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DRC - Ebola outbreak in North Kivu and Ituri: July 30, 2018+

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  • Translation Google

    Ebola in Butembo: These practices of the response agents which disturb the culture and the tradition

    Friday, June 14, 2019 - 11:16

    Since the declaration, ten months ago, of the first Ebola Virus outbreak in the North-North (Beni, Butembo and Lubero) of North Kivu province, the response teams are carrying out acts that offend the culture and tradition of the Yira community (majority people in this part of North Kivu).

    Even though communities do not dare to be publicly outraged, they are still surprised and worried about what "Ebola brings to them".

    Digging graves before the death of the sick
    Among the Yira, including the Nande, it is not customary to dig the grave before the death of the patient, "even if it is in agony".

    "Moreover, before the death of the patient, one even hesitates to speculate on the place of his burial. Unless it's the patient himself, feeling his impending death, which indicates where he wants to be buried, "Rachel Vanzwa, 30, told ACTUALITE.CD.

    But with the arrival of the Ebola virus disease in Butembo (Nande reference city, Ed), communities are surprised to see the response team against the epidemic suddenly prepare "almost five graves (Bureau for example, even before the death of patients admitted to care in Ebola Treatment Centers (ETCs).

    "They seem to know that our loved ones are going to die," said a participant at the Social Symposium held May 30 to June 1, in Butembo, by religious denominations.

    "To dig a grave before the death of the patient is like wishing him a misfortune. In principle, we dig a grave for a specific person, that is to say we must know upstream who must be buried. Also, one only digs when the patient is dead. And we must not leave a grave without relatives watching over it. And if you want to bury the person somewhere else, you have to do some rituals of "moving the grave", and in the hole dug at the beginning, you have to plant a banana tree, to say that you did not dig for nothing ", explained to ACTUALITE.CD the journalist-anthropologist Christian Kahindo Muke, author of the book "The Yira Nation".

    However, Mr. Nzuva Kihanda Jean Bosco, head of the urban registry office and the population at the Butembo mayor's office, said that the response teams digging the tombs in advance, is to prevent they are overwhelmed.

    "There are times when the teams responsible for decent and secure burial (DHS) have about ten bodies to bury in the day. They are overwhelmed. This is how they prevent, digging ahead. Also, it is to shorten the time to bury a victim to avoid being attacked by protesters against the riposte, "he says.

    Employ women in funeral activities

    Sunday, May 12, 2019. Matanda Hospital. 11:00'. When Ms. Kasivika Sabina's relatives wanted to remove from the morgue of this hospital the remains of this former local civil society activist, presumed dead of Ebola, for her burial, they are "surprised to see the coffin containing the body of the deceased. 'illustrious gone to be carried by young girls'.

    "They were 17-year-old girls, members of their dignified and safe burial team who brought us the body of our mother. It surprised us because growing up, we know that a woman can not carry a body. It's not because it's a job that you have to violate culture, "says Ms. Micheline Kalipi, who witnessed the event.

    A member of the response team, who spoke to ACTUALITE.CD on condition of anonymity, reports that it is true that women are also employed in safe and dignified burial teams (DHS).

    "But with the comments of the civil society and the anthropologists of the response, the question has stopped in the health zone of Katwa, but in that of Butembo, the girls continue to be employed in the teams of EDS, notably as hygienists in mortuaries, "he reveals.

    "Among the Yira, a woman does not bury and can not, therefore, be used in the transport of remains. Because they are considered as easy gateways for spirits. We must move them away from the dead, "warns Christian Kahindo Muke.

    Bury pregnant women with their children

    It also happens to the response teams to bury pregnant women with the child. According to a member of the response team, "It is forbidden to manipulate the bodies of people who died of Ebola. Not easy, therefore, to separate them.

    Specific cases reported at ACTUALITE.CD, are those recorded in December 2018 in the health zones of Kalunguta and Vuhovi, where pregnant women were buried with their children.

    "It's not just about culture or tradition, but it's a general rule that you can not bury two people in the same grave, it's like putting them in a mass grave," says anthropologist Christian Kahindo Muke.

    "A pregnant woman carries two people in herself: herself and the child. Each of them has ancestor protection. To bury them together is to violate ancestral taboos. This can sometimes be considered a source of misfortune in the family. In certain circumstances, this woman may not be welcomed in the village of the ancestors, "said Mr. Edgard Mateso, member of the Asbl Kyaghanda Yira.

