H5N1

DRC: 11 NGOs warn of 'catastrophic' situation of hundreds of thousands of displaced people in Ituri

Via Actualite.cd: DRC: 11 NGOs warn of "catastrophic" situation of hundreds of thousands of displaced people in Ituri. The Google translation:

Humanitarian Action Against Hunger, AVSI, Danish Refugee Council, Intersos, Mercy Corps, Norwegian Refugee Council, Oxfam, Solidarity International, Tearfund, Trócaire and Welthungerhilfe have issued an alert on the need for funding to meet the needs of many hundreds of thousands of people affected by the resurgence of violence in the Djugu and Mahagi territories in Ituri province.

These 11 organizations report that most people who have fled the violence live in appalling conditions lacking clean water, medicines and sanitation.   

Others spend the night cramped in public places, such as churches and schools, or try to survive in overcrowded makeshift camps exposed to heavy rains and life-threatening diseases.  

In some cases, 500 people have to share a single toilet.   

These living conditions also increase the risk of sexual violence against women and girls.    

"The situation is catastrophic. Many children are malnourished. Most people lost everything and witnessed the worst atrocities. Now they are facing a terrible dilemma: finding themselves with nothing to eat or risking their lives by returning to their fields," confirms Corinne N'Daw, country director Oxfam in the DRC.    

According to Benjamin Vienot, Country Director of Action Against Hunger in the DRC, humanitarian organizations have not had sufficient funding to cover needs and they still face insecurity in this part of the country.   

"Humanitarian organizations have not been able to reach all those who needed help during the last crisis in 2018 due to lack of funding and insecurity, which made access to the people extremely difficult. We are now faced with an equally dark picture," he added.   

Ten months after the beginning of 2019, DR Congo received only 35% of the necessary funds, in a country where 15.6 million people are affected by severe food insecurity.   

Other parts of the country are also beset by the humanitarian crisis. These are the provinces of South Kivu, Tanganyika and Kasai.  

Ituri: The fight against Ebola facing the May May presence in the Mangina Health Zone

Via Radio Okapi: Ituri: The fight against Ebola facing the May May presence in the Mangina Health Zone. The Google translation:

The Ebola Response Team in Mangina, Mambassa Territory reports that since August 2018, it has registered approximately 310 positive cases of Ebola. 

She says there is a high prevalence in recent days as a result of population resistance mainly in the health areas of Lwemba and Biakato. According to the local response team, "there is insecurity due to the presence of May May militiamen who control certain localities. It's been a month since the agents do not reach the village of Baiti and others where there are many suspicious cases," says this source. 

Regarding security in this area, the Mambasa Territory Administrator reports that "Putsa and Yombe local chiefs took machetes last week to assault the response team. The deputy chief of Butama locality has also urged its population to refuse to be vaccinated," said the administrator of Mambasa.  

The latter says that he has dismissed the deputy head of Butama. He also suspended the local leaders of Putsa and Yombe, for having "manifested the resistance".  

Another problem encountered in the response to the Ebola virus disease, "is the state of disrepair of roads that does not facilitate the transfer of patients and the mobility of the response team in the area."  

Response coordination requires the intervention of the competent authorities to put an end to these obstacles that may favor the spread of the disease in the region.

Northeast Syria: MSF forced to evacuate staff due to extreme volatility in the region

Via MSF.org: Northeast Syria: MSF forced to evacuate staff due to extreme volatility in the region. 

AMSTERDAM/NORTHEAST SYRIA - Following the launch of Turkish military operations and the extremely volatile situation in northeast Syria, Médecins Sans Frontières (MSF) has taken the difficult decision to suspend the majority of our activities and evacuate all our international staff from northeast Syria. 

Since Wednesday 9 October, the extreme volatile situation in northeast Syria has forced MSF international staff to evacuate from our projects in Ain Issa, Al Hol, Tal Abyad, Tal Tamer, Tal Kocher/ Yaroubiyah, Kobane/ Ain Al Arab and Raqqa city. These have been extremely difficult decisions, as MSF is very aware of the needs of fleeing and vulnerable people in the region. 

However, the highly unpredictable and fast-changing situation at present has made it impossible for MSF to negotiate safe access to deliver healthcare and provide humanitarian assistance to people in distress. Given the numerous groups fighting on different sides of the conflict, we can no longer guarantee the safety of our Syrian and international staff.   

“The people in northeast Syria have already endured years of conflict and uncertainty. The latest developments have only increased the need for humanitarian assistance, yet it is impossible to deliver it with the current insecurity,” says Robert Onus, MSF emergency manager for Syria.  

