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716 Days
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716 Days

The long battle to end the DRC’s deadliest Ebola outbreak

Democratic Republic of Congo (DRC)
Written by International Medical Corps

On August 1, 2018, an outbreak of Ebola was declared in the North Kivu and Ituri provinces of the Democratic Republic of the Congo (DRC) that grew to become the second-largest ever—exceeded in size only by the 2014 outbreak in West Africa. It wasn’t until June 25, 2020—and nearly 3,324 cases later, leading to 2,287 deaths—that the outbreak in the east would be officially declared over by the World Health Organization (WHO).

The medical staff, which is enabled to enter the red zone, are getting ready and are putting on their special equipment.
The medical staff, which is enabled to enter the red zone, are getting ready and are putting on their special equipment.
A nurse at the Screening and Referral Unit.
A nurse at the Screening and Referral Unit.

Here, we cover the timeline of our response, look back at landmark moments and meet survivors, volunteers—and the health workers who helped to end the outbreak.

August 2018

“Past Ebola outbreaks in the DRC have been well-controlled within a few weeks. Little did we know that the 10th outbreak in the country would spread so extensively—we have learned to never underestimate an outbreak.”

Dr. Eta Ngole, International Medical Corps, DRC

On August 1, just days after an outbreak in the northwest of the country had officially been declared over, the WHO announces the presence of a cluster of Ebola cases in the North Kivu province of the DRC, an area in the east where conflict is common and widespread. In response, International Medical Corps teams begin Ebola prevention, monitoring and surveillance activities, drawing on our extensive experience responding to the 2014 West Africa Ebola epidemic, as well as to the outbreak we’d just wrapped up.

“There is the fear that the conflict will somehow affect our ability to respond to the outbreak.”

Dr Joseph Fair, a virologist and outbreak response specialist with International Medical Corps, speaking to NPR about how conflict in the area of the outbreak could hamper response efforts.

September 2018

The Ebola Treatment Center in Makeke in the Ituri province built by International Medical Corps.

“No one should be sleeping well tonight around the world.”

Peter Salama, then Emergency Response Chief for the WHO, speaking about a confirmed case of Ebola in Butembo, home to an estimated 1 million people.

Our response continues to expand, as we train frontline health workers in 15 health facilities and open an Ebola Treatment Center (ETC) in Makeke—the sole ETC in Ituri province, where the outbreak has spread.

October 2018

Two health workers are shot and killed by Congolese rebels on the outskirts of Butembo, as case numbers continue to rise amid an unstable climate.

Beni, in North Kivu province, becomes the new epicenter of the outbreak, with more than 100 new cases recorded.

November 2018

December 2018

“Many times, we felt like the outbreak would never end. In December, when the ETCs almost had to close due to attacks, we asked ourselves, “will it ever end?”

Dr. Eta Ngole, International Medical Corps, DRC

January 2019

We start 2019 with great news from our ETC in Mangina, in North Kivu province.

There’s more good news three weeks later, when Sylvie, Ezechiel and Solange are discharged from our ETC.

Sylvie, Ezechiel and Solange are cured and discharged from our ETC.

But overall case numbers continue to rise.

February 2019

Our screening and referral units (SRUs) have now screened more than 600,000 people for the virus.

March 2019

April 2019

The DRC’s Ebola outbreak is spreading at its fastest rate yet, eight months after it was first detected, the WHO said on Monday.

Reuters

As the outbreak continues to escalate, so too does our response. We’ve now constructed 43 screening and referral units (SRUs), trained 1,350 healthcare workers in infection prevention and control (IPC) measures and conducted more than 880,000 screenings for the virus.

And in better news still, our ETC cures its ninth patient.

The 9th cured patient at the Mangina ETC.

May 2019

Global news outlets start covering the outbreak as confirmed cases pass the 1,500 mark.

June 2019

“Health workers are afraid to wear protective equipment because they fear they will be targeted by armed groups, the World Health Organization has said.”

The Guardian

Conflict continues to hamper response efforts, as confirmed cases pass 2,000. A case is confirmed in neighboring Uganda, prompting fears of the outbreak spreading there.

But we still have hope.

July 2019

July starts positively, as the number of patients we have cured at our ETC passes 100.

And there’s more reason for positivity, as more patients are discharged.

But momentum is lost when a case is confirmed in the city of Goma, the capital of North Kivu, home to 2 million people and an important trading hub between the DRC and Rwanda.