    Regarding the coordination of the response, the source replies that their "socio-anthropologists have conducted research that attest that there are rituals that are performed before these kinds of burials."

    Bury "family and customary leaders" in public cemeteries

    Response teams are able to bury some Ebola patients in public cemeteries while among them there are "great family and customary leaders" who should only be buried on their ancestral lands (amahero) .

    "It's about distance, security and trust. This often happens for distant distances. When a family says they want to go and bury their relative who died of Ebola, for example, in Kipese, it is difficult to accept, because first of all, Kipese is far from Butembo (more than 60 km), so we have to cross insecure villages where militiamen are active. Which is dangerous for EDS teams. In addition, we can not deliver the body, because we fear that relatives can go handle it, which is a great public danger. In such a situation, the deceased is placed in a nearby public cemetery, "says Mbusa Kambalo Olivier, a former employee of the riposte.

    It disturbs the culture because, according to Kahindo Muke Christian, among the Yira, to bury someone on his ancestral land, is to confirm its origin. "For example, in the event of land conflicts in our country, we ask each of the parties to prove that their ancestors were buried on this conflict land, so that we can recognize the origin, even the right of inheritance."

    "But burying people in public cemeteries, while they still have their ancestral lands, is like decreeing their exclusion and creating for their offspring the difficulty of proving their right of inheritance", he explains to NEWS .CD.

    Claude Sengenya

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • Translation Google
      EPIDEMIOLOGICAL SITUATION
      EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

      Friday, June 14, 2019


      The epidemiological situation of the Ebola Virus Disease dated June 13, 2019 :
      • Since the beginning of the epidemic, the cumulative number of cases is 2,120, 2,026 confirmed and 94 probable. In total, there were 1,420 deaths (1,326 confirmed and 94 probable) and 588 people cured.
      • 322 suspected cases under investigation;
      • 12 new confirmed cases, including 5 in Mabalako, 3 in Biena, 2 in Kalunguta, 1 in Rwampara and 1 in Mandima;
      • 9 new confirmed case deaths:
        • 2 community deaths at Biena;
        • 7 deaths at CTE, including 4 in Beni and 3 in Mabalako;
      • 3 new cures out of ETCs, 2 in Mabalako and 1 in Butembo.
      ... Meeting of the Emergency Committee of the International Health Regulations
      • The meeting of the Emergency Committee for International Health Regulations , convened by the Director-General of WHO, was held on Friday, June 14, 2019. The Emergency Committee concluded that the Ebola outbreak in the provinces North Kivu and Ituri did not constitute a public health emergency of international concern, although it constitutes a health emergency for the Democratic Republic of Congo.
      • The Committee noted that epidemiological trends are evolving positively in the Butembo and Katwa epicentres. However, the response is beginning to face challenges related to community acceptance and security in areas such as Mabalako where the epidemic has resumed recently. On the other hand, the response continues to be limited by the lack of adequate funding and limited human resources.
      • The Committee commended the communication and collaboration between the DRC and Uganda that rapidly contained Ebola cases that crossed the border. Uganda's rapid response proves the importance of preparing border countries for DRC.
      • After lengthy discussions, the Committee considered that the criteria for declaring a public health emergency of international concern were not fulfilled. The Committee considered that all public health measures and recommendations needed to end the epidemic were already being implemented by WHO and the affected countries.
      ...

      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • Translation Google
        EPIDEMIOLOGICAL SITUATION
        EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

        Saturday, June 15, 2019


        The epidemiological situation of the Ebola Virus Disease dated June 14, 2019 :
        • Since the beginning of the epidemic, the cumulative number of cases is 2,134, 2,040 confirmed and 94 probable. In total, there were 1,427 deaths (1,333 confirmed and 94 probable) and 588 people healed.
        • 363 suspected cases under investigation;
        • 14 new confirmed cases, including 5 in Mabalako, 3 in Mandima, 2 in Butembo, 2 in Katwa, 1 in Kalunguta and 1 in Lubero;
        • 6 new confirmed case deaths:
          • 4 community deaths, 2 in Mandima, 1 in Mabalako and 1 in Lubero;
          • 2 deaths at CTE, including 1 in Beni and 1 in Butembo.
        • The 3-year-old brother of the index case tested in Uganda died on his arrival at the CTE de Beni on Thursday, June 13, 2019.
        ...
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • Translation Google
          EPIDEMIOLOGICAL SITUATION
          EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

