One year ago today, the Democratic Republic of the Congo (DRC) recorded the first case of Ebola virus disease – its tenth outbreak since 1976. Since then, the Government, UN agencies and health NGOs have battled to contain the deadly virus but cases continue to be reported. The outbreak has added yet another layer to one of the world’s most complex humanitarian crises in which 13 million people – or one in 10 people in need across the world – now require emergency assistance to survive. Yet humanitarian partners have received just 27 per cent of the over $1.6 billion needed to reach the most vulnerable 9.6 million people in DRC this year.
Here we outline five of the biggest challenges facing the DRC and what is being done about them.
A complex battle against the deadly Ebola virus
DR Congo is going through its longest and most complex battle against Ebola. This is the largest Ebola outbreak in the DRC so far with 2,687 total confirmed or probable cases and 1,806 deaths recorded in North Kivu and Ituri provinces as of 29 July.
North Kivu is one of DRC’s most restive provinces. Insecurity, combined with a history of disaffection with national authorities and foreigners are a major hindrance to health response efforts. So far, 198 attacks have been recorded against responders and health facilities, causing seven deaths and 58 injured health workers and patients.
Despite this, the World Health Organization, DRC Ministry of Health, UNICEF and NGOs have made heroic attempts to contain the virus. As well as administering Ebola vaccines to at-risk communities, they are isolating all suspected and confirmed cases so they can get the best possible care; tracking down people they have come into contact with; treating the sick, carrying out safe and dignified burials; and engaging with communities to try to build trust in the Government-led response effort.
So far the disease has been prevented from spreading across the region. But to end the outbreak, partners in the Government-led response urgently need a number of things, including: more progress in gaining the trust and full engagement of the communities affected by the virus; an enabling, safe environment for responders to work and for patients to seek care; and a more united approach in which NGOs and UN partners work to their comparative advantages under the Government’s leadership. They also need the world’s political and financial support: hundreds of millions of US dollars are needed to support every aspect of prevention and response.
Ongoing conflict and mass displacement
Clashes between non-state armed groups, militias and the Congolese armed forces continue, particularly in the Kasais, North Kivu, South Kivu and Tanganyika provinces. Civilians in these areas are at the mercy of repeat attacks, which have led approximately 4.5 million people to be displaced across the country. This displacement causes food insecurity, disrupts children’s education, puts women and minors at risk of sexual violence, and destroys people’s livelihoods, forcing people to rely on humanitarian assistance to survive. Year-round, UN agencies and NGOs are delivering aid to displaced communities, including cash transfers, food aid and emergency education, although they themselves are often victims of the attack.
Measles continues to spread
In June, the DRC Government declared a measles epidemic, with close to 100,000 cases recorded from almost every province. The Health Ministry and the World Health Organization have vaccinated over two million children against measles since the beginning of 2019, and hygiene and sanitation projects are being rolled out throughout the country. However, health and sanitation systems are severely weakened, and poorly equipped to address the outbreak. And continued insecurity, as well as community mistrust, has meant millions of children have not yet been vaccinated.
Cholera hard to contain
Parallel to measles, families across the DRC have been hit hard by water-borne cholera resulting from poor access to clean water. As of mid-July, some 13,700 reported cholera cases and 280 deaths have been recorded this year. WHO, UNICEF, the Ministry of Health and partners are undertaking epidemiological surveillance, prevention programmes including mass vaccination campaigns, risk communication and treatment to try to contain the crisis.
The world’s second-worst hunger crisis
Though DRC has 80 million hectares of fertile, farmable land, decades of conflict continue to have a devastating impact on people’s ability to harvest or access sufficient food, leaving 13 million people food-insecure. The hunger crisis has rapidly deepened in the conflict-ridden Kasai region, where one in four people are at risk of going hungry and infant acute malnutrition rates have reached 14 per cent. Aid agencies run large-scale cash distribution, food relief and infant nutrition programmes, but are chronically under-funded and able only to reach the most vulnerable.
Humanitarian agencies are doing all they can to relieve the suffering. But to scale up, the Humanitarian Response Plan needs to be fully funded.