Ebola disrupts healthcare in DR Congo

The Democratic Republic of the Congo’s record Ebola outbreak has triggered a wider health crisis, with thousands of children missing routine vaccinations and pregnant women avoiding health facilities as fear of infection and disruptions to medical services keep families away from care.

The disruption is increasing the risk of deaths from preventable illnesses such as measles, malaria and diarrhea, particularly among children, according to the United Nations Children’s Fund.

Health data from Ituri Province, the epicenter of the outbreak, show that between April and June, the use of essential health services fell by 42 percent in the outbreak hot spots of Bunia, Mongbwalu, Nizi and Rwampara, while province-wide utilization declined by nearly 13 percent.

According to UNICEF, “routine childhood immunization has been among the hardest-hit services”. In the outbreak hot spots, first-dose measles vaccinations declined sharply, including a 69 percent drop in Mongbwalu.

Across Ituri Province, administration of the third dose of the pentavalent vaccine fell by 22 percent, while second-dose measles vaccinations declined by 18 percent. Health facilities delivered more than 23,000 fewer routine vaccine doses during May and June than in April.

Maternal health services have also been severely affected. Facility-assisted deliveries dropped by 13 percent across the province and declined even more sharply in some outbreak areas, falling by 38 percent in Bunia, 30 percent in Rwampara and 70 percent in Nizi.

Death toll

The outbreak, now the worst Ebola epidemic ever recorded in the DR Congo and the fastest-growing on record, continues to place enormous strain on the country’s healthcare system.

DR Congo had reported 4,381 confirmed cases and 2,011 deaths as of Tuesday.

UNICEF said no similar seasonal decline in healthcare utilization was recorded during the same period last year, suggesting the reductions are directly linked to the Ebola outbreak and growing fears among communities.

“The data suggest that fear of infection, combined with disruptions to services, is deterring lots of children and their families from seeking care,” said John Agbor, UNICEF representative in the DR Congo.

“One doctor told our team that before the current outbreak, his facility saw an average of 500 patients a month but that has dropped to almost nothing,” Agbor said.

Children continue to bear a disproportionate burden of the outbreak, accounting for nearly one quarter of confirmed infections, and almost one-third of Ebola-related deaths.

Wessam Mankoula, head of the Continental Incident Management Support Team, said the agency’s analysis shows children under five and adults older than 60 face the highest risk of dying from the disease.

“Children under five experience the fastest progression of disease, from the onset of symptoms to death,” Mankoula said. “This is why we are deploying pediatricians to Ebola treatment centers to support clinical case management for children under five.”

To restore confidence in health services and slow transmission, UNICEF, in coordination with the DR Congo Ministry of Public Health, the World Health Organization and Africa Centres for Disease Control and Prevention, has trained and deployed about 13,000 frontline community workers and influential community leaders.

The teams have reached more than 2.4 million people with information on Ebola prevention and early detection and conducted over 505,000 household visits.

“The Ebola outbreak is severely disrupting the entire health system, with inevitable consequences for cases of malaria, diarrhea, and other treatable illnesses that are the biggest killers of children,” Agbor said.

“Ensuring that health posts remain open, safe, and trusted is essential to saving lives today and preventing future outbreaks tomorrow as we invest in a more resilient health system.”

sharon@chinadailyafrica.com