          Sunday June 16, 2019


          The epidemiological situation of the Ebola Virus Disease dated June 15, 2019 :
          • Since the beginning of the epidemic, the cumulative number of cases is 2,148, 2,054 confirmed and 94 probable. In total, there were 1,440 deaths (1,346 confirmed and 94 probable) and 588 people cured.
          • 319 suspected cases under investigation;
          • 14 new confirmed cases, including 6 in Mabalako, 2 in Katwa, 2 in Kalunguta, 1 in Beni, 1 in Rwampara, 1 in Musienene and 1 in Mandima;
          • 13 new confirmed cases deaths:
            • 5 community deaths, including 3 in Mabalako, 1 in Beni and 1 in Musienene;
            • 8 deaths at CTE, including 3 in Mabalako, 3 in Beni, 1 in Butembo and 1 in Komanda.
          ...
          Destruction and arson of sanitary control at checkpoint Mudzipela in Ituri by strangers in the night of 15 to 16 June 2019.

          This Sunday, June 16, 2019, a group of bikers tried to attack an Infection Control and Prevention (IPC) team that was cleaning up a confirmed case of Ebola in Hoho in the area. of Rwampara health. Urban authorities sent police reinforcements to disperse the bikers and allow the PCI team to return to coordination. No agents of the riposte were hurt.
          ...
          118 Contaminated health workers

          Two health workers, including one in Rwampara and one in Musienene, both unvaccinated (refusal), are among the new confirmed cases. The Musienene health worker is a community death.

          The cumulative number of confirmed / probable cases among health workers is 118 (5.5% of all confirmed / probable cases), including 39 deaths.
          ...

          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • Translation Google

            Bunia: third confirmed Ebola case, this is a 13-year-old boy


            Posted By: Loikaon: June 15, 2019 In: health

            The city of Bunia recorded Thursday its third confirmed case of Ebola, according to the provincial coordination of the response to this disease in Ituri.

            This is a 13-year-old boy, after a 14-year-old girl, who was notified on June 12 in the Hoho district in the southwestern outskirts of Ituri. The first case was that of a 28-year-old woman from Beni who died on 06 June 2019 after having stayed in a health center after samples were taken to reveal the presence of Ebola. All of these people come from the same family.

            The response coordination says to undertake several decontamination activities, mainly the health structures where the patients have stayed in this part of the city, epicenter of the contagion.

            Vaccination of high-risk people, active search for people who come into contact with the sick are also part of the work of the response teams.

            The provincial authorities, for their part, called on the population to strictly observe hygiene measures and to systematically check entries at the border with neighboring North Kivu.

            Editor

            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • Translation Google
              EPIDEMIOLOGICAL SITUATION
              EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

              Monday, June 17, 2019


              The epidemiological situation of the Ebola Virus Disease dated June 16, 2019 :
              • Since the beginning of the epidemic, the cumulative number of cases is 2,168, 2,074 confirmed and 94 probable. In total, there were 1,449 deaths (1,355 confirmed and 94 probable) and 596 people healed.
              • 297 suspected cases under investigation;
              • 20 new confirmed cases, including 14 in Mabalako, 1 in Musienene, 1 in Beni, 1 in Bunia, 1 in Rwampara, 1 in Kalunguta and 1 in Kyondo;
              • 9 new confirmed case deaths:
                • 4 community deaths, including 3 in Mabalako and 1 in Kalunguta;
                • 5 deaths at CTE / CT, including 3 in Mabalako, 1 in Katwa and 1 in Bunia;
              • 8 new healed CTEs, including 6 in Mabalako and 2 in Butembo;
              • The three Ebola cases tested in Uganda were reclassified to the Mutwanga Health Zone after extensive investigations revealed that this is the area in which their symptoms started after their stay in Mabalako.
              ...
              Epidemiological situation

              Mabalako : The Mabalako response teams launched a few days ago the active search for Ebola cases in the community and health facilities. As Mabalako became the main hot spot of the epidemic, it was necessary to strengthen the level of epidemiological surveillance to detect Ebola cases and isolate them as quickly as possible in order to break the chain of transmission in the community.

