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Winning the hearts of communities fearful of Ebola

Goma, Democratic Republic of the Congo, 24 June 2019 – “You cant take my son away because I know you..

Goma, Democratic Republic of the Congo, 24 June 2019 – “You cant take my son away because I know you will go kill him. You will inject him with Ebola. Thats what everybody here knows.”

This response from an angry father, faced with the possibility that his son would be moved from a local hospital to an Ebola Treatment Centre, reflects the reality of containing an epidemic in an area where folklore, rumour and suspicion of outsiders abound.

For Dr. Ramses Kalumbi, Surveillance Team Leader for the World Health Organization (WHO) in Goma, reassuring his patients and their families is all in a days work. Empathy, patience and compassion are a vital part of the treatment offered by his team of doctors, psychologists and health workers.

The Ebola-affected city of Butembo, where the 27-year-old man has been working as a driver, is 350km away – an eight-hour journey by road. He had returned home to visit his family when he started to feel unwell.

Initial symptoms indicated malaria but his high fever and diarrhoea have rung alarm bells, and now he is terrified. So far, the tiered system of surveillance set up by the government and WHO have kept the disease out of Goma, but nobody can afford to take any chances.

His case came to the attention of a surveillance team combing health facilities and neighbourhoods to identify patients with symptoms that might indicate Ebola infection.

Such cases are quickly sent to the alert centre which deploys investigators to assess the patient and decide whether to authorise a transfer to the nearest Ebola Treatment Centre for blood tests. If the test returns positive, the patient is isolated for treatment and if negative the patient is returned to the initial health facility or to their family to continue previous treatment.

Coupled with distrust of health workers is a belief among many people in Goma that Ebola does not exist.

“They do not have family members in the regions affected by the disease. They are people who have not travelled to see the devastation,” says Bahati Sabimana Faustin, a traditional healer who works in the Bujavu area of Goma.

Support from traditional healers like Faustin who have had training in how to recognise Ebola symptoms play an important role in containing the disease and in encouraging the community to take precautions.

“If a patient comes to me with high temperature, vomiting, diarrhoea or bleeding, I receive them, put them in a separate room and contact the alert centre for further investigation,” Faustin explains. So far he has referred two patients but both were found not to be suffering from Ebola.

“There are many people who do not believe Ebola is real but after getting the right information, they often change their minds. I tell them that Ebola exists. I am certain it is there. Ebola is real,” he says.

Back in the primary health facility, Dr Kalumbi and a psychologist from the ministry are engaging with the family in an attempt to reassure them that their son will be safe.

“Look at me baba. Look at me. I am one of you,” Dr Kalumbi says, looking in the eyes of the angry father. “I will take care of your son. My promise to you is that no one will hurt him.”

“Look at my son, he is healthy except that he has malaria,” the father replied. “I hear all the time that you take healthy people like him and inject them with Ebola. My son will not leave this hospital. You can take his blood and do the test but you will not take him away.”

The conversation between the father and Dr. Kalumbi went back and forth, with each fear and rumour being met with calm responses from the medical team. Gradually the tension subsided.

“We care about your son and that is why we will take him to the treatment centre,” Dr Kalumbi says. “It will be a protection for him and all of you, if he truly has Ebola.”

Moments later the father agreed, on condition that he could accompany his son as the Ebola tests were administered.

As they arrived at the centre, Dr. Kalumbi received a phone call. It was from the young mans mother who pleaded with him: “Please do not inject my son with Ebola. His life is in your hands.”

She was met with the same calm, reassuring response that no one injects patients with Ebola, it is just a disease that needs to be attended to immediately.

In this case the results were good. The young man was Ebola free and was returned to his family.

As importantly, the trust that was built up between Dr. Kalumbi and the family chips away at the fears and the disinformation that he and hundreds of his colleagues face as they hit the streets again tomorrow and the following days – scouting, screening patients, tracking and engaging communities in order to stop the spread of the Ebola Virus inside the rest of the country and beyond.

“Nothing terrifies families like the isolation of one of their own for Ebola treatment,” Dr. Kalumbi says. “They fear that they will never return. There is only one way to win their trust and that is through an honest discussion and empathy.”

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A high-level delegation visited Yei River State to intensify Ebola preparedness in Sudan

Juba, 16 July 2019 – On 15 July 2019, a high-level delegation led by Dr Makur Matur Kariom, Undersec..

Juba, 16 July 2019 – On 15 July 2019, a high-level delegation led by Dr Makur Matur Kariom, Undersecretary, Ministry of Health and Mr Alain Noudehou, UN Resident/Humanitarian Coordinator and comprising Ambassadors of donor countries, heads of United Nations (UN) agencies, , and Representatives of international non-governmental organizations visited Yei town.

The objective of the visit was to among others reassure local authorities of the continued support of the development partners and the one UN in South Sudan; secure sustained commitment of the local authorities to the EVD preparedness efforts and publicize in the national press key messages to the general public regarding Ebola preparedness.
South Sudan is one of the four priority one countries (Burundi, Rwanda, South Sudan, Uganda) prioritized by WHO to enhance preparedness and operational readiness based on the proximity to the outbreak area as well as the capacity to manage Ebola virus disease (EVD) outbreaks in the Democratic Republic of Congo (DRC).

The risk of transmission of EVD into countries that share borders with DRC, including South Sudan, has been classified as “very high” by WHO. Cases of EVD have recently been confirmed in Uganda, Goma and in Ariwara, a town in DRC located just 70km from the border with South Sudan.