“It is with a heavy heart that MSF has taken the difficult decision to suspend the majority of its activities and evacuate its international staff out of northeast Syria. We cannot operate at scale until we can gain the assurances and acceptance of all parties to the conflict that we can operate safely.  

“We are extremely worried about the safety of our Syrian colleagues and their families who remain in northeast Syria in these troubled times. We will continue to support our Syrian colleagues remotely and explore all possible options to deliver assistance to the people in northeast Syria, despite the constraint,” says Onus. 

The decision to suspend the majority of MSF’s activities comes as the humanitarian situation spirals further out of control and needs are likely to increase. 

In Tal Tamar town, MSF teams were providing blankets, emergency food rations, bottles of water, and soap to the thousands of displaced people who were arriving in the town daily after having fled from their homes with little more than the clothes on their backs.  

Until October 13, MSF was supplying water to several villages in the area to overome water shortages after an airstrike reportedly damaged the water pumping station, cutting off the water supply to whole towns.  

Airstrikes, shelling, and armed clashes have had a grave impacts on the civilian population and on the ability of humanitarian organisations to deliver aid safely.  

On 13 October, dozens of people wounded by an airstrike were brought into Tal Tamer hospital. In Ain Issa town, MSF teams witnessed the population fleeing their homes on foot and seeking safety away from the ongoing conflict. Health workers were evacuated and relocated from the Ain Issa hospital, which had been one of the main hospitals treating wounded people over the past five days.    

Today, as MSF teams depart, we have heard from our staff that the people in Ain Issa camp are severely lacking food, water and medical assistance. Just last week, MSF teams were providing healthcare and, supplying water and mental health support to people living in the camp. Now they are left in a very precarious situation and we are extremely worried for their wellbeing. 

MSF calls on all parties to the conflict to ensure the protection of civilians. We further call on them to provide humanitarian organisations with safe and unhindered access to the civilian population so they can deliver assistance, at a time when it is urgently needed. 

Note: MSF remains present in northwest Syria, providing health care in various facilities and via mobile clinics, as well as supporting health structures in the area.

Mambasa: Young people attack Ebola response team after child's death

Via Radio Okapi: Mambasa: Young people attack Ebola response team after child's death. The Google translation:

Calm returned on Monday (October 14th) to Lolwa-center, after a strong tension recorded Sunday in this village located 64 kilometers north of Mambasa on the national road number 4. This tension was due to the anger of the population, who protested against the death of a child at the general hospital of the place.  

For the protesters, the staff caring for Ebola in this medical facility are the cause of this death. In particular, they ransacked all the handwashing devices there.  

This happened around 4 pm local time. It all started with the death of a three-year-old child who was suffering from malaria. The latter was admitted to the Lolwa General Hospital to receive care. 

Local civil society sources report that the parents of this child first removed it from the health facility, considered a transit center for Ebola patients. Some time after his death, they again returned to the same hospital because he had a high fever. And he gave up the ghost. 

This death was not well perceived by local youth. They accused health care workers of the Ebola outbreak of being responsible for the death. 

In their anger, they ransacked the handwashing and isolation posts of suspected Ebola cases. Military personnel stationed in this area intervened to restore order.  

Political and notable actors in Mambasa condemned these acts. Among them, the former governor of Ituri, Jefferson is not Abdallah Pene Mbaka. The latter requested that the perpetrators of these acts be arrested for their actions.

DRC Ebola: 'It's not normal for life-saving response teams to be targeted by armed groups' (Félix Tshisekedi)

Via Actu30.info: DRC - Ebola: "It's not normal for life-saving response teams to be targeted by armed groups" (Félix Tshisekedi). Excerpt from the Google translation:

During his meeting with the Republic of Congo's Foreign Minister, Jean-Claude Gakosso, in Kinshasa on Friday, Felix Tshisekedi expressed his dissatisfaction with the armed attacks against the Ebola response teams.  

"It is not normal for life-saving response teams to be targeted by armed groups," said the President of the Republic of Congo and President-in-Office of the Great Lakes Region International Conference. 

The two personalities evoked, during the exchanges, besides the question of the Ebola virus disease which remains a danger for the populations of the East of the DRC, the insecurity which annihilated the efforts of the fight against this disease.  

And this is precisely the purpose of the meetings that are currently held in Congo-Brazzaville and during which experts of the ICGLR reflect on possible answers to this question, said the Congolese diplomat.

DR Congo's Ebola outbreak slows but still entrenched in insecure areas

Via Reuters: Congo's Ebola outbreak slows but still entrenched in insecure areas: WHO.

