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May 16, 2023
  • The Ebola virus (EBOV) causes critical and acute illnesses that are quite fatal if it remain untreated for a longer time. The first case of the Ebola viral disease was occurred in the year 1976 with a simultaneous outbreak in two places i.e. Nzara, South Sudan and the Democratic republic of Congo. The disease occurred in Congo near the Ebola river and thus the name was given as Ebola virus. It was considered that the outbreak in Western Africa from 2014 to 2016 was the most complex and the largest outbreak since the discovery of Ebola virus. There were high death case reported and most of them were fatal as compare to other outbreaks (Barry et al., 2018). The viral families Filorviridae have three genres called as Ebolavirus, Cuevavirus and Marburgviru. There was identification of five different species under the Ebola virus as well. The virus that caused the outbreak in West Africa was belonging to Zaire ebolavirus species.

    Recently, the democratic republic of Congo suffered their tenth Ebola virus outbreak in 40 years and it was started on 1st August 2018. The outbreak was declared in the Equateur province and it has still reported not to be contained. There are more than 50 members in Ebola response team and they are working in critical conditions because the place lacks proper roads, misinformation within the local community members regarding the disease and the risk associated with people who are infected and are yet to be treated (Kelly et al., 2018). There are two treatment centers established one with 40 beds and the other one with 10 beds. Based on the information given by the healthcare authorities, more than 70 cases have been reported out of which there 41 deaths are already reported. There are more than 40 admission registered for the Ebola treatment. Out of 20 confirmed cases from the testing laboratory, 12 people already dead and only 7 people were able to cope up with the infection and now are fine. Reports suggest that there are no intervention or cure for this virus, however, with a proper care to the patient, the human body has the ability to develop immune response and kill the viruses. It is always suggested that more sooner the treatment is given, there are more better chance of getting it healed. Because of this, it is sparingly important for the infected people to seek treatment as early as the symptoms started appearing (Kelly et al., 2018).

    Challenges in Fighting Ebola

    One of the major challenges in the context of fighting against Ebola is raising awareness among the people regarding intervention. In the places like Equateur and North Kivu, there are several superstitions and misconception regarding Ebola and things that happens in the healthcare centre. The local practices and their perspective often clashes with the safety precaution suggested by the national authorities. The population residing in Congo has a high degree of resistance towards the healthcare messages communicated to them. It is the reason because of which the actors involved in spreading the awareness about Ebola need to have more active participation and hence sensitization of the population. They are required to disseminate the preventive measures and requirement of early detection of cases in order to get a proper treatment intervention as well (Shoemaker et al., 2018).  The surveillance activities are also enhanced during the outbreak at Equateur where the team was looking for the patient having signs and symptoms of Ebola infection and hence providing intervention as quickly as they can. The MSF was not responsible for these activities but they were actively participated with the health ministry and the WHO to make sure a proper surveillance system can be made. There were significant level of logistic constraint because of the under developed condition of the community and hence it was complicating the situation more. The current impossibility of measuring the outbreak was still questionable with the technology in 21st century. The ministry of DRC was leading the response to the outbreak with the help of the WHO. The team was sent to North Kivu and Equateur province to inspect the number of cases. The emergency pool of the WHO was also mobilized in these areas as soon as the outbreak was declared. The most critical component of the Ebola response is to be able responding to the new alert as quickly as possible and take a decision on setting up the structures for the intervention to be given. The MSF was consisting of a rapid response team composed of nurses, doctors, experts of water and sanitation, epidemiologist and the health promoters (Mbala-Kingebeni et al, 2018).

    Major Resistance in Fighting against Ebola

    There was significant effort made to overcome the outbreak but the only challenge that not allowing a proper intervention is the resistance of the population to come over the healthcare center and tell the healthcare experts regarding the contacts and the precautions to be taken for safe burials. At the time of intervention, there were activities involved in establishing the treatment center. Things were majorly challenging in Lokolia because the place lack facilities and the healthcare center infrastructure had to be started from the scratch. The team tries their best to promote the hygiene and health, transportation of the infected patient, housing decontamination and preparing the dead bodies for a safe burial. There were counselors who supported the patient and the family members psychologically. Even after having tough conditions, there was 50 tons of material mobilized along with a dozen of more staffs.  The accesses to the area affected were quite difficult and in the middle of forest and bad condition, it is quite inhuman to survive there. The villages in Equateur and North Pivu are highly isolated and significantly limited access to any other places nearby (Meakin et al., 2018).

    As compare to Equateur province, the outbreak also occurred in Noth Kivu province. The number of effected cases was quite high and reaching to 300, it is considered to be one of the largest Ebola outbreaks as compare to others. Based on retrospective investigation, the point when the infection started was back in May 2018 around the similar time when there was a outbreak in Equateur as well.  Reports suggest that there was no connecting link between these two outbreaks. The delayed alert and the late responses can be because of various factor including the surveillance system breakdown, the access and movement are highly limited in these area similar to Equateur. It was also reported that the healthcare workers of these area also began strike in May because of no payments of salaries. It was reported that a person died because of hemorrghagic fever and a family member of the same person was having similar symptoms and reported dead after few days. There was a joint investigation planned on the site with six more suspects came out to be tested positive and hence the outbreak was declared in North Kivu. On August 7 2018, the national laboratory confirmed the outbreak of Zaire virus which is considered to be the deadliest strain of Ebola virus that affected West Africa in 2014- 2016 outbreak. The same virus also found in the cases of Equateur province outbreak in 2018, although the strain was quite different that was affecting the current outbreak (Nkengasong et al., 2018).

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