              Bunia : The new confirmed case detected in Bunia was cared for at a health post in Hoho, in the Rwampara health zone, together with a confirmed case notified on 7 June 2019. It had been listed as a contact but refused to be followed and vaccinated. He died at Bunia transit center and 23 of his contacts were listed. The new confirmed case of the day in Rwampara is also a co-patient of the confirmed case of June 7, 2019.
              ...
              The dignified and safe Bunia burial team was attacked by young people from the Kindia district of Bunia while trying to bury the deceased patient at the Bunia Transit Center. The youths violently assaulted the team members and took away phones and money. All the agents of the team were found and were able to return to the coordination. The body of the deceased was brought back to the transit center of Bunia.
              ...

              https://us13.campaign-archive.com/?u...&id=af145ced43
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment


              • Translation Google

                Bunia: Resistance against the Ebola response teams invited itself, in the manner of neighboring North Kivu

                Posted By: Loikaon: June 17, 2019In: Health

                The urban authorities of Bunia met on Monday, June 17, 2019 to take action against a resistance encountered at the weekend by the Ebola virus response teams in the Hoho district, where a total of 6 cases have already been reported.

                The police had to shoot in the air to disperse a group of young people who wanted to attack these teams.

                Among the decisions taken, the arrest of 5 of the youths who threatened the agents of the response as well as the reinforcement of the sensitization of the population to the measures of hygiene,

                The same scenario was repeated on Monday this time in another neighborhood, in Kindia, where health teams who had been burying an Ebola victim in a secure way faced one of the young people who suspected them of burying an empty coffin.

                Similar incidents are often recorded in neighboring North Kivu, armed groups and the civilian population, who have never believed in the existence of the disease, sometimes carry out attacks on Ebola treatment centers, killing health workers and setting fire to their facilities.

                Editor

                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


                • Translation Google

                  Mai Mai militia threatened by Ebola virus disease in the outskirts of Beni

                  Beni, June 17, 2019 (ACP) .- The Deputy Mayor of the city of Beni, Modeste Bwanakawa, announced Monday to agents and officials of the State, a threat of Ebola virus disease that has already been declared in the maquis held by Mai Mai militia in the outskirts of the city of Beni.

                  The urban authority has put forward an assessment of twelve cases (12) cases confirmed and already admitted to the Center for treatment of Ebola virus disease, CTE / Beni since two days in addition to two other probable cases that would have volatilized in nature in the middle of the city, recalling that a systematic search was launched to find the fugitives.

                  Mayor Bakwanamaha, however, expressed his concern that most of the militia admitted to CTE / Beni are most likely to come from the nearby town of Butembo, a small portion of whom are from the Mabalako health zone.

                  According to the Number 2 of the city of Beni, the militia leaders who themselves took the initiative to alert the response teams through the Urban Authorities of Beni, are ready to contribute to the eradication of this deadly disease which, as of June 17, has killed 1430 victims with more than 722 confirmed cases having been admitted and treated at CTE / Beni.

                  For him, the fact that militiamen are attacked in their maquis is likely to bring back the counter to zero in a city of Beni where it was yet to the point of eradicating the Ebola virus disease.

                  It is suspected that the Mai Mai affected by Ebola were among those who participated actively in the various attacks against Katwa CTE and UCG / Butembo from where they would have taken mattresses and several other effects used by the interned patients. ACP / Kayu / DNM / Wet / JFM

                  "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                  -Nelson Mandela

                  Comment


                  • Translation Google
                    EPIDEMIOLOGICAL SITUATION
                    EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                    Tuesday, June 18, 2019


                    The epidemiological situation of the Ebola Virus Disease dated June 17, 2019 :
                    • Since the beginning of the epidemic, the cumulative number of cases is 2,181, of which 2,087 confirmed and 94 probable. In total, there were 1,459 deaths (1,365 confirmed and 94 probable) and 602 people healed.
                    • 322 suspected cases under investigation;
                    • 13 new confirmed cases, including 4 in Mandima, 3 in Mabalako, 2 in Butembo, 1 in Katwa, 1 in Kyondo, 1 in Beni and 1 in Kalunguta;
                    • 10 new confirmed cases deaths:
                      • 4 community deaths, 2 in Mabalako, 1 in Mandima and 1 in Butembo;
                      • 6 deaths at CTE, including 3 in Mabalako, 2 in Katwa and 1 in Butembo;
                    • 6 new cures emerged from CTEs, including 5 in Katwa and 1 in Butembo.
                    ...
                    119 Contaminated health workers

                    1 health worker in Mandima is one of the new confirmed cases.