GENEVA (Reuters) - The Ebola epidemic in northeastern Democratic Republic of Congo has been confined to a rural area rife with militias and people on the move, making it harder to stamp out altogether, the World Health Organization (WHO) said on Thursday.

Only 14 confirmed infections were reported last week, the lowest in a year and down from 51 in mid-September and 126 in April at the peak of the outbreak, WHO figures show.  

“The fact that it is a smaller area is positive but the disease has also moved into more rural and more insecure areas,” Dr Michael Ryan, executive director of WHO’s health emergencies programme, told reporters on his return from a trip to Congo.  

“The virus is essentially back where it began,” he said.  

More than 3,200 people are known to have been infected with the virus, of whom 2,144 have died since the world’s second-worst Ebola outbreak was declared in August 2018. 

Ryan said the outbreak was confined to a geographic triangle stretching between the towns of Mambasa, Komanda, Oicha and Mandima, though it was still spreading at a low level. 

Better tracing of people exposed to the deadly virus, safe burials, and community acceptance of vaccinations - 236,000 to date - have helped, he said. 

“We are really reaching a point where we are more and more on top of things, more and more on top of surveillance, more and more on top of infection prevention and control,” Ryan said. “The problem is it’s back in areas that are deeply insecure.”  

Mining operations, legal and illegal, abound in the zone, with people going back and forth to their villages, while militias such as the Mai-Mai and the Islamist Allied Democratic Forces (ADF) were also active, he said. 

“We have multiple Mai-Mai groups, a very, very big ADF presence in these areas, and ADF has clearly demonstrated over the last few months that it has been carrying out attacks,” Ryan said. 

Congolese health authorities said last month that they plan to introduce a second Ebola vaccine, manufactured by Johnson & Johnson, to complement another single-dose vaccine made by Merck, but no date has been announced.  

“We all want to see that second vaccine in place. The target of this vaccine is not in the epidemic zone, it’s aimed at protecting people outside the epidemic zone, places like Goma, and will provide sort of a firewall potentially,” Ryan said, referring to a city of 2 million on the Rwandan border.

WHO AFRO: Ebola outbreak in DRC - Sitrep 62

WHO AFRO has published Ebola Virus Disease Outbreak in DRC - Sitrep 62: 08 October 2019. Excerpt:

In the past week, from 30 September to 6 October, 14 new confirmed Ebola virus disease (EVD) cases, with an additional nine deaths, have been reported from seven health zones in two affected provinces in the Democratic Republic of the Congo. Although the decline in the number of new cases is encouraging, the recent fluctuations in case numbers per week must be interpreted with caution, as case reporting is contingent upon the level of access and security. 

During mid-September, serious security incidents in Lwemba Health Area, Mandima Health Zone, stalled outbreak response activities for more than two weeks. Response activities have since resumed but remain limited. Last week, an open forum for discussion and reconciliation was held in Lwemba with partners and civil society to dispel mistrust and enhance engagement in future response activities. Improved access may result in enhanced case finding and an increase in the number of reported cases from the area. 

In the 21 days from 16 September to 6 October, 28 health areas in 11 health zones reported new cases. During this period, a total of 73 confirmed cases were reported, with the majority coming from the health zones of Mambasa (30%; n=22 cases), and Mandima (23%; n=17 cases). In the past 21 days, 10 cases were reported from Komanda and Oicha Health Zones with links to cases from Beni and Mambasa health zones. Issues with under reporting are possible in the Oicha Health Zone, as poor access and security constraints limit response activities. The occurrence of transmission along a major road in from Komanda and Mambasa also poses greater risk of spread westward to other major cities in the Democratic Republic of the Congo (e.g. Kisangani). 

As of 6 October 2019, a total of 3205 EVD cases were reported, including 3091 confirmed and 114 probable cases, of which 2142 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 59% (1796) were female, 30% (909) were children aged less than 18 years, and 5% (162) were healthcare workers. 

As of 4 October 2019, 1000 people have survived EVD in this outbreak. Of the approximately 1555 confirmed cases admitted to Ebola treatment centers, 1000 of them, or nearly two thirds, have survived. The reintegration of survivors into community can create opportunities to discuss their experiences and strengthen the participation of local communities in the response. Many survivors are working within the response, and are an important part of caring for the sick and reaching out to communities. A programme is in place to monitor survivor health and support them in the year after they leave care. 

Under Pillar 1 of the Strategic Response Plan, the estimated funding requirement for all partners for the period July to December 2019 is US$287 million, including US$120-140 million for WHO. As of 8 October 2019, US$60.4 million has been received by WHO, with additional funds committed or pledged. Further resources are needed to fund the response through to December 2019 and into Q1 2020. 

