After a spike in new confirmed cases in the Beni area, where the worst Ebola epidemic does not stop in the history of the Democratic Republic of Congo (DRC), Msf strengthens its action to contain the contagion by opening a new transit center for cases suspects. "The goal of this transit center is to strengthen the overall care capacity of Beni. Since the city became the center of the epidemic in October, many new cases have emerged confirmed in different neighborhoods. The Transit Center was built near the existing Ebola Treatment Center, whose capacity is now saturated. The proximity of the two centers will make our response to the Beni epidemic more effective, "explains Marie Burton, MSF project manager at Beni. The transit center was built on a former football field of 8 thousand square meters and required a week of intense construction work. Helped by the same young people who once played football on that field, MSF teams have worked despite frequent storms and have overcome big logistical challenges to complete the work as quickly as possible. Suspicious patients will be welcomed to the Transit Center while they wait to know the results of their tests. In the meantime MSF medical staff will immediately provide adequate care for people's clinical conditions. When the diagnosis is confirmed, Ebola-positive patients will be transferred to the nearby treatment center, while the negative ones will be transferred to other health facilities, where they will receive further treatment. So far, both suspected and confirmed cases were received in the treatment center, in two isolated departments. In the new center, individual rooms have been built instead of large marquees, to improve patient isolation. The divisions between the rooms have been fitted with large Plexiglass windows so that the medical staff can maintain eye contact with the patients, but also because patients can see their family and loved ones when they come to visit them. The basic capacity of the center, equal to 16 beds, can reach up to 32 or 48 beds in case of need, depending on how the epidemic will evolve. Our teams are increasingly committed to tracking suspicious cases since the epidemic has reached a new level. At least 30 new suspected cases are identified every day and admitted to the Ebola Center of Beni. The worst Ebola epidemic in the Democratic Republic of the Congo In just three months since it was declared, this Ebola outbreak - the tenth in the history of DRC - has become the worst ever recorded in the country. To date, 341 cases have been identified, 303 of which have been confirmed. The epicenter has moved from the small town of Mangina, where the first few cases have emerged, to the largest city of Beni, where the number of suspected and confirmed patients has grown steadily for weeks, until the total saturation of the medical ability to cure the patients. Since August 1, the virus has killed 215 people and several organizations are doing their best to prevent it from spreading further. More than 100 patients have managed to heal so far. In an area of heavy insecurity caused by the ongoing conflict, where access to parts of the population is very complex, the medical response has faced major challenges and the epidemic has not yet been stopped. "Since the center of the epidemic has moved from Mangina to Beni, the epidemic has become more difficult to control. We now observe a growing number of new cases further south, in the even larger city of Butembo. We fear that the situation can become even more difficult to manage, unless the response in this area is significantly strengthened "says Chiara Montaldo, MSF medical coordinator in Beni. In recent weeks there has been a noticeable increase in new cases at Butembo, a regional business hub, just a stone's throw from the Uganda border. The latest developments are a call to devote more resources and attention, for the risk that this big city could become a new hotspot of the epidemic. The involvement of the communities In addition to the obstacle of an ever-moving population, many of the difficulties in the response were caused by the fear of the population for such a deadly disease - which can hamper the relationship between communities and health workers. As a result, we often observe the reluctance to report new cases, to be transferred to treatment centers or to accept the intervention of the teams who are responsible for ensuring safe and dignified burials for the victims of Ebola. "We find the need for better and more effective communication from all the players involved in the response against Ebola to gain people's trust. Mortality rates are very high; people can be led to think that treatment centers are places where they go to die, when dozens of patients have been hospitalized. Being admitted to a treatment center during the initial stage of the disease increases the chances of recovery, "says Axelle Ronsse, MSF emergency coordinator for Ebola surgery. Msf active on the pillars of the intervention against Ebola Msf is present at Beni since the beginning of the epidemic in August 2018 and is active on several fronts, to contain the spread of the virus and respond to the needs of the North Kivu population. Together with other organizations participating in the intervention, MSF teams regularly visit 24 health centers to provide training and material; they hold regular meetings with local communities to share information about the disease and methods to avoid infection. Among the prevention and control activities, MSF teams are involved in the decontamination of health centers after the identification and transfer of confirmed Ebola cases to the appropriate facilities. MSF teams also vaccinated more than 600 people at Beni in October, including frontline health workers and potential contacts of patients who had already contracted the virus. In November, vaccines were also administered in the city of Butembo. Since the beginning of the epidemic on August 1, 2018, MSF teams have participated in the Ebola response in North Kivu and Ituri. MSF has opened treatment centers in the cities of Mangina, Butembo and Tchomia (the latter has now been closed), an isolation center in the city of Bunia and now a transit center in Beni. Independent of any political, religious or military authority, Msf acts impartially, according to the assessment of medical needs. The independence of the association is ensured by private donations, which represent more than 80% of its funds.