“Diseases such as Ebola dont respect boundaries, race or religion so all must ensure that they work together to prevent its cross border transmission into South Sudan”, said Mr Noudehou. He also reiterated the commitment of the UN to continue to support EVD preparedness in the country under the leadership of WHO.

As a priority one country for EVD preparedness, the Ministry of Health, National Task Force, WHO and partners are implementing the National EVD Preparedness Plan, including vaccinating front-line health workers, educating people about prevention and response measures, conducting screening at multiple locations to help with early detection of cases, training personnel in infection prevention and control as well as being preparing for safe and dignified burial processes if needed.

“Although South Sudan has not confirmed any EVD case, implementation of effective public health measures is critical to manage the risk posed by South Sudans complex humanitarian context, the history of previous (EVD) outbreaks, increasing global travel and proximity to DRC”, said Dr Olushayo Olu, WHO Country Representative to South Sudan.

At the end of the visit, the Governor of the state, the state Health Ministry and partners on the ground reiterated their commitment to intensify key interventions and increase public awareness by providing adequate information through all communication channels, religious and community leaders.

In his closing remarks, the Undersecretary, Dr Makur appreciated WHO and other partners for the strong partnership and support rendered to enhance capacities to effectively implement the International Health Regulations (IHR, 2005) and address the threats of EVD and other infectious diseases.

Ebola Virus Disease (EVD) is one of the most fatal and highly infectious diseases known to the world. The on-going outbreak in the Democratic Republic of Congo (DRC) is the second largest outbreak reported globally. As of 13 July 2019, 2 489 confirmed cases and 1 665 deaths have been reported.

WHO is working in Jubek, Gbudue, Tambura, Maridi, Torit, Wau and Yei River states alongside their respective state health ministries and partners to provide strategic public health leadership and support required to ensure that all the high-risk counties are operationally ready and prepared to implement timely and effective EVD risk mitigation, detection, and response measures. (more…)

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As post-cyclone resettlement, 200 000 people lack access to health services in Mozambique

Maputo, 21 June 2019 – 94 health facilities damaged or destroyed by Cyclones Idai and Kenneth remain..

Maputo, 21 June 2019 – 94 health facilities damaged or destroyed by Cyclones Idai and Kenneth remain unsafe and 200 000 people who have been resettled live more than 5 km away from a functioning health facility, according to a recent Post-Disaster Needs Assessment and latest data.

“The ongoing relocation of families to new resettlement areas presents new challenges for access to heath,” said Dr Djamila Cabral, WHO Representative in Mozambique. “At the resettlement sites, there is limited access to essential health care, limited or no access to water and sanitary facilities. The fact that some health facilities remain damaged is a huge risk to health.”

Humanitarian partners continue supporting the population affected by Cyclone Idai in Mozambique shifting gradually from emergency to early recovery interventions. Urgent health priorities include delivery of basic health services for the affected population – especially at resettlement sites – building back better, strengthening surveillance and laboratory capacities.

Build back better with safe hospitals

With 14 per cent of the health infrastructure in the affected provinces damaged, there is an urgent need for construction of health facilities in districts that already had few health facilities and are now hosting resettled families.

Strengthen disease surveillance, response and laboratory capacity

Many communities in resettlement sites have no disease surveillance. There is need for health-facility based, event-based and community-based surveillance and to strengthen the national surveillance system to address acute vulnerability in the coming days and weeks.

There is also need to strengthen laboratory capacities at national and provincial levels and in health facilities to ensure timely processing of specimens.

Delivery of health services to affected population

Resumption of health service delivery is in progress with many challenges. Access to power is disrupting the immunization programmes cold chain; damaged infrastructure is a barrier to service delivery; and the settlement of population far from health facilities is overstretching the already weak health system. (more…)

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One-in-five suffers mental health condition in conflict zones: new UN report

More than one-in-five people living in conflict-affected areas suffers from a mental illness, accord..

More than one-in-five people living in conflict-affected areas suffers from a mental illness, according to a new UN-backed report, prompting the World Health Organization (WHO) to call for increased, sustained investment in mental health services in those zones.

Around 22 per cent of those affected, suffer depression, anxiety or post-traumatic stress disorder, according to an analysis of 129 studies published in The Lancet – a United Kingdom-based peer-reviewed medical journal.

“The new estimates, together with already available practical tools for helping people with mental health conditions in emergencies, add yet more weight to the argument for immediate and sustained investment, so that mental and psychosocial support is made available to all people in need living through conflict and its aftermath,” said study author Mark van Ommeren, who works in WHOs Department of Mental Health and Substance Abuse.

The study also shows that about nine per cent of conflict-affected populations have a moderate to severe mental health condition; substantially higher than the global estimate for these mental health conditions in the general population.

“Depression and anxiety appeared to increase with age in conflict settings, and depression was more common among women than men”, according to the study.

The revised estimates use data from 39 countries published between 1980 and August 2017, categorized cases as mild, moderate or severe. Natural disasters and public health emergencies, such as recent Ebola virus outbreaks in Africa, were not included.

The findings suggested that past studies underestimated the burden of mental health conditions in conflict-affected areas,

showing increased rates of severe, moderate and mild mental health issues, with the latter being the most prevalent.

“I am confident that our study provides the most accurate estimates available today of the prevalence of mental health conditions in areas of conflict”, said lead author of the study Fiona Charlson of the University of Queensland, Australia and the Institute for Health Metrics and Evaluation, in the United States.

In 2016, there were 53 ongoing conflicts in 37 countries, meaning that 12 per cent of the worlds population was living in an active conflict zone – an all-time high. Moreover, the fact that nearly 69 million people globally have been forcibly displaced by violence and conflict, makes it the highest global number since the Second World War. (more…)

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