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Washing hands and fever measure

"We have reached our limits," says Richard Kitenge from the Congolese Ministry of health. "Finally, we are civilians and not the military." He is this year the second Time around-the-clock against the deadly Zaire Ebola Virus in use. The doctor has his office in the provincial capital of Goma, where each half an hour apart, a white cargo plane of the United Nations, to transport people and Material to the epicentre of the epidemic.

With over 425 people Infected and more than 240 dead, the Ebola outbreak, which is raging since the beginning of August in the Eastern Congo, is regarded as the most serious in the history of the country and the second largest in the world. The Congolese Ministry of health and international organizations have difficulties to control the epidemic. It was problematic for the volunteers to reach out to the people at all, says Kitenge: "people may listen to our advice and wash their hands, but for the war we are not equipped to do so."

The emergency surgery, especially in the densely populated area around the cities of Beni and Butembo, which is characterized by active conflict. Although the UN Mission Monusco 000 man since 1999, with approximately 16'of one of the world's largest operations in the Eastern Congo, is not the end of the war in sight. "The people don't even know who she's more supposed to be afraid of: Ebola, or from the ADF rebels," says Kitenge. Nevertheless, the doctors are cautiously optimistic: "we recently introduced a new weapon in the fight against Ebola vaccination."

The tense security situation complicates again and again, the work of the physicians and helpers. Until recently, they were caught between the UN, the rebels and Congolese troops. "Every day, a Patient flees in one of the "red zones", of which we have no access," says Kitenge. "What causes the disease, then we do not know."

neglected

Peter Salama, Director of the emergency programme of the world health organization WHO, the new Ebola vaccine the key to preventing a major disaster: "The vaccine is groundbreaking. The vaccine is the reason that we don't already have thousands of cases." There are now more than 37'000 people with the experimental vaccine were immunized, including about 10'000 nurses and 8,000 children.

Long Ebola of the pharmaceutical industry had been neglected Since the Virus in 1976, it was discovered, there were outbreaks and sporadic and usually localized in Africa. It was only when the pathogen is in West Africa between 2013 and 2016, more than 28'000 people infected and more than 11'000 patients killed, realized the world that he has the potential to spread farther than previously thought.

The development of vaccines and therapeutics has since been massively promoted. An experimental Serum with the name of rVSV-ZEBOV, was selected as one of the most promising vaccine candidates and in the final phase of the epidemic in Guinea successfully to 11'000 people tested.

Meanwhile, the vaccine is produced by US pharmaceutical company Merck and the vaccine Alliance Gavi paid, which campaigns for better access to vaccines in developing countries. Gavi and Merck have pledged that they can provide in the current outbreak in the Eastern Congo, up to 300'000 doses of the vaccine.

The vaccine was already used in an earlier outbreak in the spring in the province of Equateur successfully. The acceptance is high. "The only Problem is that the Serum is available to everyone," says Steward Mohindo, who along with other students from Beni to address the emergency, "but only for the contacts of the contacts of Infected." He goes in the individual households, the population on the vaccine to educate. The young man's self-has not been vaccinated, but has no fear of being infected with the Virus: "We follow strictly to the Protocol, so we have to shake, for example, the hands to Welcome exposed."

The densely populated area of the Ebola epicenter is located just a stone's throw from the Virunga national Park, home to endangered Gorillas. Between the green mountain of the Virunga chain of volcanoes in the border area between Rwanda, Uganda and the Democratic Republic of the Congo, lead over a hundred militias, especially the notorious Allied Democratic Forces (ADF), a decades-long brutal war for control of the raw materials of the Region such as timber, Coltan, Gold, cobalt and copper deposits.

A Million refugees

More than a Million people are fleeing from the violence. The emergency in front of a big Problem. "The risk is high that among the refugees, the infected people are," says Yves Willemot, representative of the children's organization Unicef in Goma. Unicef estimates that the risk of the disease spreading in the neighbouring countries, meanwhile, as "very high". The staff at the borders have been equipped with thermometers and trained to recognize the first signs of Ebola.

The most Ebola-affected regions around Beni with 200'000 and Butembo with four million inhabitants boom are also trade centers. They are on the main transport routes in the Region, and nodes are also points of illegal trade in timber and diamonds, the ranges through Uganda and Kenya to Hong Kong, Indonesia and Europe. So far, more than 14 million travellers, were investigated.

For the reconnaissance work of hundreds of Volunteers go from house to house, but we also utilize other media and channels to reach as many people as possible: film screenings in villages, interactive radio shows, Workshops with community leaders, religious leaders, youth groups and Whatsapp groups.

Under the guidance of the Congolese Ministry of health will be sent, also, paid Volunteers, door-to-door to find all of the Infected and their contacts. A Person with risk of contagion is identified, it is tested to be the case in the laboratory, and then a vaccination offered. After vaccination, the person Concerned must be observed for 21 days – the maximum incubation period for the Virus. "It can take up to ten days for immunity to build up after someone is vaccinated. So we have to be fast," says Guido Cornale, Unicef's chief coordinator in Beni.

It is hard work and extremely difficult to identify the right people. "Imagine an Ebola-death occurs in a community," said Cornale. "We must first identify all persons who participated in the funeral. Then again, we have to find all those who were in contact with them. It all adds up. Especially if you travel around then, too."

the riddle of the infected children

there are Always new complications, in which the detective work of contact the viewfinder is used. So erratic were the rising number of cases of infected children, the epidemiologists with a puzzle. The number of women and children affected is much higher than in previous epidemics, Cornale. The phenomenon was of concern, because of the reason it long remained in the Dark.

Finally, Cornale and his Team found the answer: most of The women and children had been infected in medical facilities. Almost all the victims had visited stations in which nurses practice a combination of traditional and modern medicine and did not adhere to hygiene measures. "Do not use gloves, you do not have hand-washing stations. Often multiple patient use sheets, the same bed, the same needle," said Cornale.

Due to the security situation, the government is difficult to monitor these informal health facilities. Therefore, emergency responders are working to map every single one of the private medical practitioner. "The idea is to set up a performance-oriented financial system," said Cornale. "If the private practitioner to comply with our hygiene requirements, we will pay you a Bonus. The new approach truly gives us the hope that we can end the epidemic quickly."

It threaten elections – and riots

Even if employees of aid organisations have done much to stop the further spread of the Ebola Virus, you must be fast now. Shortly before Christmas, on 23. December, since the years of President Joseph Kabila abducted elections. Although he will himself run for a third term, has heated up the political atmosphere. The bickering Opposition fears that the President is his selected successor at any price by pressing – Anti-Kabila protests are now already beaten bloody. Local Newspapers are full of lurid articles that illustrate the Flare-up of renewed violence in the Region.

International relief organizations are concerned about the possible impact of the elections on population movements, not only within the Congo, but also across borders. The refugee Committee of the United Nations has already reported tens of thousands of people have fled to Uganda. There now began first vaccinations.

(editing Tamedia)

Created: 10.12.2018, 18:35 PM

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