Three Congolese medics have been detained over the murder of a World Health Organization (WHO) doctor who was fighting an Ebola outbreak in Democratic Republic of Congo, a military prosecutor said on Wednesday.
Cameroonian doctor Richard Valery Mouzoko Kiboung was shot dead on April 19 in an attack on a hospital in the eastern city of Butembo.
The arrested doctors will be prosecuted for “terrorism” and “criminal conspiracy,” Lieutenant-Colonel Jean-Baptiste Kumbu Ngoma, military prosecutor for Butembo in North Kivu province, told AFP.
The three are accused of holding meetings on April 14 to plot the assassination of Mouzoko, he added.
The WHO said Mouzoko had been deployed as part of a medical team to help rein in the Ebola outbreak which started last August in North Kivu.
The prosecutor said the doctors were “among the moral authors” of the attack on Mouzoko. He said one more doctor was being sought in the case.
In a letter to the mayor of Butembo, the local doctors’ association expressed indignation at the arrests and said they would go on strike if their colleagues were not released within 48 hours.
But the military prosecutor dismissed their demands as “out of the question”.
“It’s a delicate situation. As a man has died, we absolutely have to know the truth about what happened,” the coordinator of the fight against Ebola in DR Congo, Jean-Jacques Muyembe, told AFP.
More than 1,800 people have died from the virus in the past year.
The outbreak is the second deadliest on record, after the epidemic that struck West Africa in 2014-2016, which killed more than 11,300 people.
Efforts to roll back the highly contagious haemorrhagic fever have been hampered not only by fighting but also by resistance within communities to preventative measures, care facilities and safe burials.
Attacks on health workers have had a devastating effect, with seven murdered and more than 50 seriously hurt, according to an unofficial tally.
After the killing of Mouzoko in April, WHO chief Tedros Adhanom Ghebreyesus said: “We will not be intimidated… we will finish our work.”
The World Health Organization on Wednesday declared the Ebola outbreak in the Democratic Republic of Congo a “public health emergency of international concern,” a rare designation only used for the gravest epidemics.
The year-old Ebola epidemic in eastern DR Congo, the second deadliest on record, has largely been contained to remote areas, but this week saw a patient diagnosed with the virus in provincial capital Goma, the first case in a major urban hub.
“It is time for the world to take notice,” WHO chief Tedros Adhanom Ghebreyesus said in a statement, as he accepted the advice of his advisory board to invoke the emergency provision, activated by the UN health agency only four times previously.
Those included the H1N1, or swine flu, the pandemic of 2009, the spread of poliovirus in 2014, the Ebola epidemic that devastated parts of West Africa from 2014 to 2016 and the surge of the Zika virus in 2016.
The Ebola virus is highly contagious and has an average fatality rate of around 50 percent. It is transmitted to humans from wild animals and spreads among people through close contact with the blood, body fluids, secretions or organs of an infected person.
Responders had hoped that this Ebola outbreak would be easier to control, thanks in part to a new vaccine.
While more than 160,000 people in the affected provinces of North Kivu and Ituri have been vaccinated, containment efforts have been hampered by chronic unrest in the region and a lack of trust in communities for health workers.
A panel of top WHO officials that met in Geneva on Wednesday to issue the emergency call expressed “disappointment about delays in funding which have constrained the response.”
A fresh UN funding appeal for several hundred million dollars to cover the ensuing six months is expected in the coming days.
Reacting to the emergency declaration, the president of Doctors Without Borders, Joanne Liu, called for “a change of gear” in response to the outbreak.
“We need to take stock of what is working and what is not working,” she said.
The International Federation of Red Cross and Red Crescent Societies welcomed the decision, voicing hope that the emergency call “will bring the international attention that this crisis deserves.”
Goma case ‘game-changer’
Since August last year, the DRC Ebola outbreak has killed more than 1,600 people out of more than 2,500 cases.
WHO has held off on making the emergency declaration on three previous occasions, but the confirmation of a case in North Kivu’s capital Goma escalated the crisis.
