On June 4, 2019, Acting Assistant Administrator of the U.S. Agency for International Development, Admiral Tim Ziemer appeared before the Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations to discuss with lawmakers on way to respond to the worrisome and growing spread of Ebola in North and Ituri Provinces in the Democratic Republic of the Congo (DRC).
The tragic situation is happening in the eastern part of the country in and around Beni. Humanitarian needs including lack of access to water and food due to poverty and ongoing violence driven by armed conflict has made the outbreak of Ebola, the second largest in history, very difficult to contain. Some of the same medical professionals from United States Agency of International Development (USAID), World Health Organization (WHO), and Centers for Disease Control (CDC) who dealt with the 2014 outbreak in Liberia are in the DRC to address the ever-spreading Ebola outbreak, which poses a grave threat to the Congolese people, neighboring countries, as well as the US and beyond.
The Admiral, reporting on the actions of USAID, explained to the Committee that it was taking efforts to coordinate its operations among US government agencies, partners, donors, and international organizations. Following the deployment of a group of medical experts from the USAID and CDC as first responders in the Disaster Assistance Response Team (DART), these entities have been able to save many lives and prevent a much larger outbreak. According to the Admiral, these initial responses were critical because they allowed the US government to identify needs and coordinate activities.
USAID has taken a series of steps to help contain the crisis and overcome challenges. First, they have provided expertise to locals through training programs, and they have provided them with the tools necessary to track the disease and stop its transmission. A Congressman suggested that social media and cell phones should be networked as a way for the locals to share information about the disease. Technical guidance was also provided, the Admiral continued, for the proper disposal of bodies infected by the disease and medical waste, however local traditions that require people to clean the dead person before burial, increases the risk of contact as the infected bodies are highly contagious.
Second, USAID and its partners have sought to engage with faith and community leaders so as to address local resentment and misperceptions about the health intervention. Having traveled the world many times over, the Navy Admiral explains that his recent trip to eastern Congo was one of the most important as well as one of the most sobering, for through his interactions with local traditional and religious leaders, he heard directly about how much mistrust and suspicion the community members harbor toward the health intervention. He discerned that this is due to a history of failed policies of intervention, including conflict resolution interventions which have not been successful in reducing the violence.
To dispel rumors among the locals that the people conducting the intervention introduced the disease to the country in order to wipe out populations and extort money in what is called by some locals as the “Ebola economy”, the Admiral advocates for continuing engagement of the locals through community outreach and educational programs. He explains that recent attacks on WHO facilities resulted in a death of a WHO worker and caused the organization to suspend its operations, during which time lives could have been saved. There were also attacks on burial sites, probably having to do with the fact that the people feel like their local customs have been disrespected. Each day that the facilities are closed because of this violence is more time for the disease to spread; tracking operations and vaccination campaigns which have been essential to saving lives were stopped temporarily.
Perhaps most importantly, USAID has strengthened infection prevention and control measures, training nearly 3,000 health care workers in patient screening, isolation and appropriate waste management. Proper screening, one Congressman noted, must be done to ensure the disease does not spread out of the country and never arrives in the US, however the Congressman was concerned that the screening process may not detect the disease, making it difficult to isolate.
Taking this into consideration, the Admiral suggests continuing to support members in areas affected by the disease by supplying urgently needed protective equipment as well as care for people who have contracted the disease to help ensure their survival. Critically, USAID must enhance its coordination and cooperation with partners on the ground, just as it has been doing; for example, it provided its partners with 53 metric tons of personal protective equipment at more than 100 health facilities. The Admiral also recommends broadening the response to address non-Ebola humanitarian needs; USAID has done this by providing food, for example, to approximately 45,000 beneficiaries.
To control and contain the outbreak of Ebola, says the Admiral, the network of responders including USAID personnel must engage the community so that it gains a greater acceptance and ownership of the public health intervention. The community should come to see, just as he did firsthand, how hard partners on the ground are working to help alleviate the suffering of the Congolese people; and they should be encouraged to know that these aid workers care deeply about the people and will continue to help them long after the outbreak is over. But this can only be accomplished if the team of responders shifts its strategy to what the Admiral calls a more holistic humanitarian approach, one which integrates faith-based organizations and vital NGOs. The long-term strategy will make sure that the region is prepared for any potential advancement of the disease. Involving multiple sectors in a “whole of society approach” will improve efforts to prevent, detect, and control infectious disease.
Written by Jerry Canto, Research Intern at AFJN
Edited by Ntama Bahati, Policy Analystat AFJN