By Alpha Bedoh Kamara
On August 1st, 2018, the pronouncement by the Government of the Democratic Republic of the Congo (DRC) that preliminary laboratory results indicate a cluster of cases of Ebola virus in North Kivu province, after the Ministry of Health declared the end of an outbreak in Equateur Province in the far western part of the country, some 2500 km from North Kivu, shows how complex the virus has become.
In West Africa, the Mano River Union which comprises of Sierra Leone, Liberia, and Guinea, was devastated by the Ebola crises throughout 2013 -2016, causing thousands of deaths and destabilizing the economies of the three nations, as well as threatening neighbouring West African countries.
The West African outbreak was the most widespread outbreak of the Ebola virus disease (EVD) in history and as the recent development in the DRC is being monitored lessons learnt from West Africa should be taken into consideration and measures taken to control and stop the spread of the virus in the country.
- Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
- The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
- The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.
- The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests. The 2014–2016 outbreak in West Africa involved major urban areas as well as rural ones.
- Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials and social mobilisation.
- Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development. – Source WHO
Africa is unique, culturally diverse with various traditional practices that may play greater roles in creating the enabling environment for viral diseases, such as Ebola. And until measures are taken to address the causative factors, such as understanding the cultural practices and beliefs of the people, their response to mainstream information and access to public health facilities, it will be hard to contain the disease.
While efforts are being made to understand the nature of the disease, there is no specific medical treatment for Ebola hemorrhagic fever according to the CDC. But nations could bring their people together and fight against the disease by engaging the various publics using the various communication platforms and providing timely healthcare response for suspected cases.
In West Africa, the international community, the WHO, and the health ministries of the affected countries realized that the crises were beyond clinical response and therefore need for novelty approach in fighting a faceless killer. Hundreds of people were dying every day, including healthcare practitioners. Everyone was in panic and the hospitals were ghost domains.
With international consensus, the governments had to take the bull by the horns by implementing radical actions to temporarily stopping all cultural, traditional, and spiritual practices that may cause the spread of the virus. Of course it was a high hill to climb, but the benefit started showing as cases dropped and hopes renewed.
What we learned from the West African crises is that implementation of the rule of law in fighting diseases is very vital for successful public health intervention. The government administration alone will find it challenging in a continent where majority of the people look up to their traditional and spiritual leaders. Lack of trust for public officers and the government, poverty, illiteracy, poor or lack of standard healthcare, among other challenging factors, all work against national programs aimed at saving lives.
Therefore, for the WHO and governments to be successful in containing diseases outbreaks, people in local communities such as traditional headmen and spiritual heads should be taken on-board to discuss such issues to engage the grassroots.
Perhaps, the approach is being applied in the DRC; but the recent pronouncement indicates there was a gap in communication as to the nature of the prevalence of the disease in North Kivu province, and it’s worrisome.
But as the situation is being monitored it is prudent that everyone major stakeholder is taken on board in fighting the disease, not only public health experts and healthcare practitioners.