Tedros this week called the Goma patient a “potential game-changer,” because the city is a “gateway” to Africa’s Great Lakes region and the wider world.
The Goma patient has been described as an evangelical preacher who travelled to Goma from Butembo, one of the towns hardest hit by Ebola.
He had reportedly touched several Ebola patients in Butembo and concealed his identity in order to evade health screenings while en route to Goma.
The emergency committee cited the patient, who has died, as a “specific cause for concern”.
Even if the risk of global spread is “still low”, the Goma case posed “worrying signs of possible extension of the epidemic,” the committee said.
A city of about one million people, Goma sits on the northern shore of Lake Kivu, adjacent to Rwanda’s town of Gisenyi.
It has a port that links to DRC city Bukavu and the South Kivu province as well as an airport with flights to the capital Kinshasa, Uganda’s Entebbe and Addis Ababa, the capital of Ethiopia.
Checking temperatures at borders
At the Goma-Gisenyi crossing on Wednesday, megaphone announcements instructed all travellers to wash their hands “to prevent Ebola sickness virus,” using basins of water with added bleach.
Health workers wearing yellow high-visibility jackets took the temperature of people crossing the border, in both directions.
WHO’s announcement provoked a mixed response from DR Congo’s Health Minister Oly Ilunga Kalenga, who has been critical of the motive of some non-governmental organisations in raising donations for the crisis.
He said that while he “accepts” WHO’s decision, he hoped it was not “the result of pressure from different groups… who want to use the statement as an opportunity to raise funds for humanitarian actors”.
“We hope there will be greater transparency and accountability by humanitarian actors in how they use their funds to respond to this Ebola outbreak,” he said in a statement.
The WHO’s international health regulations, drafted in 2005, say that the emergency label should apply to a situation that is “an extraordinary event that poses a public health risk to other countries through the international spread and that potentially requires a coordinated international response.”
Some fear that making the emergency call could trigger border closures, which the head of the WHO emergency panel, Robert Steffen, strongly urged against.
Thousands of doses of Ebola vaccine arrived Wednesday in the Democratic Republic of Congo, which is facing an outbreak of the deadly virus, the health ministry said.
Congolese authorities declared the outbreak in the northwest region near Congo-Brazzaville on May 8, and three have died from the disease, according to an official toll.
The number of reported cases is 42, including two confirmed, according to a World Health Organization tally.
“Five thousand four hundred doses of vaccine arrived from Geneva this morning,” said health ministry spokeswoman Jessica Ilunga. They would be kept in Kinshasa until a refrigerated transportation chain could be guaranteed.
The WHO said the risk of the disease spreading was “high” and announced it was preparing for the “worst case scenario”.
Chief executive Doctor Tedros Adhanom Ghebreyesus visited the affected Bikoro area last weekend, saying he hoped for a “better way out” of the latest outbreak in DRC.
Oxfam announced Wednesday that it has made available an initial $68,000 (57,000 euros) to fight the spread of the disease.
Ebola is one of the world’s most notorious diseases, being both highly infectious and extremely lethal.
The worst-ever Ebola outbreak started in December 2013 in southern Guinea before spreading to neighbouring West African countries Liberia and Sierra Leone, killing more than 11,300 people out of nearly 29,000 registered cases.
The Federal Ministry of Health has dismissed reports of the resurgence of Ebola in Calabar, Cross River State, as a mere rumour.
The Permanent Secretary at the Ministry of Health, Mr Linus Awute, told journalists in Abuja that the story which has been making the rounds since Wednesday was a case of an undergraduate student of the University of Calabar who fell ill and was admitted into the university’s teaching hospital.
According to him, although the patient who died seven hours after admission, had symptoms similar to that of the Ebola virus, results from tests already conducted proved negative.
He, however, told the journalists that further test on the blood samples of the deceased was being carried out at the Redeemers University laboratory to identify the nature of the disease that killed the student.
A campaign group, Global Witness, has raised an alarm over the forceful acquisition of land from owners in Liberia.
According to Reuters, the group, which has called for a government investigation, says communities in Liberia are being pressured to sign away their land to make way for palm oil plantations and Liberians have been beaten and arrested for refusing.
