Key facts
- Ebola surveillance teams in Bunia, Democratic Republic of Congo, are struggling with a lack of resources, including insufficient vehicles.
- Challenges include delayed test results, patients refusing testing, and health facilities not reporting suspected cases.
- The specific strain of Ebola circulating, Bundibugyo, is difficult to detect early and has no vaccine or treatment.
- The official death toll from the outbreak is 1,405, with 3,200 infections, but actual numbers may be significantly higher.
- Health workers report payment issues, with some not having received wages since the outbreak began.
Ebola surveillance teams in Bunia, Democratic Republic of Congo, are facing significant logistical and operational challenges as they attempt to contain a surging outbreak. On a typical day, only four cars are available to transport these teams across the city, forcing some, like Dr. Moubarack Kano, to use their personal vehicles. These teams are tasked with tracking infections across an area with 1 million people spread across 23 health districts.
Frontline workers report that crucial information, such as test results, is often delayed, and some patients are refusing to be tested. This makes it difficult for surveillance teams to map the chains of transmission and identify individuals at risk. Dr. Kano noted that the disease is often discovered only after it has already spread, describing the team's efforts as 'just chasing' Ebola.
At one clinic, named 'Jesus is saviour,' records showed several patients diagnosed with typhoid fever, a condition with early symptoms similar to Ebola. The specific strain circulating in Congo, Bundibugyo, is difficult to detect due to its milder early signs and lacks a known vaccine or treatment. Nurses at some facilities were unaware of the Ebola alert system or its contact number.
Further complicating matters, some health facilities are hesitant to issue alerts. This reluctance stems from the risk of losing patients, who might be transferred to other facilities, leading to a loss of income. The cost of phone calls for reporting can also be a barrier for some workers. Even when alerts are raised, a shortage of staff can lead to critical delays in response, as illustrated by a case where a father reported his sick children, who later died before the team could intervene.
In one instance, a mother refused testing for her two children, who were exhibiting fever and pain, because she did not believe they had Ebola. A psychologist was dispatched to speak with the family. Dr. Kano, a veteran of previous Ebola epidemics, stated that the current response is hampered by poor planning, logistical bottlenecks, and the recruitment of inexperienced staff.
Health workers involved in the outbreak have also reported not being paid since the latest epidemic was declared on May 15. While authorities have acknowledged operational difficulties and are working to address payment issues, the challenges on the ground persist. The outbreak has officially infected 3,200 people and caused 1,405 deaths, though the World Health Organization suggests the true figures could be two to four times higher.