GENEVA, 15 July 2019 - On behalf of everyone at UNICEF, thanks to OCHA and WHO for hosting this important discussion.
Yesterday’s confirmed case in Goma makes clear: we are at a pivotal juncture in the response.
As we discuss the situation and plan next steps, let’s remember to consider the “human" impact of the Ebola outbreak and the devastating toll it has on the lives of children.
Thirteen-year old Dieudonné from Mangina lost eight members of his family to Ebola. "They all died of Ebola,” he told us. "It was my entire family. It was first my mum and then my sisters and aunts followed."
Despite his sorrow, Dieudonné is determined to carry on.
He — like so many others — is looking to us. All of us — their communities, national actors, and the global community — for help and support.
Dieudonné is just one of many children and young people directly affected by Ebola. Compared to previous outbreaks, this one affects more children — especially those under five years old. They are disproportionately affected, and they in turn are re-infecting others — women especially.
Preventing infection among children must therefore be at the heart of the Ebola response.
Ebola also affects children in different ways than adults.
For first responders at the community level — including many of the groups and organizations represented here today — this means adapting our responses to the unique physical, psychological and social needs of children and young people.
For example, children who lose a parent due to Ebola or whose parents are infected by the disease are at risk of being stigmatized, isolated or abandoned, in addition to the heartbreak of losing a loved one. They are doubly affected by Ebola.
And so, together with the Government, WHO, OCHA, Medair, IFRC and many other national and international partners, UNICEF staff members are working around the clock to meet the immediate and longer-term needs of the children and families affected.
UNICEF and our implementing partners have 1,200 staff on the ground, along with nearly 2,000 social mobilizers and psychosocial workers contributing to key areas of the response. This includes infection prevention and control, psychosocial and nutrition support, pediatric care, and support for supplies and logistics.
Also, given our longstanding presence and experience within communities, UNICEF is leading on “community engagement.”
This is an essential component of any outbreak response. The trajectory of this Ebola outbreak hinges on deeply personal decisions taken by individual households and communities with no previous experience of this terrifying disease. To defeat Ebola, they require knowledge, skills and resources.
From the start of the outbreak in North Kivu, it was evident that we would face tremendous challenges in this work with communities. We had to walk a very fine line in order to remain neutral in a very politicized environment, particularly during the high-stakes electoral period. This seriously undermined our ability to engage communities, and there was more than one setback in the response.
We have learned hard lessons about the ways in which people’s perceptions about the disease can be manipulated; and how violence, or fear of violence, can derail the work to prevent and treat Ebola – even in communities that want to work with us.
Once the elections were behind us, we were able to again start working on building a critical mass of community engagement that is now showing results, although this work will always remain vulnerable to the conflict dynamics of the region.
We are working with longstanding national institutions including Initiative for a Cohesive Leadership, and Search for Common Ground, who are working behind doors, bringing together the social and political influencers, community leaders and members of armed groups, that can allow Ebola response teams to work in a safe and trusting environment.
We are scaling up our work with pre-existing, village-level Community Action Committees to identify the concerns and needs of the population, so that we can collectively adapt the response, and address humanitarian needs.
We have listened, and we have learned. We are responding with a lighter footprint. We have adjusted burial practices so that they are both culturally acceptable and medically safe. We are decontaminating sensitive sites at night, to protect affected households from stigma and discrimination. And we will keep listening and learning.
We have seen consistent reactions from the community that underline the need to improve the way the entire Ebola response is being implemented by all actors. They have made very clear that every aspect of the response, from preparedness through to medical treatment and beyond, must ensure a constructive approach to engaging with the community and doing no harm. There are efforts underway to improve how we coordinate with all actors involved in the response to achieve this, which is a key priority to deliver on going forward.
For UNICEF, this means getting communities to understand, accept and ultimately lead a response, that to them, must seem alien and overwhelming. We are there to support them.
To build this acceptance, awareness and action, we work with a broad range of influential political, community and religious leaders, Ebola survivors, and mass media, to bring crucial knowledge on symptoms, prevention and treatment to at-risk households and communities.
UNICEF-supported psychosocial workers are often the first people that a family newly affected by Ebola meets. The role they play in supporting families to make safe decisions related to treatment or burial, is crucial to preventing the spread of infection.
We know that each time that the outbreak moves to a new health zone, the work needs to be started anew. This is why community engagement is now part of preparedness activities in all at-risk areas in DRC and neighboring countries.
Through the new Strategic Response Plan, we’re also working to rehabilitate critical basic services and structures, while strengthening social safety nets and social cohesion. This longer-term, more comprehensive approach is essential in a context like northeast DRC, which was in crisis long before the Ebola outbreak.
Ebola cannot be defeated in isolation. We need to address the full range of long-standing needs among communities that have suffered through decades of conflict and other pressing needs. This approach will contribute towards rebuilding trust.
In Goma this weekend, we’ve seen again that good preparedness is indispensable. In DRC, emergency response efforts must be redoubled. High-risk countries must be equipped and ready to respond quickly to contain the disease as soon as it spills over. It is not a question of ‘if’ but a question of ‘when’. We must be vigilant.
Our work is not done until the last case is successfully treated, and transmission completely stopped.
For this, we need faster isolation of patients, additional vaccines, better infection prevention and control to prevent a rapid, “super-spreader” event from occurring.
This can only be achieved by a well-financed response — one that is grounded in strong community engagement, and well co-ordinated among all partners, without exception.
UNICEF hopes that today’s session is an important moment in gathering the needed support and resources around this critical issue.
Lives are hanging in the balance. And young people like Dieudonné are counting on us to deliver. We must not let them down. ***