Local health workers need more training and support to contain epidemic
One year after the current Ebola outbreak was declared in the Democratic Republic of Congo (DRC), Oxfam staff say the virus, violent conflict and inadequate healthcare are creating a lethal mix.
While some progress has been made to contain Ebola, which has claimed the lives of almost 1,800 people, a second case has just been reported in Goma, the biggest city in eastern DRC. Recent cases have also been reported in Uganda, which shows the devastating potential for it to spiral out of control.
Oxfam’s Country Director in the DRC, Corinne N’Daw, said: “We sincerely hope that this new case in Goma is quickly contained, as the virus could spread rapidly in a city that is home to two million people.”
Widespread turmoil caused by increased violence and displacements in the country are hampering efforts to control the Ebola virus, which Oxfam said is part of a much wider humanitarian crisis. Across the DRC more than 12.8 million people need humanitarian assistance, yet the country has only received a quarter of the emergency funding it needs so far this year, leaving a shortfall of $1.2 billion.
In the province of Ituri, hundreds of thousands of people are living in overcrowded, makeshift camps, following a massive upsurge in violence in June, that has claimed hundreds of lives. Newly displaced people are arriving daily and at least 25 of the camps have doubled in size over the last month. The situation is dire, with very little clean water and sanitation, resulting in conditions that are highly conducive for the spread of diseases.
In addition to the displaced people living in camps, tens of thousands more are living within host communities, causing additional strain on people who are already extremely vulnerable and have virtually no access to healthcare.
Corinne N’Daw, said: “The unending violence in the region is devastating the lives of hundreds of thousands of people, preventing them from getting essential services, like healthcare, and ultimately hampering the larger humanitarian and Ebola response.
“Ebola is rightly getting global attention and funding, and this new case in Goma shows that this is desperately needed, however the wider crisis is being largely ignored. It is vital that funds are also provided to help the millions of Congolese people who have been displaced by violence, including those recently fleeing to camps in Ituri. International efforts are also urgently needed to tackle the root causes of the violence that has plagued the DRC for decades.”
Inadequate health systems in the DRC are exacerbating the problem; before the latest outbreak of Ebola, there were only nine trained medical doctors per 10,000 people in the country. While more resources have been brought in to combat Ebola, recent perception and practice surveys have shown that local health workers, who are on the frontline of the Ebola response, often feel ill-equipped. Many have reported not knowing all the symptoms (notably the “dry” symptoms like abdominal pain); how to spot a case or where to refer people who are showing signs of the virus; or feel unable to refer potential cases to the Ebola Treatment Centers.
In Mandima, an area that has reported 200 cases since the beginning of the outbreak, more than 75 percent of health workers surveyed said they didn’t feel they had been given enough training or information. In Butembo, one of the worst-affected areas, nearly 50 percent of health workers surveyed said they did not feel they were sufficiently informed to be able to identify a suspect case.
“There needs to be much more training and support for local health workers on the frontline. A priority for the new funding for Ebola, promised by the World Bank and other donors, must aim to equip health workers with the skill and resources they need to do their jobs,” N’Daw said. “Having properly trained local staff is also crucial in terms of building trust with affected communities, something that has been a major issue so far in the response.”
Oxfam’s Ebola response has helped more than 600,000 people by working directly with affected communities to build trust and help prevent the spread of the deadly disease. The international agency is already working in Goma and ready to scale up its response should any further cases emerge.