Palm oil is a cornerstone of the nation’s development and the country is emerging as a new frontier market for what has become the world’s cheapest oil.
In 2010, the Liberian Government had agreed to lease the company alleged to be behind the forced deals, Golden Viroleum (GVL), 544,000 acres of land for over 60 years.
However, GVL is said to have dramatically expanded its operations in Liberia at the height of the Ebola outbreak in 2014, clearing thousands of acres of land while community support groups were busy dealing with the crisis.
In reaction, GVL said it only signed pre-existing agreements during the outbreak.
The World Health Organisation (WHO) has declared Liberia free of the dreaded Ebola Virus Disease after no new cases were reported for over a month.
On Saturday the World Health Organization said in a statement: “The outbreak of Ebola virus disease in Liberia is over.”
The last confirmed death in Liberia was on March 27 and no new cases were reported in 42 days – twice the maximum incubation period for the deadly disease.
Liberia recorded more than 4,700 deaths from Ebola, a figure higher than what has been recorded in any other affected country.
Find the full statement by the World Health Organization below:
The Ebola Outbreak In Liberia Is Over
9 May 2015
Today, 9 May 2015, WHO declares Liberia free of Ebola virus transmission. Forty-two days have passed since the last laboratory-confirmed case was buried on 28 March 2015. The outbreak of Ebola virus disease in Liberia is over.
Interruption of transmission is a monumental achievement for a country that reported the highest number of deaths in the largest, longest, and most complex outbreak since Ebola first emerged in 1976. At the peak of transmission, which occurred during August and September 2014, the country was reporting from 300 to 400 new cases every week.
During those 2 months, the capital city Monrovia was the setting for some of the most tragic scenes from West Africa’s outbreak: gates locked at overflowing treatment centres, patients dying on the hospital grounds, and bodies that were sometimes not collected for days.
Flights were cancelled. Fuel and food ran low. Schools, businesses, borders, markets, and most health facilities were closed. Fear and uncertainty about the future, for families, communities, and the country and its economy, dominated the national mood.
Though the capital city was hardest hit, every one of Liberia’s 15 counties eventually reported cases. At one point, virtually no treatment beds for Ebola patients were available anywhere in the country. With infectious cases and corpses remaining in homes and communities, almost guaranteeing further infections, some expressed concern that the virus might become endemic in Liberia, adding another – and especially severe – permanent threat to health.
It is a tribute to the government and people of Liberia that determination to defeat Ebola never wavered, courage never faltered. Doctors and nurses continued to treat patients, even when supplies of personal protective equipment and training in its safe use were inadequate. Altogether, 375 health workers were infected and 189 lost their lives.
Local volunteers, who worked in treatment centres, on burial teams, or as ambulance drivers, were driven by a sense of community responsibility and patriotic duty to end Ebola and bring hope back to the country’s people. As the number of cases grew exponentially, international assistance began to pour in. All these efforts helped push the number of cases down to zero.
Liberia’s last case was a woman in the greater Monrovia area who developed symptoms on 20 March and died on 27 March. The source of her infection remains under investigation. The 332 people who may have been exposed to the patient were identified and closely monitored. No one developed symptoms; all have been released from surveillance.
Health officials have maintained a high level of vigilance for new cases. During April, the country’s 5 dedicated Ebola laboratories tested around 300 samples every week. All test results were negative.
While WHO is confident that Liberia has interrupted transmission, outbreaks persist in neighbouring Guinea and Sierra Leone, creating a high risk that infected people may cross into Liberia over the region’s exceptionally porous borders.
The government is fully aware of the need to remain on high alert and has the experience, capacity, and support from international partners to do so. WHO will maintain an enhanced staff presence in Liberia until the end of the year as the response transitions from outbreak control, to vigilance for imported cases, to the recovery of essential health services.
Evolution Of The Outbreak
The start of the outbreak was deceptively slow. Health officials were on high alert for cases following WHO’s confirmation, on 23 March 2014, of the Ebola outbreak in Guinea. Liberia’s first 2 cases, in the northern county of Lofa near the border with Guinea, were confirmed on 30 March 2014.