On July 17, the WHO declares the Ebola outbreak a global health emergency: “Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders—coming from not just WHO but also the government, partners and communities—to shoulder more of the burden.”

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General

As we approach the one-year anniversary of the deadly outbreak, we get good news from our ETC: seven more patients, including a five-month-old, have been cured!

Nine more people cured of Ebola from the Mangina ETC.

“Every day was a memorable moment—especially those when a patient was discharged from the ETC, and every day as our teams stayed safe despite working in communities where conflict is common and the risk of contamination with Ebola is high.”

Dr. Eta Ngole, International Medical Corps, DRC

August 2019

We pass two landmarks in our response, curing 150 people at our ETC and providing more than 1 million screenings at our SRU’s.

We also play a role in the research trial that discovers two drugs that help lower the mortality rate of the deadly virus: “Two new Ebola treatments are proving so effective they are being offered to all patients.”

CNN

But the progress comes too late for many, as the grim milestone of 2,000 deaths due to the virus is passed.

September 2019

October 2019

In response to a case of Ebola being reported in a town near the South Sudan border, we start Ebola awareness-raising activities in South Sudan, using dance and radio shows to engage with community members.

Ebola awareness in South Sudan community.

United Nations Secretary-General Antonio Guterres and WHO Director-General Dr. Tedros Adhanom Ghebreyesus visit our Mangina ETC.

United Nations Secretary-General Antonio Guterres visits Mangina ETC.

And great news follows just days later, when the 1,000th survivor of the outbreak leaves our ETC.

November 2019

Constance Kavira is cured of Ebola after catching it from her work as a nurse.

Nurse Constance Kavira is cured of Ebola.

December 2019

We’re featured in a PBS account of the realities of fighting Ebola in a conflict zone.

February 2020

February starts positively with a successful trial by our Ebola research team.

And the reunification of Tresor with his family.

March 2020

We build 23 new SRUs along the DRC’s eastern border.

Dr. Eta Mbong gets his temperature checked on the Beni-Mangina road.

"As surveillance, funding from donors, vaccination and getting the community engagement with prevention measures increased, the case numbers started to decrease."

Dr.Eta Ngole, International Medical Corps, DRC

April 2020

June 2020

Health officials in the DRC are alarmed in early June, as four people die from Ebola in Équateur Province, about 750 miles away from the ongoing outbreak in the east.

But there is good news toward the end of June, as the eastern outbreak is officially declared over by the DRC Ministry of Health and WHO.

“The feeling was like, yes, at last, it’s over. But it also brought back memories of patients who had lost their lives to the outbreak, as well as their families. It made us think of colleagues who had lost their lives on the frontlines, that they had not done so in vain.”

Dr. Eta Ngole, International Medical Corps, DRC

The 716-day battle against the DRC’s deadliest Ebola outbreak would not have been won without the tireless work and sacrifices of everyone involved in the response. A special mention must, however, be given to community health workers like Masika and Mayongezo, who helped to build trust within communities and fought potentially life-threatening rumors by sharing important health messages with their communities. Simply put, community health workers were—and continue to be—an indispensable part of any outbreak response.

Masika and her daughter in Ngoyo. Masika learned infection protection and control from International Medical Corps, and says her children fall ill far less often as a result.
Masika and her daughter in Ngoyo. Masika learned infection protection and control from International Medical Corps, and says her children fall ill far less often as a result.
Mayongezo, a Ngoyo community member, expresses gratitude for the health education he received on how to prevent Ebola and COVID-19.
Mayongezo, a Ngoyo community member, expresses gratitude for the health education he received on how to prevent Ebola and COVID-19.

A special mention must also be given to the health workers who braved not only a deadly disease but often an environment vulnerable to conflict erupting at any minute. Despite the risks and level of vigilance needed to maintain a response of this kind, their commitment to the cause never wavered.

North Kivu and Iruri provinces in the Democratic Republic of the Congo.

“The west is relatively safe, meaning the chances of the outbreak being controlled earlier are higher. However, funding fatigue, the spread of COVID-19 and other competing needs keep us cautious on how soon this will happen. The people of the DRC still need your support to overcome all these so they can dream of better lives.”

Dr. Eta Ngole, International Medical Corps, DRC

While Dr. Eta can deservedly celebrate the end of the eastern outbreak, our attention is now firmly on the burgeoning outbreak in Mbandaka.

But we already know one thing for sure—together, we can stop Ebola.

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