

République démocratique du Congo – Note d’informations humanitaires pour la Province du Nord-Kivu (26.03.2019)





Response teams are facing daily challenges in ensuring timely and thorough identification and investigation of all cases amidst a backdrop of sporadic violence.
GENEVA, Switzerland, March 29, 2019 – The ongoing Ebola virus disease (EVD) outbreak in the North Kivu and Ituri provinces saw a rise in the number of new cases this past week. At this time, response teams are facing daily challenges in ensuring timely and thorough identification and investigation of all cases amidst a backdrop of sporadic violence from armed groups and pockets of mistrust in some affected communities. Despite this, progress is being made in areas such as Mandima, Masereka and Vuhovi, where response teams are gradually able to access once again and acceptance by the community of proven interventions to break the chains of transmission is observed.
During the last 21 days (6 – 26 March), a total of 125 new cases were reported from 51 health areas within 12 of the 21 health zones affected to date; 38% of the 133 health areas affected to date (Figure 2). The majority of these cases were from remaining hotspot areas of Katwa (36), Butembo (14), and three emerging clusters in Mandima (19), Masereka (18) and Vuhovi (17), in addition to a limited number of cases in other areas (Table 1). All cases link back to chains of transmission in hotspot areas, with onward local transmission observed in a limited number of towns and villages within family/social networks or health centers where cases have visited prior to their detection and isolation.
As of 26 March, a total of 1029 confirmed and probable EVD cases have been reported, of which 642 died (case fatality ratio 62%). Of 1029 cases with reported age and sex, 57% (584) were female, and 30% (307) were children aged less than 18 years. The number of healthcare workers affected has risen to 78 (8% of total cases), including 27 deaths.
Community engagement efforts to encourage greater local participation and ownership of the outbreak response is ongoing and has yielded some success in many areas. In Butembo and Katwa this past week, a total of 4171 households have been visited by community health volunteers and Red Cross volunteers. This past week also saw the establishment of nine community committees to enhance direct dialogue with healthcare workers and empower community members to partake in the decision-making process of the local response. Special dialogues are being held in the communities where there have been the most frequent incidents. Herein, an anthropologist first meets with the community to ascertain their concerns, then arranges for communal meetings where these concerns can be discussed, including amongst local youth leaders, women’s associations, traditional practitioners, and healthcare providers.
As of 26 March, 324 EVD patients have recovered and been discharged from Ebola Treatment Centres. In Beni, local NGOs and international teams are currently conducting eye care training for ten ophthalmologists and establishing dedicated eye care clinics to provide screening and eye care for EVD survivors. To date, 145 survivors have been screened in these clinics and a total of 293 survivors have enrolled in the survivor’s programme.
Notable strides have also been made in improving IPC capacities in healthcare facilities. Since January, IPC field teams have decontaminated over 250 healthcare facilities and households, provided over 100 supply kits, and trained over 3000 healthcare workers in IPC. A recent National IPC workshop has been completed to aid the implementation of new IPC strategies, while the establishment of an IPC task force has further improved partner communication and coordination at all levels. The work is, however, is ongoing and IPC teams continue to respond to new instances of nosocomial transmission with the emergence of clusters in previously unaffected communities and health facilities.
These local successes do not come without its challenges. When visiting communities in high risk areas, Ebola response teams sometimes face security challenges. Though no major security incidents have been reported over the last 10 days, the overall situation remains fragile. WHO and partners have recently established operational analysis and coordination centres to both gain a more holistic understanding of how we can engage communities more effectively, as well as further increase operational awareness of the day to day operations to ensure the safety of frontline healthcare workers and the communities they are aiding. WHO and partners have also strengthened physical security in the treatment centres and accommodations of healthcare workers.
Finding a balance between providing adequate operational protection to community members at risk of Ebola and healthcare workers while simultaneously winning the trust of communities remains an iterative learning process. WHO is constantly evolving the response efforts to address these operational challenges and will continue to step up collaboration with communities to increase acceptance on the ground.
*Data in recent weeks are subject to delays in case confirmation and reporting, as well as ongoing data cleaning
**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.






