US News: Here’s why Ebola has been so hard to contain in Eastern Congo - PressFrom - United Kingdom
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US NewsHere’s why Ebola has been so hard to contain in Eastern Congo

03:20  26 june  2019
03:20  26 june  2019 Source:   washingtonpost.com

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Why has the current Congolese outbreak been so challenging for the government and other stakeholders to contain ? Most reports focus on insecurity in eastern Congo . Analysts have observed a spike in Ebola cases coinciding with organized attacks by armed groups on response teams.

The organization has said that the most recent Ebola outbreak remained contained to eastern One out of four people interviewed in eastern Congo a month after the outbreak began wrongly believed Some wondered why money was being poured into fighting Ebola when many more people were

Here’s why Ebola has been so hard to contain in Eastern Congo © Ronald Kabuubi/AP Workers wearing protective clothing bury Agnes Mbambu, who died of Ebola. The 50-year-old grandmother of a 5-year-old boy who became Ebola's first cross-border victim, lived in the village of Karambi, near the border with Congo, in western Uganda.

Public health authorities have recorded more than 2,000 cases in the ongoing Ebola outbreak in eastern Congo. Last week, a 5-year-old boy died of Ebola in neighboring Uganda, signifying the outbreak has spread across the border. The latest update published by the World Health Organization (WHO) suggests the Congolese outbreak is not close to ending — the number of new cases is actually on the rise.

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Ebola has been reported in a number of locations in eastern Democratic Republic of the Congo , making the current outbreak Nancy Aossey of International Medical Corps speaks with Nick Schifrin about prevention, treatment options and why the health crisis is likely to get worse before it gets better.

Why is it spreading even though there' s a vaccine? The history of conflict in the DRC has lead to a There have been repeated attacks on health workers and facilities, slowing down vaccination Among them is widespread resistance to the idea that Ebola exists, a conspiracy fuelled by some political

This is the second-deadliest Ebola outbreak on record. In the 2014-2016 Ebola epidemic in West Africa, health authorities recorded more than 28,000 cases, and more than 11,000 people died.

Why has the current Congolese outbreak been so challenging for the government and other stakeholders to contain? Most reports focus on insecurity in eastern Congo. Analysts have observed a spike in Ebola cases coinciding with organized attacks by armed groups on response teams.

Video: Why Ebola is continuing to spread in the Congo (Reuters)

But insecurity isn’t the only challenge hampering Ebola response. Recently published research drawing on data collected in the two deadliest outbreaks suggests one other major factor hampering response: citizen mistrust of government. Here’s what you need to know.

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An escalating Ebola epidemic in conflict-wracked eastern DR Congo has surpassed the 2,000 cases mark, two-thirds of which have been fatal, according to government figures. Since August last year, there have been 2,008 confirmed and probable cases with a death toll of 1,346

The Ebola outbreak in DR Congo has spread from the countryside into a city, prompting fears that the disease will be increasingly hard to control. Ebola is a serious infectious illness that causes internal bleeding and often proves fatal. It can spread rapidly through contact with small amounts of bodily

Ebola in Congo, 2018-2019

Ebola is a viral disease that infects immune system cells. Early symptoms resemble the flu or malaria. Ebola can be gruesome — potentially resulting in internal or external bleeding, organ failure — and often death.

Congolese health officials officially announced the current Ebola outbreak in August 2018. As of June 16, there are 2,168 confirmed and probable Ebola cases, and 1,449 reported deaths.

Gallery: As cases pass 2,000, key facts about Congo's Ebola epidemic (Reuters)

The region in which the Ebola outbreak is occurring is small, comprising a few territoires  (counties) in the far north of North Kivu and several territoires in Ituri province. However, these are some of the most insecure areas in Congo, where up to 175 armed groups are active.

The government has little meaningful control of its territory, especially outside major cities. Citizens have experienced conflict since the First Congo War began in 1996, and while there are periods of calm from time to time, violence is an unfortunate fact of life for many residents of the outbreak zone.

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Four people have tested positive for Ebola in eastern Democratic Republic of Congo just days after another outbreak that killed 33 people in the northwest was declared over, the health ministry said on They head to a region where deep security problems could complicate efforts to contain the virus.

Editor’ s Note (8/6/18): Although the country’ s ninth Ebola outbreak was ultimately contained , a week after that outbreak was declared over evidence of a new Ebola emergency was reported elsewhere in the country.

This makes Congo’s Ebola crisis different from previous outbreaks, dating back to 1976. While the Congolese have effectively contained previous outbreaks, those occurred in other, much more secure regions of the country. Likewise, the 2014 West Africa outbreak occurred in countries that were stable and fully under government control.

Insecurity hampers health-care logistics

Why does this matter? For one thing, insecurity makes delivering medical care and other forms of assistance much more difficult. Armed groups and civilians have attacked health-care workers and facilities responding to the Ebola crisis. The logistics of getting needed supplies to the region, from vaccines to protective equipment, are extremely challenging. And reaching communities that may be affected, but are located in areas controlled by or beyond rebel lines, can be nearly impossible even for the bravest of health professionals.