                    The cumulative number of confirmed / probable cases among health workers is 119 (5.5% of all confirmed / probable cases), including 39 deaths.
                    ...



                    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                    -Nelson Mandela

                    Comment


                    • USAID ADMINISTRATOR MARK GREEN'S REMARKS AT PRESS ROUNDTABLE ON EBOLA

                      Remarks
                      For Immediate Release
                      Tuesday, June 18, 2019
                      Office of Press Relations
                      Telephone: +1.202.712.4320 | Email: press@usaid.gov

                      June 18, 2019
                      Sheraton Four Points
                      Nairobi, Kenya
                      ...
                      First, I'm very pleased that the UN has responded to the donor community's call for a reset, and appointed David Gressly, a veteran of many crises, to lead the Ebola response in DRC. One of the most important things that we've heard from him, and had a very good discussion with him -- he said that, given all that he has seen in DRC and seen in other crises zones, there was nothing that he saw that was insurmountable. And, I agree with that optimistic assessment. And, I believe that as we move forward, when more order is brought to what has been a chaotic situation, I think that we will see progress. Steps need to be taken, but I believe they are steps that we can take.

                      Second, with over 2,168 cases and over 1,400 deaths, we need to turn distrust in the community, which has been well-reported by many of you, into an asset. We need to turn it into a community-based response. We need a response that engages all parts of the community not only to tackle the virus, but to rebuild the institutions that will be necessary so as not to leave the area vulnerable again for the next shock which could come its way. This includes a commitment to transparently communicating to the community all aspects of the response, from testing and treatment to finances and hiring.

                      And, there is no reason for information to be withheld from the community at all.
                      We want to see a continued and deepening engagement, and utilization of the NGO and faith-based community actors who, as they pointed out to us -- they have been there for years, and they will continue to be there, partnering with local leaders, long after everybody else has left.

                      We need to see vaccines deployed more broadly, and we need to see an application of the latest recommendations in that regard. And, we need to see an effective approach to addressing security concerns in the region, and that needs to be done without militarizing the response, which will only further alienate the local community.
                      ...
                      Obviously, the crisis is far from over. I will have a few more announcements in coming weeks, as it relates to USAID's response efforts.
                      ...

                      https://www.usaid.gov/news-informati...undtable-ebola
                      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                      -Nelson Mandela

                      Comment


                      • Can someone explain to me exactly how this is supposed to work:



                        I get that's it some kind of insurance policy to cover the costs in the case of a large multi-nation Ebola outbreak, but the incentives here seem perverse, to say the least. The article doesn't do a good enough job explaining exactly who is making what bets here.

                        Comment


                        • Translation Google

                          North Kivu: a suspected case of Ebola reported in Goma

                          BY AFRICA INFO MAGAZINE ON JUNE 19, 2019 HEALTH

                          It is since Monday, June 18, 2019 that the Central market of Goma (Virunga market) in the province of North Kivu (Eastern DRC) is on alert for a suspected case of Ebola virus.

                          Although not yet confirmed, this is the case of an infant from one of the valleys in the Central Market of Goma.

                          In her absence, she left her baby under the responsibility of a trader in the same market. After a while, she noticed that the child had very strange signs of diarrhea mixed with blood.

                          Surprised by this constant, the traders alerted the Ebola response team of the Ministry of Health.

                          Since Tuesday, the market is under the fear in connection with this discovery.

                          The doctors, who are examining this case at the General Reference Hospital of North Kivu where the patient was brought, have promised to give more details in a short time, to enlighten the public.

                          Joel Kininga KJ

                          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                          -Nelson Mandela

                          Comment


                          • Translation Google
                            EPIDEMIOLOGICAL SITUATION
                            EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

                            Wednesday, June 19, 2019


                            The epidemiological situation of the Ebola Virus Disease dated June 18, 2019 :
                            • Since the beginning of the epidemic, the cumulative number of cases is 2,190, 2,096 confirmed and 94 probable. In total, there were 1,470 deaths (1,376 confirmed and 94 probable) and 604 people healed.
                            • 325 suspected cases under investigation;
                            • 9 new confirmed cases, including 3 in Beni, 3 in Mabalako, 2 in Mandima and 1 in Musienene;
                            • 11 new confirmed case deaths:
                              • 4 community deaths, 2 in Mabalako, 1 in Mandima and 1 in Beni;
                              • 7 deaths at CTE, including 4 in Beni, 2 in Mabalako and 1 in Katwa;
                            • 2 new healed from the CTE of Mabalako.
                            ...

