Waiting for the all-clear: how medics and villagers rallied when Ebola returned to DRC | Ebola

HHis two-year-old daughter died first, then his mother, then his wife. But Bope Mpona Héritier still had no idea about the illness that took their lives. Then the 25-year-old also started developing symptoms. When his blood was tested and sent to Kinshasa, the capital of the Democratic Republic of Congo, the results confirmed that he had the Ebola virus.

“I felt pain everywhere,” he said. “I had a migraine, severe pain in my eyes and throat, and I was vomiting. I couldn’t eat anything because I had no appetite, so I lost a lot of weight.”

No one in Bulape could have imagined that a deadly virus like Ebola could reach their remote region of Kasai province. But on September 4 this year, the Ministry of Health declared an epidemic there, the 16th in the country. Ten days later, 35 confirmed cases were reported, including 16 deaths, some among health workers. A coordinated effort involving multiple agencies worked around the clock to contain it.

Now, health workers and residents of Bulape hope to be on track to getting the green light. The countdown began on October 19, when the last patient left the hospital. If no new cases are reported within 42 days, the epidemic can be officially declared over in early December.

But getting to this point hasn’t been easy.

Ebola is a rare but serious viral disease that causes fever, weakness and muscle pain, before “wet” symptoms develop such as vomiting, diarrhea and, in many cases, internal and external bleeding.

It is transmitted to humans by wild animals, such as fruit bats and primates, and is spread through the bodily fluids of infected people. It is often fatal if left untreated.

Since the discovery of the virus in 1976, 16 epidemics have occurred in the DRC, according to the US Centers for Disease Control and Prevention (CDC). The most recent large-scale outbreak, the largest in DRC history, occurred in North Kivu and Ituri between 2018 and 2020. It is the second largest global outbreak after that in West Africa between 2014 and 2016, which spread to several countries, infecting more than 28,600 people and killing 11,325 people.

The latest outbreak was complicated by the remoteness of the affected area. “It took some of us four days to reach Bulape from Kinshasa because we had to cross forests,” remembers Chiara Montaldo, coordinator of the medical response in Kasai for Médecins Sans Frontières (MSF). “We had to bring everything from outside, like medicine, materials to build tents, and even water decontamination equipment,” she explains.

Shortly after reaching the affected area, doctors from MSF, the World Health Organization and the DRC Ministry of Health established a 32-bed Ebola treatment center at Bulape General Hospital, where Héritier was admitted.

“By the time we got there, I had passed out, so I didn’t know where I was,” he said. “I received early treatment and was vaccinated. MSF therefore told me that I had a better chance of surviving than many others. »

Bulape’s isolation, while a logistical nightmare, also helped keep the virus local. In contrast, the 2014-2016 outbreak in West Africa quickly spread to three countries.

Montaldo says: “The numbers in this outbreak were of a magnitude that we could not imagine for Ebola. In North Kivu the numbers were also large, but there the main challenge was the conflict. [between armed groups in Ituri and North Kivu].”

Reaching a remote area like Bulape was not the only challenge. Unlike in North Kivu, there was also a serious shortage of human resources.

“One of the problems we faced early on was that there weren’t enough local nurses or doctors trained to deal with an Ebola outbreak,” says Montaldo. “Of course, we come with an international team, but we try to recruit locally. In the end, we managed to put together a team composed mainly of local staff.”

As infection rates continued to rise through early and mid-September, the fight against Ebola became an emotional battle – for health workers and patients – as well as a medical battle.

“In the tent where I was, there were three other patients. I saw them all die one by one,” says Héritier.

Even for epidemic veterans, like Montaldo, the virus’s high mortality rate can sometimes make doctors’ efforts hopeless. “Here we know that even if we treat people in the best possible way, they may still die,” she says.

For survivors, the trauma lingers. “What else did I have to live for?” asks Heir. “I wanted to kill myself, but I didn’t even have the strength to do it.”

MSF provided patients with psychological support – a lifeline for Héritier. “I spoke a lot with a psychologist and he encouraged me to keep fighting. He gave me the belief that I could beat Ebola. He told me: ‘Just because they died doesn’t mean we have to do it.'”

While treating patients who contracted the disease, MSF and its partners on the ground also quickly mobilized to vaccinate more than 35,000 people in the region.

“That’s something we haven’t had in the past, and it’s definitely helped reduce the infection rate,” Montaldo says.

A total of 19 patients infected with the virus have recovered out of 64 confirmed or suspected cases; there have been 45 deaths so far.

Héritier was one of the lucky ones, but returning home was not easy. “A lot of things have changed in my life,” he says. “Some of my friends are too scared to go near me because they think I’ll infect them. I think they’ll eventually forget and things will go back to normal.”

As he prepares to return to work on his farm, Héritier remains hopeful. “People should not be afraid of diseases,” he said. “We need to trust that doctors will help us and not live in fear. I am proof of that.

“I was sick and unable to walk, and yet here I stand. »