Here’s why Ebola has been so hard to contain in Eastern Congo © Provided by Thomson Reuters, LLC The world's worst epidemic of Ebola, a hemorrhagic fever, began in Guinea in December 2013 and swept through Liberia and Sierra Leone, killing more than 11,300 people by 2016. Pictured: A grave digger prepares new graves for Ebola victims at a cemetery in Freetown, Sierra Leone December 21, 2014. REUTERS/Baz Ratner

While the outbreak continues unabated, the WHO declined to declare a public health emergency of international concern (PHEIC), even after cases emerged last week in Uganda.

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Congo has experienced 10 Ebola outbreaks since the virus was discovered on the Ebola River in 1976, altogether killing some 900 people. In another worrying development, angry youths burned down a health center in the village of Manbangu where vaccinations were underway

But this time, heading east , to the Democratic Republic of Congo . Where health officials have confirmed the outbreak after taking So, what can be done to contain this latest outbreak of Ebola ? Presenter: Dareen Abughaida. Inside Story - Why are so many journalists being killed in Mexico?

One organization supporting the Ebola response in eastern Congo is Doctors Without Borders (known by its French initials — MSF — for Médecins Sans Frontières), a humanitarian organization that provides medical care in emergency situations, including in conflict zones. While MSF’s own staff members have faced violence from armed groups, they also pointed to community mistrust as a serious obstacle to their Ebola response efforts.

What the research says about mistrust and Ebola response

A leading health journal, the Lancet Infectious Diseases, recently published an important research article studying how Congolese citizens are navigating the current Ebola outbreak. Surveying a random sample of 961 adults living in Beni and Butembo — cities in eastern Congo affected by the outbreak — the researchers found evidence of how citizens’ mistrust shapes how they respond to the epidemic.

Less than a third of the study participants trusted that local authorities represent their interests (according to the study, citizen trust is even lower as you move up levels of governance). A quarter of the study participants believed that the Ebola outbreak was not real. Study participants with low institutional trust and belief in misinformation had a decreased likelihood of adopting behaviors that would prevent Ebola infection, including acceptance of Ebola vaccines.

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There has never been an outbreak of Ebola in West Africa. Hence, the medical workers were not familiar with what was happening when it initially broke The argument is not identical, already there have been some major changes. First, drugs that are in the testing stages for Ebola have been used

WHO officials say they are pleased with the progress being made in limiting the spread of the Ebola virus, but that the outbreak of this fatal disease in Congo ’ s conflict-ridden North Kivu and Ituri Among the challenges is a growing resistance in some communities to measures used to contain the virus.

Gallery: The deadly consequences of Ebola (StarsInsider)

These findings are consistent with research that a team of political scientists including MIT’s Lily Tsai found during the West African Ebola outbreak. In their study conducted during the Ebola outbreak in Monrovia, Liberia, they found that Liberians who distrusted government took fewer precautions against Ebola. Those who distrusted government were also less compliant with Ebola control policies.

The research is consistent with what Ebola responders are reporting

These studies are consistent with MSF concerns that community mistrust keeps health workers from containing the outbreak. Earlier this year, two MSF-run Ebola treatment centers were targets of arson attacks. MSF’s International President Joanne Liu remarked on how so many new Ebola cases involved people who died in the community, not in treatment centers. She said, “That means that we have not reached them, and they have not sought our care.”

It’s not surprising that people in eastern Congo might not trust political leaders in this crisis. Their communities have been subject to conflict and violence for more than 20 years, and people long ago learned that they could not depend on government to protect them. The promises of NGOs and foreign aid workers have likewise often been unreliable over time.

Here’s why Ebola has been so hard to contain in Eastern Congo © Provided by Thomson Reuters, LLC Ebola causes fever, flu-like pains, bleeding, vomiting and diarrhea and spreads among humans through contact with bodily fluids of an infected person. Pictured: Some of the ultrastructural morphology displayed by an Ebola virus virion is in a colorized transmission electron micrograph (TEM) obtained by Reuters August 1, 2014. Frederick Murphy/CDC/Handout via Reuters

What would begin to build trust in this crisis situation? Research by one of us (Laura Seay) suggests that working closely with local religious organizations is one potential avenue. Churches and mosques were the only institutions to survive the violence in many areas of eastern Congo, and most people have high levels of trust in community-based Catholic, Protestant and Muslim leaders.

Closely coordinating messaging with religious leaders about the symptoms, the need to go to health facilities for treatment, and changes to burial rituals may be the only avenue to build needed trust in the short time required to stem the outbreak.

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'We know better than this': As Ebola outbreak rages, the world just watches.
The Ebola outbreak raging through Congo has sickened thousands of people and killed more than 1,500 - and the number of new victims continues to climb. The situation is dire, but it’s hardly unprecedented. Less than five years ago, an epidemic in West Africa killed more than 11,000 people, shattering communities, destroying economies and leaving a generation of orphans behind. When it was over, world leaders took a solemn vow: never again. Health officials studied the failures of their sluggish and haphazard response so they would recognize the warning signs of a crisis not to be ignored. That crisis is now here.

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