Disease trackers on Wednesday launched yet another Ebola vaccination campaign in the Democratic Republic of Congo — only this time, they’re doing it in a war zone.
The World Health Organization said responders plan to give the experimental shot to 40 front-line health workers in Mangina, before vaccinating community members in that town and nearby Beni before the end of the week.
Officials at WHO, the U.N.’s public health arm, said they have access to the road between the towns, which are part of North Kivu — a mineral-rich part of northeast DRC riven by decades of conflict between government forces and militant groups that have multiplied or splintered over the past two decades.
Marauding militias will force aid workers to coordinate with local leaders to gain trust and access to affected territory during the outbreak, which has resulted in over 40 confirmed or probable cases and 36 deaths that may be attributable to the virus.
“We don’t know to what extent we will be able to rely on armed escorts for broader contact tracing outside those small towns,” WHO spokesman Tarik Jasarevic said. “That’s going to be a critical determining factor in our ability to respond.”
Medicins Sans Frontieres, also known as Doctors Without Borders, said it’s an unprecedented situation for their aid workers.
“It is the first time we face an Ebola outbreak response in an area of conflict,” Gwenola Seroux, emergency cell manager for MSF. “This is going to make the response all the more difficult, especially in terms of limiting the spreading of the disease in areas difficult to access. Our ability to move on the ground is going to be limited.”
Ebola is a serious illness that is transmitted to people from wild animals and spreads from human to human through the bodily fluids of people who exhibit symptoms.
The outbreak in North Kivu is the DRC’s 10th since Ebola was discovered there in the late 1970s. It was confirmed at the start of August, just days after WHO celebrated the end of a separate Congolese outbreak 1,500 miles away.
That outbreak was marked by twin challenges — it unfolded in an extremely remote area, and posed the risk of border-hopping into other nations.
Those hazards exist in North Kivu, too, especially since the epicenter is not far from trade routes with Rwanda and Uganda. If that wasn’t tricky enough, this fight is occurring “in the context of a war zone,” Peter Salama, WHO’s emergency response director, said in announcing the outbreak.
There are daily attacks on civilians by resistance groups such as the Mai-Mai and Allied Democratic Forces, according to MONUSCO, an existing U.N. peacekeeping force in the DRC. Suspected ADF members wearing what looked like Congolese military uniforms abducted more than a dozen civilians near an oil press in early August, and locals found 14 dead civilians in the jungle later that month.
MONUSCO has troops available to support the logistical and security needs of the anti-Ebola campaign, such as providing escorts for aid workers. The mission’s deputy force commander has been in the impacted area for the last two days to coordinate support.
Yet even the number of people fleeing the violence could complicate the response.
Sarah Hassan, a health care analyst at the Eurasia Group, said there are 1 million internally displaced people in the area and steady outflow of people to Uganda, Burundi and Tanzania.
“All these regions will have to heighten surveillance at ports of entry,” she said.
The International Committee of the Red Cross has been aiding displaced people in parts of the affected region since 2008. It said in the past two years, it has been difficult to access parts of the territory due to the conflict.
“We are deeply concerned that people in northern North Kivu have already been affected by years of armed conflict and an Ebola outbreak could be devastating to already vulnerable communities,” said Nicolas Lambert, the ICRC’s deputy head of delegation in DRC.
The Red Cross said its 19-person aid team arrived in Beni and Mangina on Tuesday to help locals curb Ebola through safe burials and other best practices, while WHO tracks down contacts of infected persons for a vaccine campaign that could determine the arc of the outbreak.
The vaccine, which is supplied by Merck, is not fully licensed yet, though it helped aid workers stamp out the last DRC outbreak and was effective in Guinea during the widespread West African outbreak of 2013-2016.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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