Today, the epidemic in North Kivu and Ituri is still a very, very worrying situation. You look at the last 12 weeks of the epidemic, and they're the worst 12 weeks since the beginning. If you just talk about six months ago, what we were looking at, was something like 15 cases a week, whereas now we're talking about something on the order of like 100 cases per week. What we're seeing today is transmission in several different areas at once, including recently some cases that did cross the border into Uganda.

John Johnson
Emergency Coordinator

There's lots of key challenges today. I think, the fact that we've lost good surveillance of where the epidemic is going and where it's headed, if you look at the number of cases that are being reported, there's been several estimations that we're only seeing about 65%, 75% of the cases that are actually occurring are being reported, that there's quite a few cases going unnoticed. If you look at the number of community deaths in this outbreak, it's around 40%, meaning that about 40% of Ebola cases aren't seeking care, and they are instead dying in the community before getting to a health center.

I think also, as far as community engagement goes, if you look at past Ebola outbreaks, where the trend started to really turn around was when the community themselves bought into the response and started taking control of their own healthcare and making sure that there was no transmission in the community.

For community engagement, there's still a lot of work to be done. Honestly, if you look at where this Ebola outbreak is happening in North Kivu, which's an area that's got a long history of violence by different armed actors, it's a community that's already a bit suspicious of outsiders. We're talking about the Ebola virus, which is a poorly understood disease that’s highly lethal. You're talking about a number of factors that make it very, very difficult for us to reach and engage with this community.


Whereas before, we were working very, very closely in the response focusing just on Ebola, we were not necessarily thinking about all of the other things that affect the population.

Our priority shifted and we said, "Listen, it needs to not just be Ebola, but it needs to be healthcare for everyone." We decided that we would try to focus more on supporting the national Congolese health system in general in an Ebola context. That means making sure people have access to free care, making sure they have access to quality care, and also that these health centers can be protected for, and we can prevent nosocomial infections or infections that inside a health center or hospital for any type of infectious disease, but especially Ebola, and when there is a case of Ebola that arrives, we want to make sure that they get the right type of care, and that they get referred to the best place for them, which is usually the Ebola treatment center.