Fighting Ebola When Mourners Fight the Responders

Fighting Ebola When Mourners Fight the Responders
An Ebola outbreak in eastern Congo — the second-largest in history — is escalating in part because locals don’t trust health workers and government officials.
By Joseph Goldstein
May 19 2019
https://www.nytimes.com/2019/05/19/world/africa/ebola-outbreak-congo.html

BENI, Democratic Republic of Congo — When Ebola came to this city in the Democratic Republic of Congo, Janvier Muhindo Mandefu quit farming and got work burying the highly contagious bodies of Ebola victims.

But Mr. Muhindo is less afraid of Ebola than of the mourners he encounters at funerals. He and his burial team have been attacked by relatives of the dead, one swinging a hoe. Mourners have shouted at team members, accusing them of stealing the organs of corpses, and have threatened to throw them into the open graves. Last month a mourner brandished a hand grenade, he said, sending everyone scattering and leaving a 3-year-old Ebola victim unburied.

“Someone like me can be buried alive,” Mr. Muhindo said as his colleagues hosed down their trucks at the Red Cross compound after another day of burials.

This Ebola outbreak in eastern Congo, the second-largest ever recorded, is now spiraling out of control. Despite some early success — helped by a new and effective vaccine — the disease has come roaring back in the past two months.

Efforts to combat the epidemic have been hobbled by attacks on treatment centers and health workers; deep suspicion of the national government, which is managing the eradication efforts; and growing mistrust of the international medical experts who have struggled to steer patients into the treatment centers, according to interviews with dozens of family members, politicians, doctors and health workers in recent weeks.

When a doctor was killed, and treatment centers attacked by gunmen or set on fire, front-line health workers suspended their work, giving the virus time to spread. Some medical and aid groups have decided to pull some of their personnel from the very areas where Ebola has hit hardest.

So far nearly 1,150 people have died in the outbreak, according to the World Health Organization. But that is a significant undercount, aid groups said in interviews. Health workers have been turned away regularly from homes where someone has died, leaving them unable to test for Ebola.

Earlier in the outbreak, the police would remove these bodies from homes, at gunpoint if necessary, said Philemon Kalondero, 39, who is often the first member of his Ebola response team to arrive at a grief-stricken home.

“The new protocol is that we just abandon the body,” he said. “They will learn their lesson when they get sick.”

Initial Optimism

When the outbreak was discovered last summer, health workers had reason to worry. This part of eastern Congo has long been beset by dozens of armed groups fighting over land, natural resources, ethnicity and religion — including one outfit with ties to the Islamic State.

Yet optimism ran strong among the arriving wave of international health experts and humanitarian workers, many of whom had experience treating Ebola, an often fatal disease caused by a virus that is transmitted by body fluids. 

They came with lessons learned from the outbreak that tore across West Africa starting in 2013, killing more than 11,000 people. And they were buoyed by a recent success: the speedy containment of an outbreak in western Congo. 

They also brought medical advances: a strikingly effective vaccine, experimental treatments, and a transparent container known as the “cube” that Ebola patients live inside, reducing the transmission risk to doctors and visitors. 

Some of the responders hoped that big outbreaks were already a thing of the past.

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