Ebola preparedness and response
Focus countries: Uganda, South Sudan, Rwanda & Burundi
Challenge
The Democratic Republic of Congo (DRC) is facing a large-scale epidemic of Ebola Virus Disease (EVD) in the Eastern provinces of North-Kivu and Ituri since August 2018 and continues to report 10 to 15 suspected cases per day, including health worker infections as well as community deaths.
The Ebola cases in Uganda have demonstrated that the risk of Ebola spreading beyond the DRC remains very high.
Solution
While response efforts inside DRC need to be redoubled; preparedness efforts in high-risk neighbouring countries are also urgently being stepped-up.
The quick and effective response in Uganda has demonstrated the value of investing in preparedness. The three confirmed cases were rapidly detected and isolated. Uganda benefits from strong Government leadership and extensive experience with Ebola outbreaks and other hemorrhagic diseases, however, without the investments in preparedness made over the past nine months, Ebola could have spread.
While urgent action is required to arrest the DRC outbreak and ensure neighbouring countries are prepared to respond, Ebola may become endemic in the region and cannot be address solely with short-term humanitarian action. Increased advocacy is required with Governments and development partners to put in place longer-term plans and strategies to tackle Ebola in a similar vein to other endemic diseases, such as cholera, and for more sustained multi-year funding streams to mitigate and respond to recurrent outbreaks.
An estimated additional US$80 million is still required to achieve minimal preparedness in the priority countries. In Uganda, vaccinations, expanding preparedness to all priority districts, and ramping-up community engagement, all remain paramount for mitigating the risk. And yet all are under-resourced. Unlike Uganda, the other three priority countries (Rwanda, South Sudan and Burundi) do not have experience in dealing with Ebola outbreaks and thus – with a particular focus on South Sudan and Burundi – require a higher level of international support, including through funding for key preparedness measures.
Operational readiness in each at-risk country requires understanding of the operational environment.
- In Uganda, there are increasing reports of tensions between Congolese refugees and Ugandan host communities that require additional conflict-mitigation measures, including engagement with both communities and Governments.
- In South Sudan, although there is a large humanitarian infrastructure, insecurity as well as limited national capacity remain key concerns.
- In Burundi, progress in undertaking preparedness has been impacted by overarching political dynamics, including between the Government and donor community.
- In Rwanda, there is a need for discussion on the measures that may be taken if the DRC outbreak reaches Goma on a large scale.
What is UNICEF doing in response to the outbreak?
UNICEF works with partners on three broad areas to respond support the overarching goal of ultimately defeating Ebola and getting to zero cases.
- Risk communication and community engagement to inform, protect and engage communities. We work with a broad swathe of influential community and religious leaders, Ebola survivors, psychosocial workers, and mass media, to bring crucial knowledge on symptoms, prevention and treatment, to the households and communities most at-risk. We are learning from continuous research and analysis of community feedback to better understand local needs, fears and concerns, and to adapt the response, to one that is socially and culturally acceptable. We have made changes to the burials process; we are conducting decontamination at night; and we are responding with a lighter footprint. We will keep listening and learning.
- Infection prevention and control to help prevent further spread of the disease. We have installed handwashing units in health facilities, schools and critical transit sites. We distribute supplies, including thermometers and chlorine to treat water. And we’ve enabled people to gain access to safe water.
- Psychosocial support to assist families, particularly children affected by the disease. UNICEF and its partners have trained psychosocial workers to assist children and families directly affected by the disease, and people who are contacts of those who have contracted the disease. We set up child care centers next to the Ebola treatment centers in Beni and Butembo, where Ebola-survivors look after young children who have been separated from their parents due to Ebola treatment, or orphaned.
