Democratic Republic of The Congo Battling Ebola Outbreaks
How International Medical Corps is helping in the fight against Ebola
The deadly Ebola virus continues to plague countries in Africa. Since 2018, the Democratic Republic of the Congo (DRC) has almost constantly suffered from outbreaks of Ebola virus disease, a hemorrhagic fever with an alarmingly high mortality rate. Given our experience helping to lead the response to the 2014 Ebola outbreak in West Africa, International Medical Corps was called on in April 2018 to help the DRC fight an outbreak in Équateur province, in the country’s west, and has since responded to more.
In early February 2021, new cases of Ebola emerged in North Kivu, on the country’s conflict-ridden eastern edge, dashing hopes that the disease had been eradicated from the country after the previous outbreak, in Équateur, had officially been declared over in November 2020. Our teams, already on the ground, immediately began work with the Ministry of Health to battle the disease.
Though that outbreak was contained in early May 2021, a new outbreak in the same area was announced in early October. International Medical Corps has been asked to support case management for suspect cases at five isolation centres, providing training to clinicians and other healthcare professionals, along with hygiene supplies and equipment—including vital personal protective equipment (PPE).
In addition, an outbreak of Ebola was declared in February 2021 by the World Health Organization (WHO) in Guinea, the first time the disease has been reported in West Africa since the world’s largest outbreak of the disease—which International Medical Corps played a key role in ending—was officially declared over in 2016. We deployed an emergency response team to the country composed of experienced staff who supported response efforts during the West Africa response, specifically in Guinea, Sierra Leone and Liberia, as well as the most recent DRC responses. Though the outbreak was declared over in June, our staff remains in touch with health authorities in Guinea and is ready to respond as appropriate.
Fighting Ebola Across the DRC
When the April 2018 outbreak in Équateur, the country’s ninth, was declared over in July of that year, a resurgence was close behind. On August 1, 2018, a new outbreak was declared in the country’s eastern provinces that would grow to become the second-largest Ebola outbreak ever, exceeded in size only by the 2014 outbreak in West Africa. After almost two years, thanks to the persistence and skill of our staff and other healthcare workers in the region, the end of the outbreak in this region was officially declared over on June 25, 2020.
Celebration was muted, however, at the beginning of June of that year the government had announced a new outbreak—the country’s 11th—back in Équateur province. As with other outbreaks, International Medical Corps deployed a rapid response team to support response efforts by the DRC Ministry of Health and the WHO, and ran Ebola Treatment Centers (ETCs) in the region. We also helped with treatment, infection prevention and control, screening, training and capacity-building. After this outbreak was officially declared over on November 18, 2020, we continued supporting regional health authorities during a 90-day period of heightened surveillance.
When the 10th outbreak in the east was officially declared over, 3,470 cases had been reported (including 3,324 confirmed and 153 probable cases), with 2,287 deaths and 1,171 survivors. Then the DRC’s 11th outbreak was declared over, it had sickened 130 people (119 confirmed and 11 probable) and killed 55, according to DRC Ministry of Health data.
In the beginning of February 2021, another resurgence of the deadly disease, famous for its unpredictability, occurred. Luckily, we were able to draw on previous work to battle this outbreak, the country’s 12th. As part of our efforts to expand local response capacity in the region, we built, opened and operated an ETC in Makeke (now transitioned to a hospital for the community); operated Ebola Transit Centers in Beni and Mambassa; and operated an ETC in Mangina, the initial epicentre of the outbreak. In addition to providing treatment, vaccination and contact tracing during this last outbreak—officially declared over on May 3, 2021—International Medical Corps constructed nearly 100 screening-and-referral units throughout the region.
The country is now dealing with a 13th outbreak, which emerged in North Kivu in early October. International Medical Corps is providing case management services, training, and supplies and equipment to healthcare providers in the region, and remains in close contact with the Ministry of Health, local health officials and the international community to identify any additional support we can provide.
Responding to the Largest Ebola Outbreak in History
International Medical Corps has extensive experience and expertise in stopping the spread of Ebola, having responded in Guinea, Liberia, Sierra Leone, Mali and Guinea-Bissau in the wake of the 2014 West Africa Ebola epidemic, the world’s largest. We served as a key implementation partner for the World Health Organization, fielding a team of more than 1,500 and treating nearly 460 Ebola-positive patients in our five treatment centres. We helped host governments prevent further transmission of the virus, provided critical training to frontline health workers—and, importantly, stayed after the outbreak to continue to build local health systems and provide mental health and psychosocial counselling to those affected by the deadly disease.
