MSF mulls response in DRC Ebola hotspot after attacks

MANILA — Two attacks on Médecins Sans Frontières Ebola treatment centers in the Democratic Republic of the Congo within a span of four days have pushed the organization to rethink its strategy to gain trust among the local community.

A 70-bed treatment center in the district of Katwa — the current epicenter of the epidemic — was attacked on Sunday, killing one and forcing MSF to shut down its operations in the district. A second attack followed Wednesday, on a treatment center in Butembo. The incidents have prompted the organization to recognize the need for Ebola response actors to do a better job on community engagement.

“The control of the epidemic won’t be achieved without the mobilization of the population, and it is clear that the actors of the response, MSF included, did not manage to gain this trust,” Emmanuel Massart, MSF's emergency coordinator in Katwa, told Devex on Wednesday. 

“If the response doesn’t manage to win the trust of the people affected by Ebola, it is impossible to care for patients, and impossible to contain the outbreak,” he added.

Assailants threw stones and set fire on parts of the MSF-managed facility in Katwa, destroying medical wards and equipment, according to a news release.  All staff and patients were evacuated, except for one who reportedly died. It’s unclear if the victim is a family member of a patient or nurse at the facility, as communicated by DRC’s Ministry of Health.

On the night of the attack, four of the confirmed patients with Ebola from the Katwa center were transferred to Butembo, where MSF runs a 90-bed Ebola treatment center. With the fresh attack on the center on Wednesday, it’s unclear how the organization’s operations in the city will be impacted.

There is one other 20-bed transit center operating in the city, managed by the NGO Alliance for International Medical Action, where the six suspected Ebola patients evacuated from MSF’s facility in Katwa were transferred. Additionally, MSF has ongoing operations in Bunia, Bwana Sura, Kayna, and Biena.

At the moment, the organization is rethinking its position in the context of the Ebola response in Katwa, which registered the most number of confirmed cases (231) and deaths (173), according to the latest statistics from the DRC Ministry of Health. But nothing has been decided yet, Massart said.

The incidents from this week were not isolated. This February alone, Massart said MSF was made aware of at least 30 incidents targeting Ebola responders in the city.

Community engagement could mean consulting the population on solutions, such as involving them in developing a strategy for health promotion, said Massart. MSF, he said, has trained and is working directly and well with the community in Kalunguta, Kanyunga, and Butuhé for infection protection, control, and health promotion.

“Even if it is more challenging to replicate in big urban areas such as Butembo and Katwa, a similar approach needs to be applied,” he said.

“The response must be adapted to the context not the other way around,” he added.

MSF emergency desk manager Hugues Robert said in a news release following the attack in Butembo that the organization is currently focusing efforts in bringing both its staff and patients to safety.

The Ebola epidemic is still not under control more than six months since the outbreak was determined in August 2018 in North Kivu province. While Ebola response actors were able to stop the transmission in the initial hotspots of Mangina and Beni, and some other locations, the epidemic has spread out to 19 other health zones. A total of 548 people have died from the outbreak, and a total of 872 cases have been reported to date.

On Feb. 13, the country’s health minister launched the country’s new Ebola strategic response plan for February to July. But the plan, which requires a total of $148 million, has so far only received less than $10 million in pledges. In a news release, World Health Organization Tedros Adhanom Ghebreyesus has called on donors to continue supporting the outbreak response.

“We have a shared responsibility to end this outbreak,” he said.