Under Pillar 5 Regional Preparedness, the funding requirement for all partners is US$66 milllion, of which WHO requires US$ 21 million. As of 8 October 2019, WHO has received US$ 1.6 million. While some additional pledges are in the pipeline, increased funding for preparedness in neighbouring countries is urgently needed. WHO is appealing to donors to provide generous support. A summary of funding received by WHO since the start of this outbreak can be found here.

DRC: Ebola response agents threatened by Mai-Mai in Mambasa

Via Radio Okapi: DRC: Ebola response agents threatened by Mai-Mai in Mambasa. The Google translation:

Ebola response agents and their facilities are under heavy threat of Mai-Mai militia attacks in Mambasa territory (Ituri). They have issued leaflets in several places to announce an imminent attack, said Sunday, October 6 the administrator of the territory. The NGO CODEPEF reports that some residents have already left the outlying areas of Mambasa.  

Leaflets were collected from three different locations, in which the militiamen announced their imminent incursion into Mambasa center. According to the administrator of the territory, these armed men even launched telephone messages to blackmail the response team. 

They demand - through these messages - money to organize the funeral of one of their brother who died of Ebola about three weeks ago in Mangina.   

According to the NGO CODEPEF, among the attack targets of these militiamen, there is in particular the Ebola treatment center installed in the general reference hospital of Mambasa, the hotel Pygmies, which hosts the agents of response, and the grouping office, which hosted the response team.  

Panicking, some residents fled to Mambasa center to avoid being victims. Some agents of response are afraid to go on ground.  

The deputy coordinator of the NGO CODEPEF, Laurent Keya, indicates that these threats are taken very seriously, because these militiamen have already attacked Lwemba and Bikatato and done damage: 

"We ourselves have seen these tracts, which announced the attacks of these elements Mai-Mai to the chief town of the territory of Mambasa. Why do they want to come to attack Mambasa? We, the people of Mambasa, accept that organizations come to work here ..."    

The administrator of the Mambasa territory ensures that all steps are taken to secure the population and response activities, "which are proceeding normally. Local sources report that the FARDC has intensified patrols in Mambasa-center.

DRC Ebola: CMRE update, October 6

CMRE has published Situation épidémiologique du 06 Octobre 2019. In addition to zero new cases on October 5, we also learn that the response shutdown in Lwemba seems to have been resolved. Excerpt from the Google translation:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI OCTOBER 05, 2019   

Sunday, October 06, 2019   

Since the beginning of the epidemic, the cumulative number of cases is 3,204, of which 3,090 are confirmed and 114 are probable. In total, there were 2,142 deaths (2028 confirmed and 114 probable) and 1004 people healed. 

• 414 suspected cases under investigation; 

• No new cases confirmed; 

• 1 new confirmed death at CTE in Ituri in Komanda; 

• No one healed out of ETCs; 

• No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths. 

• 19th day without response activities in Lwemba to Mandima health area in Ituri, where dialogue is ongoing in the community.

   

The data presented in this table are subject to change after extensive investigation and after redistribution of cases and deaths in their respective health areas.

NEWS  

Reconciliation between displaced people from Lwemba to Biakato and communities left in Lwemba in Mandima in Ituri   

The Lwemba communities who moved to Biakato in Mandima in Ituri reconciled on Sunday, October 06, 2019 with the communities that remained in Lwemba in the presence of the response team led by the Deputy General Coordinator, Dr. Justus Nsio Mbeta, Chief of Cheffery and the MCZ of Mandima, Coordinator of the Mangina Response Subordinate Coordination, as well as some partners the Ministry of Health, including WHO, MSF, UNICEF and the United Nations; 

- From this meeting, follows the following recommendations: setting up a community committee to support the response, the local recruitment of sensitizers in the monitoring of community-based surveillance, decontamination and the workforce in the community; burning houses. The Ministry of Health has promised the next supply of drugs to Lwemba; 

- The Deputy General Coordinator for the Ebola Response to the Epidemic, representing the Ministry of Health and the Technical Secretariat of the CMRE, Dr. Justus Nsio Mbeta, took this opportunity to recall the regulatory role of the Ministry Health and the role of each partner involved in the response; 

