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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Burkina Faso: Growing Violence Threatens Health Care
Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, t..
Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, the number of displaced has increased fivefold, from 50,000 last December, to 270,000 in August. As ever, the most vulnerable suffer most: the very young, and the very old.
When Alidou Sawadogos elderly mother fell ill, he faced a long and dangerous journey to get treatment for her.
“When she collapsed, a friend called me,” he explains. “By the time I arrived she was already unconscious. I decided to take her to the health center and luckily someone who had a motorcycle helped me. Because of the violence many people who are sick wait at home and die. Everyone is afraid of taking the road to the health center in Barsalogho.”
Across Burkina Faso, the rising insecurity has forced over a hundred health centers to close, or to limit their work. Half a million people now have little or no access to health care. Dedicated health workers, among them Dr Bertrand Dibli in Barsalogho, are struggling to meet the needs, and to stay safe themselves.
“This is one of the few health centers that isnt closed,” he says. “We dont have enough equipment. And the insecurity has caused huge anxiety among health workers. Even coming here to Barsalogho is a huge challenge because the route is so dangerous.”
The ICRC has been working to support Burkina Fasos health professionals, with medical kits, and vaccination campaigns. During his visit to the country, ICRC President Peter Maurer expressed his concern at the multiple challenges facing Burkina Fasos people.
“We are very concerned,” he said. “Very worried about the upsurge in violence, its a vicious circle that is trapping the civilian population between armed groups.”
“We also see,” Mr Maurer added, “that it is not only the violence that is affecting the country, it is also under development, and climate change. Together with the violence that is obstructing the health services, its an accumulation of factors.”
And so the ICRC – jointly with the Burkinabé Red Cross – is also delivering food to the displaced, and helping to improve access to water supplies. All of this, says nurse Jeanette Kientega, is desperately needed by a population uprooted by conflict, and denied access to basic health care.
“By the time they are able to get here, it is often too late” she says. “Sometimes we can help, but if they have already been ill a long time, it is difficult. We try to do what we can.” (more…)
World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC
WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the G..
WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the Government and other key partners, are working in close partnership on the Ebola Crisis Response in the Democratic Republic of the Congo (DRC). Central to this partnership is the assessment of the financing needs, and deployment of resources, with the goal to put an end to the current deadly outbreak.
The World Bank is today announcing that US$50 million in funding is to be released to WHO for its lifesaving operational work on the frontlines of the outbreak. The WHO is announcing that this US$50 million in funds will close the financing gap for its emergency health response in DRC through to the end of September 2019, and is calling on other partners to mirror this generous support in order to fund the response through to December.
The funding comprises US$30 million from the Pandemic Emergency Financing Facility (PEF) and US$20 million from the World Bank. The US$50 million in grant funding is part of the larger financial package of approximately US$300 million that the World Bank announced last month to support the fourth Strategic Response Plan for the DRC Ebola outbreak.
“WHO is very grateful for the World Banks support, which fills a critical gap in our immediate needs for Ebola response efforts in DRC, and will enable the heroic workers on the frontlines of this fight to continue their lifesaving work,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “We keenly await further funding from other partners to sustain the response through to the end of the year.”
The DRC government, working in collaboration with the World Bank, WHO, and other key partners, has finalized the Fourth Strategic Response Plan (SRP4), which outlines the total resources needed for the DRC Ebola Crisis Response from July to December 2019. The financing announced today is part of the World Banks previously announced financial package of up to US$300 million and covers over half of SRP4s needs, with the remainder requiring additional funding from other donors and partners.
“The World Bank is working closely with WHO, the Government of DRC, and all partners to do everything we can to put an end to the latest Ebola outbreak,” said Annette Dixon, Vice President, Human Development at the World Bank. “The partnership between our organizations and the Government is critical for responding to the emergency as well as rebuilding systems for delivery of basic services and to restoring the trust of communities.”
