BUNIA – Six months after Congo declared an Ebola outbreak, the deadly disease remains largely uncontrolled as efforts to stop its spread continue to falter.
Government figures show that more than 11,000 people have been infected and nearly half have died. The outbreak is the deadliest among Congo’s 17 Ebola epidemics and is on course to exceed the death toll of the West African outbreak, which killed 11,000 people from 2014 to 2016.
Fundamental response measures, including contact tracing and patient isolation, remain insufficient. That shortfall has fueled concern over whether authorities can bring the epidemic to an end, with experts saying control is unlikely within the next year.
When officials announced the outbreak in mid-May, 43 people had already died, indicating that the virus may have been spreading undetected for a considerable time. It has since reached eight of Congo’s 26 provinces, expanding at a speed that aid organizations have compared with a wildfire.
Fresh hotspots continue to appear, placing additional pressure on an already overwhelmed health care system.
Questions over funding and management
The virus continues to spread through communities. The Africa Centers for Disease Control and Prevention says 80% of new infections are being identified outside the health surveillance system, suggesting that most cases are not being recorded or followed by officials.
About one in three deaths takes place at home or elsewhere in the community. In such settings, burials and other practices often occur without trained specialists, heightening the possibility of further transmission.
Health workers have repeatedly walked off the job because they have gone months without receiving their pay. At times, the strikes have left patients with confirmed Ebola infections without care.
Relief organizations have also raised concerns about the way the response is being administered. Last month, the Africa CDC said more than $700 million allocated for Ebola assistance could not be accounted for.
“A troubling disconnect between the considerable resources mobilised for the response and what is actually reaching patients, frontline workers, and communities continues,” said Doctors Without Borders, the humanitarian group also known by its French acronym, MSF.
Children face high death rates
Children are among those most at risk from Ebola, particularly when they are already suffering from conditions such as malnutrition, health experts say.
Most children who contract the virus have not received specialized treatment, a factor contributing to the high mortality rate among young patients.
UNICEF reported that children represented 35% of all deaths recorded through Nov. 4. Those younger than 5 made up 21% of total fatalities, while nearly 72% of infected children in that age group died.
Conflict and attacks hamper response
Ebola responders are working in extremely difficult conditions, as public health measures collide with established social and cultural practices.
Since the outbreak began, health workers have faced attacks, including some that proved fatal. Medical facilities have also been targeted, adding to the risks of operating in a region already marked by instability.
The outbreak is centered in eastern Congo, especially in Ituri and North Kivu, where residents are confronting the Ebola epidemic alongside persistent armed conflict.
Clashes between government forces and hundreds of rebel groups, including the Rwanda-backed M23, have helped produce one of the world’s most serious humanitarian crises. The Allied Democratic Forces, an Islamic State-linked rebel organization, has also continued attacks on civilians.
The speed of the outbreak has raised concern that Ebola could spread more widely across Africa. Nigeria, Kenya and Uganda have reported confirmed cases, making this the most geographically extensive Ebola outbreak ever recorded.
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