We will continue to build on our breadth and depth of experience in DRC, where we’ve provided vital health services since 1999, as we continue to support the Ministry of Health’s efforts to contain the Ebola virus.
In early August 2018, one week after the country’s ninth outbreak was officially declared over, new cases of the Ebola virus were confirmed in the North Kivu and Ituri provinces of the Democratic Republic of the Congo by the DRC’s Ministry of Health. Since then, the outbreak—the country’s 10th—grew to be the second-largest in history, leading to a declaration by the World Health Organization of the outbreak as a Public Health Emergency of International Concern.
After two years, this outbreak was officially declared over, but a new outbreak—the country’s 11th—began to spread near Mbandaka in Équateur province, roughly 750 miles west of the outbreak on the country’s eastern edge. That outbreak was declared over on November 18, 2020.
In early February 2021, a woman sought care for nasal bleeding, leading health workers to obtain blood samples to test for Ebola, given that her husband was an Ebola survivor. Though his samples had tested negative, she was found to be positive for the disease, and later died. A second case emerged several days later in North Kivu province, where both patients had come into contact. this patient has since died. If enough cases occur that a new outbreak is officially declared, this will be the DRC’s 12th.
In early February 2021, a woman sought care for nasal bleeding, leading health workers to obtain blood samples to test for Ebola, given that her husband was an Ebola survivor. Though his samples had tested negative, she was found to be positive for the disease, and later died. A number of cases then emerged in North Kivu province, where the original case was detected, making this outbreak the DRC’s 12th. It was officially declared over on May 3, 2021.
A new outbreak was declared on October 3, 2021, within the Beni health zone of North Kivu province.
What are the potential consequences?
North Kivu province is located in northeastern DRC, along the border with Uganda and Rwanda, increasing the chances that the virus could spread beyond borders. Security issues further complicate efforts to contain the deadly virus, as the provinces have been plagued by ongoing conflict for the last 20 years. Though there were concerns that the outbreak in Équateur province could spread to the neighbouring Republic of the Congo, it was brought under control in less than six months.
How is International Medical Corps responding?
International Medical Corps’ team in the DRC is conducted disease-treatment, surveillance and infection-prevention activities in the provinces, as well as providing training to healthcare staff. International Medical Corps also distributed essential infection-prevention and hygiene supplies to health facilities—including handwashing stations, personal protective equipment (PPE), water basins, liquid soap and jerry cans—to ensure that trained staff have the resources they need to prevent the transmission of disease. We remain in close contact with the Ministry of Health, local health officials and the international community to identify any additional support we can provide. Additional International Medical Corps team members remain on standby in Kinshasa and Mbandaka to deploy as necessary.
Does International Medical Corps have experience with Ebola?
We have extensive experience and expertise in stopping the spread of Ebola, having responded in Guinea, Liberia, Sierra Leone, Mali and Guinea-Bissau in the wake of the 2014 West Africa Ebola epidemic. With a team of more than 1,500 staff, we treated a total of nearly 460 Ebola-positive patients in our five treatment units, helped host governments prevent further transmission of the virus, provided critical training to frontline health workers—and, importantly, stayed after the outbreak to continue to build local health systems as well as provide mental health and psychosocial counselling to those affected by the deadly disease.
- The DRC's most recent outbreak—its 13th—has so far had eight cases confirmed, with three probable cases and six deaths
- There were 12 cases in the DRC's 12th outbreak (11 confirmed and one probable), with six deaths
- There were 23 cases reported in Guinea (16 confirmed and seven probable), with 12 deaths
- We have drilled boreholes across the regions to provide health centres with access to clean water, and rehabilitated waste management systems, including incinerators, sharps pits, burn pits and waste zones.
- We have constructed 95 screening-and-referral units (SRUs), and are preparing to construct more.
- Since 2018, SRUs supported by International Medical Corps have conducted more than 2 million Ebola screenings and 1.2 million COVID screenings; we have trained more than 1,700 health staff in infection prevention and control.