On 7 April, 5 more cases were confirmed, 4 in Lofa and 1 in Monrovia. All 5 died. The situation then stabilized, with no new cases reported during April and most of May.
Further cases were detected in early June, mainly in Lofa county, but the trend did not look alarming, especially when compared with the situation elsewhere. At the end of June, Liberia reported 41 cases, compared with 390 in Guinea and 158 in Sierra Leone.
The impression of a calm situation turned out to be an illusion. The first additional cases in Monrovia were reported in mid-June. The city was ill-prepared to cope with the onslaught of infections that rapidly followed as the virus raced through hospitals, communities, and eventually entire neighbourhoods.
Case numbers that had multiplied quickly began to grow exponentially. On 6 August, President Ellen Johnson Sirleaf declared a three-month state of emergency and announced several strict measures aimed at getting cases down.
In mid-August, a WHO team of emergency experts estimated that Monrovia needed 1000 beds just to treat currently infected patients. Only 240 beds were available.
In September, WHO began construction of a new treatment centre, using teams of 100 construction workers labouring in round-the-clock shifts. On 21 September, the Island Clinic was formally handed over by WHO to Liberia’s Ministry of Health and Social Welfare. The clinic added 150 beds to Monrovia’s limited treatment capacity. However, within 24 hours after opening, the clinic was overflowing with patients, demonstrating the desperate need for more treatment beds.
WHO supported the construction of 2 additional Ebola treatment centres, augmenting Monrovia’s treatment capacity by another 400 beds. The remaining need was eventually met by multiple partners. The rapid increase in treatment capacity, especially in Monrovia, likely did much to turn the outbreak around.
The outbreak began to subside in late October, when more new cases were detected early and rapidly treated in isolation, and more safe and dignified burials were performed. Case-fatality rates dropped. As the number of survivors grew, public perceptions changed from viewing treatments centres as “death traps” to seeing them as places of hope. That altered perception, in turn, encouraged more patients to seek early treatment.
The incidence of new cases stabilized in mid-November, with daily reports showing only 10 to 20 new cases. During the early months of 2015, cases dwindled further, eventually allowing detection and investigation of the last remaining chains of transmission. From late March on, daily reports consistently showed zero cases.
Factors that contributed to success: big dreams
A number of factors contributed to the success of Liberia’s Ebola response..
The first decisive factor was the leadership shown by President Sirleaf, who regarded the disease as a threat to the nation’s “economic and social fabric” and made the response a priority for multiple branches of government. Her swift and sometimes tough decisions, frequent public communications, and presence at outbreak sites were expressions of this leadership.
As President Sirleaf famously stated in her memoir, “The size of your dreams must always exceed your current capacity to achieve them. If your dreams do not scare you, they are not big enough.”
Second, health officials and their partners were quick to recognize the importance of community engagement. Health teams understood that community leadership brings with it well-defined social structures, with clear lines of credible authority. Teams worked hard to win support from village chiefs, religious leaders, women’s associations, and youth groups.
One of the first signs that the outbreak might be turned around appeared in September 2014, when cases in Lofa county, Ebola’s initial epicentre, began to decline after a peak of more than 150 cases a week in mid-August. Epidemiologists would later link that decline to a package of interventions, with community engagement playing a critical role.
In Lofa, staff from the WHO country office moved from village to village, challenging chiefs and religious leaders to take charge of the response. Community task forces were formed to create house-to-house awareness, report suspected cases, call health teams for support, and conduct contact tracing.
See-through walls around the treatment centre replaced opaque ones, allowing families and friends to watch what was happening inside, thus dispelling many rumours. Calls for transportation to treatment facilities or for burial teams were answered quickly, building confidence that teams were there to help.
The effectiveness of this response, which was duplicated elsewhere, points to a third factor: generous support from the international community, including financial, logistical, and human resources. This support added more treatment beds, increased laboratory capacity, and augmented the number of contact tracing and burial teams. The deployment of self-sufficient foreign medical teams from several countries had a dramatic impact on the outbreak’s evolution.