- For the community victim of the fire, she asks for the guarantee of guarantee of their security, the emergency humanitarian aid, the compensation of their destroyed property and the reconstruction of their burned houses, the commitment or the hiring of all victims in the various services at all levels, the immediate arrest of all the alleged perpetrators of these uncivil acts and the care of the children affected; - These fires occurred following the death of a nurse from Lwemba, confirmed with Ebola Virus Disease. His death sparked the uprising of the population to burn down the houses and other property of all the unknowns of Lwemba. This remains the cause, even, the cessation of the activities of the response in this Health Area for more than 15 days; 

- The leaders of the Lwemba community also asked for the construction of the houses for the displaced, the organization of an intercommunal dialogue session by the Administrator of the territory or his delegate and the rehabilitation of the road to Lwemba ; 

- In the response, WHO is responsible for epidemiological surveillance, communication and prevention against infection (IPC) and immunization, UNICEF is in charge of communication, psychosocial care and PCI, MSF and ALIMA take care of the treatment of patients in the Ebola treatment center and the PCI and psychosocial support within CTE, WFP brings food products to contacts, IOM takes care of Entry and Control Points (water supply, soap and chlorine); 

- As for the National Institute for Biomedical Research (INRB), Dr. Nsio stated that he is in charge of the diagnosis and gives MSF and ALIMA the medicines to treat patients with CTE. 

- The World Health Organization has pledged to rebuild houses burned, to provide community surveillance (community watch) and investigations of all suspected cases, as well as to build a transit center in Lwemba, while UNICEF has pledged to improve communication and awareness through the use of space, to support ICH, decontamination and psychosocial, to provide water sources and to build latrines in 5 priority schools; 

- On the other hand, Médecins Sans Frontières intends to help the community of Lwemba to resume primary health care, to organize triage in the Health Zones present in the village and to break the PCI, as well as to train sensitizers; 

- At the end of this Lwemba meeting, all partners, including WHO, UNICEF and MSF, met around the Deputy General Coordinator at the Biakato Reference Health Center to review the joint and shared planning of activities in Lwemba.

VACCINATION

- Since vaccination began on August 8, 2018, 234,108 people have been vaccinated;

- The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS

- Three high-risk contacts were intercepted on Saturday 05 October 2019 at Maboya Checkpoint (PoC) in Butembo. They are all from the same family and came from the Kabasha Health Area to Kalunguta for Bunyuka in Vuhovi;

- They are all contacts of a confirmed case, died of the Ebola Virus Disease (EVD) of September 30, 2019 in Kabasha;

- The 1st contact is a little girl of 8 years old, unvaccinated who presented fever at 38 ° C. She was taken to the CTE of Butembo for the care after validation of the alert was validated;

- The 2nd contact is a 24 year old man vaccinated and asymptomatic. This is the biological father of the 1st contact;

- The 3rd contact, grandmother of the 1st contact, 54, unvaccinated and asymptomatic;

- Since the beginning of the epidemic, the cumulative number of travelers checked (temperature measurement ) at the sanitary control points is 102,840,774 ;

- To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

Fomeka-Beni mental health center: More than 60 patients in a space designed for 23 people

Via Radio Moto Butembo-Beni, a reminder that not all Ebola casualties actually contract the disease: FOMEKA-BENI mental health center: more than 60 patients in a space designed for 23 people. The Google translation:

Built for a capacity of 23 patients, the Psycho-Clinical and Pastoral University Center FOMEKA-Beni currently has about sixty patients. One room even contains two to three patients for lack of space.  

This concern was presented to Radio Moto Butembo-Beni this Friday, October 4, 2019 by KAMBALE KAHUNDE Jean Louis, psychologist at the FOMEKA-BENI mental health center.  

Monthly, more than 600 people attend this health facility for consultations. Faced with this situation and to save the lives of men, KAMBALE KAHUNDE Jean Louis appealed to the good will to support the psycho-clinical and pastoral center FOMEKA-Beni. 

"I will appeal to anyone of goodwill who listens to me that there is an emergency. Within its means, a partner who may be interested in the war trauma, which may be interested in trauma related to Ebola virus disease in any case it would be nice to try to help a little community," he said. 

Despite the proximity that is observed in this mental health institution because of the lack of space, the psychologist KAMBALE KAHUNDE Jean Louis is pleased that no case of Ebola virus disease has ever been recorded in this center of care since the outbreak of this epidemic in the Beni region. 

"Since the epidemic began, we are meeting the minimum of standard measures. Which means that as I speak, there has never been a case that has been recorded at our center, and that would have come out positive. So, whatever the behavior of our patients, we really try to respect the rules of hygiene," he said.  

It should be noted that some of the mentally ill persons currently in the Fomeka-Beni Mental Health Center have contracted mental illness because of the war in the Beni region. The others became ill after taking drugs.