                            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                            -Nelson Mandela

                            Comment


                            • Translation Google

                              Lubero: militiamen set fire to offices in Makumbo locality, PNC and ANR

                              POSTED BY: RMBB EDITORIAL 20/06/2019

                              Suspected Mai-Mai militiamen raided the afternoon of Wednesday June 19, 2019, in Makumbo, a town about 23 kilometers north of Njiapanda commune, in a Bapakombe group in the Bapere sector.

                              Total of twelve, they burned the offices of local Makumbo, the PNC and the ANR local. That's not all. They also destroyed the handwashing devices at Makumbo's entrance. After that, they headed towards Masange still north of Njiapanda. These alleged militiamen would have come from Ngazi, according to concordant sources.

                              Note that Makumbo has already registered several cases of death of confirmed Ebola. This insecurity is a risk of amplifying the virulence of the disease, warns the health care staff of this part of the health zone of Manguredjipa.

                              As a reminder, on Tuesday, June 18, 2019, other militiamen who came from Ngazi in Beni territory attacked a team of members of the Ebola response in the health zone of Mabalako. KOMBE Eloi commander of the subcommittee of the PNC Canteen who declared this imputation had told the journalists that these attackers were carrying certain military effects. He had also called the population to the culture of denunciation of suspected cases.

                              It must be remembered that, alongside popular resistance, insecurity is also one of the factors that slow down the response to Ebola in some parts of Beni and Lubero.

                              Des présumés miliciens maï-maï ont fait incursion, l’après-midi de ce mercredi 19 juin 2019, à Makumbo, localité située à environs 23 kilomètres au Nord de la commune de Njiapanda, en groupement Ba…

                              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                              -Nelson Mandela

                              Comment


                              • Source: https://www.who.int/csr/don/20-june-2019-ebola-drc/en/
                                Ebola virus disease ? Democratic Republic of the Congo

                                Disease outbreak news: Update
                                20 June 2019

                                This week saw a continued, gradual decrease in the number of new Ebola virus disease (EVD) cases from the hotspots of Katwa and Butembo compared to the previous weeks. However, these encouraging signs are offset by a marked increase in case incidence in Mabalako Health Zone, and especially in Aloya Health Area (Figure 1). While the spread of EVD to new geographic areas remains low, in the health zones of Bunia, Lubero, Komanda and Rwampara, recent reintroduction events illustrate the high risks in previously affected areas. Along with the rise in cases in Mabalako, there was also an accompanying increase in healthcare worker (HCW) and nosocomial infections. These findings highlight the ongoing need to comprehensively strengthen the infection prevention and control measures in the various healthcare facilities operating in these areas. The occurrence of EVD infections in these health areas also place a strain on the already limited security resources needed to facilitate access for effective response activities to continue.
                                In addition to operational challenges encountered on the ground by healthcare workers during the past ten months, the overall EVD outbreak response effort is confronting substantial difficulty in maintaining scale in the context of a US $54 million funding shortage. Without adequate funding to fill this gap, response activities will be compromised, negatively impacting the entire response, resulting in a drastic reduction in vital health services available and a cessation of operations during a critical time of the outbreak. Member States and other donors are strongly encouraged to help meet this funding gap in order to ensure that hard won progress in containing this EVD outbreak will not suffer a potentially devastating setback due to financial limitations.
                                In the 21 days, between 29 May to 18 June 2019, 62 health areas within 15 health zones reported new cases, representing 9% of the 664 health areas within North Kivu and Ituri provinces (Figure 2). During this period, a total of 245 confirmed cases were reported, the majority of which were from the health zones of Mabalako (37%, n=91), Mandima (12%, n=30), Katwa (11%, n=28), Beni (11%, n=27) , Butembo (9%, n=23) , Kalunguta (5%, n=13) and Musienene (5%, n=12). As of 18 June 2019, a total of 2190 EVD cases, including 2096 confirmed and 94 probable cases, were reported. A total of 1470 deaths were reported (overall case fatality ratio 67%), including 1376 deaths among confirmed cases. Of the 2190 confirmed and probable cases with known age and sex, 57% (1242) were female, and 29% (639) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected rising to 122 (6% of total cases).
                                No new EVD cases or deaths have been reported in the Republic of Uganda since the previous EVD Disease Outbreak News publication on 13 June 2019. Response activities are however ongoing, with active case surveillance and over 100 potentially exposed contacts identified, predominately in Kisinga and Bwera subcounties, Kasese District. Contacts will be visited daily for 21 days until the last contact completes follow-up on 2 July. All contacts remain asymptomatic to date. As of 19 June, a total of 456 individuals have been vaccinated in Uganda, including consenting contacts and contacts of contacts.
                                Following the detection of EVD cases in Uganda, on 14 June 2019, a meeting of the Emergency Committee was convened by the WHO Director-General under the International Health Regulations (IHR). The Committee expressed its deep concern about the ongoing outbreak, which, despite some positive epidemiological trends, especially in the epicentres of Butembo and Katwa, shows that the extension and/or reinfection of disease in other areas like Mabalako. This presents, once again, challenges around community acceptance and security. In addition, the response continues to be hampered by a lack of adequate funding and strained human resources. It was noted that the cluster of cases in Uganda is not unexpected; the rapid response and initial containment is a testament to the importance of preparedness in neighbouring countries. It was the view of the Committee that the outbreak is a health emergency in the Democratic Republic of the Congo and the region, but does not meet all the criteria for a Public Health Emergency of International Concern (PHEIC). The Committee provided public health advice, which it strongly urged countries and responding partners to heed. For the full statement and further details, please click here.
                                Figure 1: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 18 June 2019*




