a clear SDB strategy and plan, as well as training of SDB teams. This resulted in the deployment of one SDB expert and one Strategy and Planning expert, the latest funded by the Norwegian Red Cross. These changes in the preparedness actions were published through Operations Update 1.
On 24 December 2018, the DREF timeframe was extended for a period of 1.5 months, up to January 2019, following the WHO Assessment conducted on 28 September, which categorized the risk for Uganda at level 1 (High risk of cross border importation of EVD) and the recommendation of the National Task Force (NTF) to continue EVD preparedness activities beyond 2018. Again, IFRC allocated additional CHF 110,063 through the DREF to complement the support provided by UNICEF, WFP and IFRC-Epidemic, Pandemic and Preparedness Programme (CP3) in particular with the recruitment of an Operation Manager (URCS staff) for a period of 1.5 months. In addition, the supplementary funds allowed the realization of an integrated in-depth orientation on ECV, risk communication, PSS and CEA, to strengthen community volunteer’s basic knowledge to adequately perform their tasks and the inclusion of an SDB component in the EPoA (trainings and SDB plan). These changes can be seen in Operations Update 2.
On 11 February 2019, Operations Update 3 was published, extending the DREF timeframe up to 12 March 2019 to allow IFRC to look at more long term tools to continue supporting Preparedness activities, guaranteeing operational continuity. This update also allowed for supplementary CHF 89,597 to be allocated, to support volunteer’ screening activities at the 28 Point of Entry (PoE) and continue community-based interventions, including risk communication,
PSS and EVD awareness for the months of February and March 2019.
Since the EVD outbreak in DRC continued to spread, WHO deployed 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 categorized four countries i.e. Rwanda, Uganda, South Sudan, and Burundi as Priority-1 and remaining five 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 Red Cross Red Crescent National Societies of countries surrounding the affected area in DRC have been supporting government 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.
In the same vein, the Uganda Red Cross Society (URCS) has been supporting government preparedness efforts, coordinated through the national and district level Task Forces. URCS works in partnership with the Ministry of Health (MoH), UNICEF, WFP, IFRC and other partners, building community resilience and institutional capacity to respond to a possible outbreak, to prevent the importation of EVD into Uganda, and to prepare for response to an outbreak.
At the beginning of the Ebola threat in August 2018, the MoH identified 20 districts at Risk 1, meaning at high risk of cross border importation of EVD1. Seven (07) out of these 20 districts (Kasese, Kabarole, Bundibugyo, Ntoroko, Bunayngabo, Kisoro and Kanungu) were targeted by URCS on the base of their proximity with the DRC border and the URCS branch capacities.
The overall regional risk posed by the outbreak in the Democratic Republic of the Congo remains very high considering the chances of cross border spread. The EVD Appeal countries continue to implement precautionary and preparedness measures to mitigate against the spread of the disease. Figures as of 18 December 2019, according to World Health Organisations, indicated a total 3,351 cases of which 3,233 confirmed cases and 118 probable cases. In addition, some 2,211 deaths have been reported and confirmed to be Ebola related.