Finally, strong coordination of the international and national response was essential for success. International support was slow to start, but abundant when it arrived. Innovations such as the Presidential Advisory Committee on Ebola and introduction of a incident management system helped ensure that resources and capacities were placed where needed.
Many of these lessons and experiences are reflected in WHO’s new response plan, which aims to identify all remaining cases in West Africa by June 2015.
Facebook Inc. Chief Executive, Mark Zuckerberg, announced on Tuesday that he and his wife, Priscilla Chan, would donate $25 million to the Centres for Disease Control Foundation to fight Ebola.
The money will go to the CDC Foundation, the charitable organization that raises and distributes funds on behalf the Centres for Disease Control and Prevention to public health organizations.
“We need to get Ebola under control in the near term so that it doesn’t spread further and become a long term global health crisis that we end up fighting for decades at large scale, like HIV or polio,” he said in a post on Facebook.
“We believe our grant is the quickest way to empower the CDC and the experts in this field to prevent this outcome.”
The death toll in the outbreak, first reported in Guinea in March, has reached 4,447 from a total of 8,914 cases, World Health Organization Assistant Director-General, Bruce Aylward said on Tuesday.
The United States had its first fatality from the current Ebola outbreak when Thomas Eric Duncan died in a Dallas hospital last week.
One of the nurses who treated him has also been diagnosed with the disease.
The Lagos State Governor, Mr Babatunde Fashola, on Friday, visited the First Consultants Hospital Obalende in Lagos, which has been certified ready for operation after the decontamination done for its treatment of the index Ebola patient, the Liberian-American, Patrick Sawyer.
Governor Fashola, briefing newsmen after the tour of the facility, said that his visit to the hospital was in order to identify with the staff on the way forward, adding that since the Ebola Virus Disease had been dealt with professionally, the way forward was to get on with life.
“It was also a doctor who just refused to give up on them, Dr. Davis, and this is the way it must be. Whether you are a journalist, a soldier, a police officer or a footballer, just do what you do with dedication and all will be well”, he said.
The Governor said the first stage of the containment process was to save lives while the second stage was to help affected businesses get up and run again.
He reiterated the need for members of the public to put the issue of EVD behind and get on with their lives.
“We (Nigerians) must not live in fear of what we do not know. We have dealt decisively, comfortably and professionally with what we know. Anything that comes out from the woodworks then we must confront it again and deal with it and resolve it,” he said.
Governor Fashola also told the Chief Medical Director of the hospital, Dr. Benjamin Ohiaeri, to articulate the equipment losses suffered by the hospital as a result of the decontamination after the death of the index case, with the view to assisting the hospital replace such equipment.
He, again, paid glowing tribute to the hospital staff, particularly the management, for the role they played in bringing the index case to the knowledge of the State Government instead of taking the easy way out. He added that if they had not insisted on detaining the patient, the story would have been devastatingly different.
Addressing the public, Governor Fashola said that everything relating to the issue of Ebola has been settled, adding that what remains was for the people to ensure that they take cleanliness very seriously by washing their hands regularly with soap and water.
The CMD, Dr. Ohiaeri, while regretting both the human and material losses suffered by the hospital as a result of the EVD infection from the index case, praised the Governor and the State Ministry of Health for their prompt response to the information on the index case, adding that although the Governor was on lesser hajj at the period, the Ministry acted promptly and professionally.
First Consultants Hospital was where the index case of EVD in the country, Mr. Patrick Sawyer from Liberia, was received and attended to on Sunday, July 20, 2014, after he was rushed from the Murtala Mohammed International Airport where he collapsed on arrival from his country.
He died at the hospital on Friday, July 25. As a result, the hospital was shut down and decontaminated later with some of the equipment destroyed as part of the decontamination process.
With the Governor during the visit were some members of the State Executive Council including the Commissioner for Health, Dr. Jide Idris and his Special Duties counterpart, Dr. Wale Ahmed as well as other top government officials.