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                                *Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning. Other health zones include: Alimbongo, Biena, Bunia, Kalunguta, Kayna, Komanda, Kyondo, Lubero, Mangurujipa, Masereka, Mutwanga, Nyankunde, Oicha, Rwampara and Tchomia.
                                Figure 2: Confirmed and probable Ebola virus disease cases by week of illness onset by health zone. Data as of 18 June 2019




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                                Table 1: Confirmed and probable Ebola virus disease cases, and number of health areas affected, by health zone, North Kivu and Ituri provinces, Democratic Republic of the Congo, data as of 18 June 2019**




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                                **Total cases and areas affected based during the last 21 days are based on the initial date of case alert and may differ from date of confirmation and daily reporting by the Ministry of Health.
                                Public health response

                                For further detailed information about the public health response actions by the MoH, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:
                                WHO risk assessment

                                WHO continuously monitors changes to the epidemiological situation and context of the outbreak to ensure that support to the response is adapted to the evolving circumstances. The last assessment concluded that the national and regional risk levels remain very high, while global risk levels remain low. Weekly increases in the number of new cases were observed from February through mid-May 2019, with lower though still substantial rates since then. A general deterioration of the security situation, and the persistence of pockets of community mistrust exacerbated by political tensions and insecurity, especially over the past four weeks, have resulted in recurrent temporary suspension and delays of case investigation and response activities in affected areas, reducing the overall effectiveness of interventions. However, recent community dialogue, outreach initiatives, and restoration of access to certain hotspot areas have resulted in some improvements in community acceptance of response activities and case investigation efforts. In order to ensure staff safety and security, security mitigation measures are being enhanced, and procedural, operational, and physical security challenges are being addressed. The high proportion of community deaths reported among confirmed cases, relatively low proportion of new cases who were known contacts under surveillance, existence of transmission chains linked to nosocomial infection, persistent delays in detection and isolation in ETCs, and challenges in the timely reporting and response to probable cases, are all factors increasing the likelihood of further chains of transmission in affected communities and increasing the risk of geographical spread both within the Democratic Republic of the Congo and to neighbouring countries. The high rates of population movement occurring from outbreak affected areas to other areas of the Democratic Republic of the Congo and across porous borders to neighbouring countries during periods of heightened insecurity further compounds these risks. Additional risks are posed by the long duration of the current outbreak, fatigue amongst response staff, and ongoing strain on limited resources. Conversely, substantive operational readiness and preparedness activities in a number of neighbouring countries have likely increased capacity to rapidly detect cases and mitigate local spread. These efforts must continue to be scaled-up.
                                WHO advice

                                WHO advises against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for travellers to/from the affected countries. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.
                                For more information, please see:

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