Rebel attacks threaten Ebola response in Congo

Rebel attacks threaten Ebola response in Congo
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Militant attacks on health-care personnel and members of the Congolese army have hindered a global response to a growing outbreak of the Ebola virus in two eastern provinces of the Democratic Republic of the Congo.
 
Global and American health officials said at least two rebel groups were behind three separate attacks over the weekend in and around Beni, a regional trading hub in North Kivu Province. Health officials responding to the outbreak were forced to pause their efforts to track and vaccinate contacts of those infected with the virus for several hours.
 
“This is probably the most complex context that we’ve ever had to fight an Ebola outbreak before,” Peter Salama, the deputy director-general for emergency preparedness and response at the World Health Organization, told The Hill in an interview. “The security situation is indeed tense and it has been there for many, many years.”
 
The violence and instability, in a region where ethnic conflict has displaced more than a million people, has kept American responders out of the region. Several American personnel were pulled from Beni and surrounding areas after an August attack on a Congolese military base.
 
A Disaster Assistance Response Team, led by personnel from the Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development, has been dispatched to Kinshasa, more than a thousand miles from the outbreak’s epicenter. Senior American officials said Wednesday that 10 to 15 DART team members were on the ground in Kinshasa, and another 21 are providing support from the United States.
 
But American responders are on the ground in neighboring Uganda, Rwanda and South Sudan, monitoring border crossings in hopes of preventing the virus’s spread across international borders. CDC has deployed 94 Americans to those countries and to Geneva, where the WHO is headquartered, to help with the response.
 
The Congolese Ministry of Health said Wednesday that 339 cases of the Ebola virus have been identified, making the current outbreak the worst in the nation’s history. Two hundred twelve people have died.
 
About half of the cases have come in Beni, a town of about a quarter million residents near the border with Uganda. Ten cases have also occurred in Butembo, a larger city south of Beni that has close trading ties across the border.
 
Salama said many of the cases are spreading through interactions at private health-care facilities, which do not register with the local government and where basic services like running water and safe needle handling do not exist. There are several hundred such facilities in Beni alone, some of which are located in private residences.
 
“The majority of transmissions, we believe, is occurring in private health facilities,” Salama said.
 
About 30 health-care workers have been infected during the outbreak, Salama said.
 
In a conference call Wednesday, senior American officials would not rule out deploying U.S. military personnel to the region, where security is ostensibly the responsibility of the United Nations Organization Stabilizing Mission in the Democratic Republic of the Congo, or MONUSCO. 
 
But deploying American troops, like the nearly 3,000 sent to Liberia to fight an Ebola outbreak in 2014, is highly unlikely. The Americans sent to Liberia operated in a support capacity, rather than for security, and America has much closer ties to Liberia, a country it helped found in the 19th Century, than it does to the DRC.
 
Some public health officials were alarmed last week when Robert Redfield, the director of the CDC, suggested at a conference on Capitol Hill that the difficulty containing the current outbreak might make the Ebola virus entrenched within the Congo River Basin for years to come. Redfield later said he was giving voice to a worst-case scenario, rather than suggesting the outbreak would spin out of control.
 
“We don’t believe that the Ebola outbreak currently is not containable. In fact in many health areas and health zones, it has been contained,” Salama said. “We believe it is containable, but it relies on scaling up at high intensity.”
 
A new vaccine, developed by the National Institutes of Health and produced by the pharmaceutical giant Merck, has been deployed for just the third time in the North Kivu region. The vaccine has been given to more than 29,500 people, mostly health care workers and those who have come into contact with someone infected with the Ebola virus, a process known as ring vaccination.
 
“This outbreak is going to take many weeks to contain, so we need to be in it for the medium term,” Salama said.