Treatment centres assist in Congo's Ebola outbreak but face old hurdles

Woman's recovery is testament to the effectiveness of a new treatment, which isolates patients in futuristic cube-shaped mobile units with transparent walls and gloved access.

90 killed since outbreak started in July

Health workers from the Alliance For International Medical Action (Alima) are seen as they prepare the facility for Ebola patients at the Ebola Treatment Center in the town of Beni in North Kivu province of Congo in August. (Samuel Mambo/Reuters)

When Esperance Nzavaki heard she was cured of Ebola after three weeks of cutting-edge care at a medical centre in eastern Congo, she raised her arms to the sky with joy and praised the Lord.
 
Her recovery is testament to the effectiveness of a new treatment, which isolates patients in futuristic cube-shaped mobile units with transparent walls and gloved access, so health workers no longer need to don cumbersome protective gear.
 
"I started to feel sick, with a fever and pain all over my body. I thought it was typhoid. I took medicine but it didn't work," Nzavaki told Reuters in Beni, a city of several hundred thousand, where officials are racing to contain the virus.
 
"Then an ambulance came and brought me to hospital for Ebola treatment. Now I praise God I'm healed."
 
The fight against Ebola has advanced more in recent years than in any since it was discovered near the Congo River in 1976. When the worst outbreak killed 11,300 people in West Africa in 2013-2016, there was no vaccine and treatment amounted to little more than keeping patients comfortable and hydrated.
 
Now there's an experimental vaccine manufactured by Merck which already this year helped quash an earlier outbreak of this strain of the virus on the other side of the country in under three months. And there are the cube treatment centres, pioneered by the Senegal-based medical charity, ALIMA.

If the population of Beni continues to show this distrust … this disease will consume the whole town.- Alain Mulonda


 
"With this system … where there are not people donning masks, the patients feel reassured and perceive that there is life here," said Claude Mahoudeau, ALIMA's coordinator for the Ebola outbreak in Beni. 

In addition, three experimental treatments have been rolled out for the first time, offering patients additional reason to hope that their diagnosis is not a death sentence.
 
Yet even the smartest science can do little about the marauding rebel groups and widespread fear and mistrust that could yet scupper efforts to contain Congo's tenth outbreak of the deadly hemorrhagic fever.
 
The latest outbreak is so far believed to have killed 90 people since July and infected another 40.
 
The stakes are high, not just for health reasons. Ebola could complicate Congo's first democratic change of power, the holding of a Dec. 23 election to replace President Joseph Kabila that is already two years late.

         
Mistrust a challenge

The affected North Kivu and Ituri provinces have been a tinder box of armed rebellion and ethnic killing since two civil wars in the late 1990s. Some areas near the epicentre require armed escorts to reach because of insecurity. Two South African peacekeepers there were wounded in a rebel ambush last week.
 
And last week, authorities confirmed the first death from Ebola in the major trading hub of Butembo, a city of almost a million people near the border with Uganda, dampening hopes that the virus was being brought under control.
 
On Monday, the World Health Organization (WHO) said more than 60 of its experts had arrived in the city and that a mobile laboratory had started testing samples.


 
Insecurity aside, the biggest challenges the government faces could be panic and downright denial, as they were during the catastrophic West Africa outbreak.

"Ebola does not exist in Beni," resident Tresor Malala said, shaking his head. "For a long time, people got sick with fever, diarrhea, vomiting and they healed. Now someone gets a fever, they get sent to the Ebola treatment centre and then they die."
 
Taxi driver Mosaste Kala was equally skeptical: "The only people dying are the ones going to the ... treatment centre."
 
Tackling these perceptions will be crucial if authorities are to halt the epidemic.
 
At a news conference on Saturday, Health Minister Oly Ilunga Kalenga acknowledged that "community resistance is the first challenge to the response to the epidemic."
 
In the district of Ndindi, in Beni, Ebola is spreading due to the community's reluctance to cooperate with health workers, 
the ministry says. Some locals have hidden sick relatives or refused to be vaccinated.
 
The problem, says school teacher Alain Mulonda, many of whose pupils were being kept at home by anxious parents, is that locals have little understanding of Ebola.
 
"If the population of Beni continues to show this distrust," he said, "this disease will consume the whole town."