The Government of DRC requested US$30 million from the PEF Cash Window to be paid directly to WHO. The PEF Steering Body approved the request bringing the PEFs total contribution to fighting Ebola in DRC to US$61.4 million. The PEF is a financing mechanism housed at the World Bank; its Steering Body is co-chaired by the World Bank and WHO, and comprises donor country members from Japan, Germany and Australia. The quick and flexible financing it provides saves lives, by enabling governments and international responders to concentrate on fighting Ebola—not fundraising.
Borno State launches first Malaria Operational Plan, reawakens fight against malaria
Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nige..
Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nigeria, the Malaria Annual Operational Plan (MAOP) was developed and launched on 08 August 2019 with technical support from the World Health Organization (WHO) and partners. Aligned to the National Malaria Strategic Plan (2014 -2020), MAOP was developed through a broad-based stakeholders workshop involving malaria stakeholders, reviewed on different thematic areas and endorsed by the Commissioner for Health and Permanent Secretary, Borno State Ministry of Health.
Speaking during the launch, the Borno state Malaria Programme Manager, Mr Mala Waziri described the MAOP as the first to be endorsed and disseminated in Borno State. “WHO has made us proud by supporting the first ever Malaria Operational Plan right from development, review, printing to dissemination.”
Dr Ibrahim Kida, the Ministerial Secretary Borno State Ministry of Health and Incident Manager of the state, described the launch as “an historic event as stakeholders across the health sector made commitments to use the document as an implementation guide for all malaria programs”. The plan was also described as an advocacy tool for planning domestic funds mobilization.
The MAOP has seven objectives among which are: provide at least 50% of targeted population with appropriate preventive measures by 2020; ensure that all persons with suspected malaria who seek care are tested with Rapid Diagnostic Test (RDT) or microscopy by 2020 and all persons with confirmed malaria seen in private or public health facilities receive prompt treatment with an effective anti-malarial drug by 2020.
The MAOP will further ensure that at least 50% of the population practice appropriate malaria prevention and management by 2020, ensuring timely availability of appropriate anti-malarial medicines and commodities required for prevention, diagnosis and treatment of malaria in Borno State by 2020.
In addition, it seeks to ensure that all health facilities report on key malaria indicators routinely by 2020 and finally strengthen governance and coordination of all stakeholders for effective program implementation towards an A rating by 2020 on a standardized scorecard. These strategic objectives have specific targets and the MAOP takes into account the humanitarian response.
“Malaria remains a leading cause of poor health in Nigeria. According to the 2018 WHO Malaria Report, 53million cases are recorded annually in Nigeria, roughly 1 in 4 persons is infected with malaria contributing 25% of the global burden,” says Dr Nglass Ini Abasi, WHO Malaria Consultant for the North East.
“Furthermore, 81,640 deaths are recorded annually (9 deaths every hour), which accounts for 19% of global malaria deaths (1 in 5 global malaria deaths) and 45% malaria deaths in West Africa. The Nigeria Malaria Strategic Plan (NMSP) 2014-2020 has a goal to reduce malaria burden to pre-elimination levels and bring malaria-related mortality to zero and WHO is working assiduously with Government to ensure the burden is reduced accordingly.”
Results from WHO’s Early Warning, Alert and Response System (EWARS) week 30 report from 223 sites, (including 32 IDP camps) show that malaria was the leading cause of morbidity and mortality accounting for 35% of cases and 46% of reported deaths. In addition, results from the Nigeria Humanitarian Response Strategy (NHRS 2019-2021) indicate 7.1million people are in dire need of healthcare and 6.2million are targeted for immediate attention.
Despite recent improvements, insecurity remains a challenge limiting access to the functional health facilities. Easily preventable and treatable diseases such as malaria, acute respiratory infection and diarrheal diseases account for the greatest proportion of morbidity and mortality among the vulnerable population. Furthermore, Malaria is endemic in North East Nigeria and the transmission is perennial with a marked seasonal peak from July to November every year. (more…)
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