As Ebola response workers face violence on an almost daily basis, working in partnership with the community is the key to bringing this outbreak to an end.
BUTEMBO, Democratic Republic of Congo, March 25, 2019 – Since the Ebola outbreak was declared in August, the confirmed and probable case count has now surpassed 1000; case numbers are on the rise which is not what we expect at this stage in the outbreak that may last another six to twelve months; in the past week we have seen 58 new reported cases – this is the highest number in a week in 2019. There could still be many more which have not been reported; working with the community is the key to getting this outbreak under control; IRC teams are supporting 59 facilities to improve infection prevention and control as well as working to protect women and children.
A thousand people have now contracted Ebola since the outbreak was declared in Democratic Republic of Congo (DRC) in August. This tragic milestone is a reminder that this outbreak is not yet under control and in order to make progress more must be done to work in partnership with the affected community. The ongoing mistrust facing health workers and the response is a symptom of the years of insecurity they have endured, and a sign that those responding must work even harder to combat the stigma and misunderstanding held by some in the community.
Tariq Riebl, IRC’s Emergency Response Director in DRC said: “Alarmingly at this stage in the outbreak, the number of cases of Ebola is once again on the rise. In the past week we have seen 58 new cases – this is the highest number in a week in 2019. With mistrust and security issues, cases are likely to be going unreported and the true figure could be even higher. These numbers show that despite the hard work being done, this outbreak is far from over. Insecurity and violence has led to the IRC and other agencies being forced to frequently suspend programs, which time and again we have seen lead to a spike in cases.
“Data shows us that working with the community is the key to stopping this outbreak. Without greater engagement we will see more lives lost. IRC’s team in North Kivu are redoubling their efforts to understand the concerns of people living in the impacted communities and to work with them to quash this outbreak. In the past weeks IRC teams have run a series of community meetings to understand their concerns as well as establishing focal points within affected neighborhoods and villages”.
“We are already almost seven months into this outbreak and at this stage we should be seeing the case rate declining, not on the rise. With an optimistic outlook this outbreak is predicted to last another six months — but realistically we could be looking towards another year of fighting this disease. The Ministry of Health and partners including the IRC are working around the clock to curtail the outbreak as quickly as possible to reduce the loss of life and further damage to the community.”
Leading on infection prevention and control, the IRC is working in 59 health clinics, training health workers to recognize symptoms and safely triage and transfer suspected Ebola patients to treatment centers; as well as working in women’s and children’s protection and community sensitization.
With more than 13 million people in need of aid, DRC is one of the world’s most complex, chronic and long-standing humanitarian crises. The IRC has been working in the Democratic Republic of Congo since 1996 responding to the humanitarian crisis in the east. It has since evolved into one of the largest providers of humanitarian assistance and post-conflict development, with life-saving programming in health, economic recovery, women’s and children protection, and livelihoods.

WHO calls on international community to join urgent push to end outbreak
As the Ebola outbreak in the Democratic Republic of the Congo (DRC) approaches 1 000 cases amid increased violence, WHO reaffirmed its commitment both to ending the outbreak and working with the government and communities to build resilient health systems.
Since the outbreak was declared in August 2018 there have been 993 confirmed and probable cases and 621 deaths in North Kivu and Ituri provinces.
“We use words like ‘cases’ and ‘containment’ to be scientific, but behind every number is a person, a family and a community that is suffering,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This outbreak has gone on far too long. We owe it to the people of North Kivu to work with them in solidarity not only to end this outbreak as soon as possible, but to build the health systems that address the many other health threats they face on a daily basis.”
More than 96 000 people have been vaccinated against Ebola in DRC, along with health workers in Uganda and South Sudan. As of 21 March, 38 of 130 affected health areas have active transmission. More than 44 million border screenings have helped to slow the spread of Ebola in this highly mobile population. No cases have spread beyond North Kivu and Ituri provinces, and no cases have crossed international borders.
However, the risk of national and regional spread remains very high, especially when episodes of violence and instability impact the response.
“As we mourn the lives lost, we must also recognize that thousands of people have been protected from this terrifying disease,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We are working in exceptionally challenging circumstances, but thanks to support from donors and the efforts of the Ministry of Health, WHO and partners, we have saved thousands of lives.”
WHO has more than 700 people in DRC and is working hard with partners to listen to the affected communities and address their concerns and give them greater ownership of the response, particularly in the current outbreak hotspots of Katwa and Butembo.
“The communities affected by this outbreak are already traumatized by conflict,” said Dr Tedros. ”Their fear of violence is now compounded by fear of Ebola. Community engagement takes time. There are no quick fixes. But we are learning and adapting to the evolving context every day.”
Despite the challenges, most communities accept response interventions. More than 90% of those eligible for vaccination accept it and agree to post-vaccination follow-up visits. Independent analysis of vaccination data indicate that the vaccine is protecting at least 95% of those who receive it in a timely manner. More than 80% of people also accept safe and dignified burials, a key to preventing onward transmission.
“Despite the increased frequency of attacks by armed groups, WHO will stay the course and will work with communities to end this outbreak together with the Ministry of Health and partners,” said Dr Tedros. “We need redoubled support from the international community, and a commitment to push together to bring this outbreak to an end.”
For the next 6 months, the combined financial need for all response partners is at least $148 million. As of 19 March, $US 74 million had been received.
“We count on donors to help close the funding gap so we can end this outbreak as soon as possible,” said Dr Tedros. “We will still be in DRC long after this outbreak has finished, working with the government and communities on the road to universal health coverage. We are committed to improving the health of the people of DRC now and in years to come.”

