Photo credit, Glody Murhabazi
Image caption The staff at the Lwiro clinic, which now only deals with smallpox cases, are exhausted.Article information
- Author, Simi Jolaoso
- Role, Africa correspondent, BBC News, Lwiro
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37 minutes ago
Medical workers on the front lines of the fight against smallpox in eastern Democratic Republic of Congo have told the BBC they are desperately waiting for vaccines to arrive so they can stem the rate of new infections.
At a treatment centre in South Kivu province that the BBC visited in the epicentre of the outbreak, they say more patients are arriving every day – especially babies – and there is a shortage of essential equipment.
Smallpox – formerly known as monkeypox – is a highly contagious disease that has killed at least 635 people in the Democratic Republic of Congo this year.
Although 200,000 vaccines, donated by the European Commission, were flown into the capital, Kinshasa, last week, they still need to be transported across the vast country – and it could be weeks before they reach South Kivu.
“We learned through social media that the vaccine was already available,” Emmanuel Fikiri, a nurse working at the clinic turned virus center, told the BBC.
He explained that it was the first time he had treated smallpox patients and that he feared every day that he would catch it and pass it on to his own children, aged seven, five and one.
“You saw how I touched the patients because it is my job as a nurse. So we are asking the government to help us by giving us the vaccines first.”
The reason the vaccines take time to transport is because they must be kept at a precise temperature – below freezing – to remain effective, and they must be sent to rural areas of South Kivu, such as Kamituga, Kavumu and Lwiro, where the outbreak is widespread.
Lack of infrastructure and poor roads mean helicopters could be used to drop off some vaccines, further increasing costs in a country already struggling financially.
At the community clinic, Dr. Pacifique Karanzo looks tired and dejected, having been rushed all morning.
Although he is wearing a protective mask, I can see the sweat running down his face. He said he was saddened to see patients sharing beds.
“You’ll even see patients sleeping on the floor,” he told me, visibly exasperated.
“The only support we have received so far is some medicine for patients and water. As for the other challenges, the staff is still not motivated.”
Photo credit, Glody Murhabazi
Image caption More and more babies with smallpox are being admitted to Lwiro Community Hospital.
Another problem, he said, is that there is not enough personal protective equipment (PPE) for doctors.
“We try to do what we can to care for the sick and not put ourselves in danger either. We are not immune to diseases.”
Entering the Lwiro community hospital, located about an hour’s drive north of Bukavu, the main city in South Kivu, one is struck by two things.
First, the loud, resounding cries of babies. The second is the stench – a mixture of urine and stagnant water.
The clinic is running out of clean water, which means they have to ration what they have in the small jerrycans under their beds.
Over the past three weeks, the clinic, which usually treats about 80 patients a month, has been overwhelmed by nearly 200 patients, increasingly younger.
“It is sad to see my firstborn suffering from this strange disease. I have a lot of pain in my heart,” said Faraja Rukara, 18.
Her son, Murhula, is currently the youngest smallpox case at the clinic – he is just four weeks old. This is the first time she, like many others here, has encountered smallpox, which is caused by a virus in the same family as smallpox.
The disease causes loss of appetite, leaving many children malnourished.
In an adjacent room, several women and children – nearly 20 – were crammed inside, sharing just seven beds and two mattresses on the floor.
The hospital’s first smallpox case recovered: 10-month-old Amenipa Kabuya. But shortly after she was discharged, her mother, Yvette Kabuya, returned, also suffering from smallpox.
Witnessing the effects of the disease on the body – the painful, pus-filled lesions, the fever and the weight loss – means people are willing to get vaccinated, which is unusual in a region that has seen vaccine hesitancy in the past.
Beatrice Kachera, 50, gently strokes the cheek of her three-year-old granddaughter, whom she had brought in urgently, panicked: “I just saw the child fall ill, I didn’t even know the name of the disease.
“We cannot wait for children and even adults to die. Bring on the vaccines,” she told the BBC.
Photo credit, Glody Murhabazi
Image caption Beatrice Kachera, whose granddaughter has smallpox, eagerly awaits the start of the vaccination campaign.
But some fear that the ongoing armed conflict in eastern Democratic Republic of Congo between the army and several armed groups, including the M23 rebels, will not make things easier.
“The conflict has a profound impact on the vaccination programme in general,” Dr Gaston Bulambo, head of the North Kivu provincial health division, told the BBC.
“It is not just smallpox vaccination, but all vaccination programmes suffer from difficulties in getting vaccines to health zones. This is due to insecurity.
The governor of South Kivu, himself from Lwiro, told the BBC that the intensity of the fighting was forcing many people to leave their homes for his province, exacerbating the spread of the disease.
“We are hosting thousands of internally displaced people and we are still facing many problems,” said Jean-Jacques Purusi Sadiki.
“Most of the money is being pumped into fighting the war, buying military equipment and feeding the army,” he added.
“The country is losing a lot of money trying to deal with this war, instead of injecting [cet argent] in social development, including in the health sector.
Photo credit, Glody Murhabazi
Image caption Lwiro hospital is overloaded with patients suffering from the highly infectious disease.
However, the governor believes that the rebel groups will not disrupt vaccine deliveries, as smallpox also affects populations in the areas they control.
He said the government was doing its best to provide doctors with what they need: “In the next two days, I will go to Lwiro myself. I will bring what is available in terms of urgent assistance to the population, until the government in Kinshasa can offer more support.
Authorities say vaccinations will begin in October, and children under 17, as well as those who have been in close contact with infected patients, will be the first to be vaccinated.
Governor Purusi Sadiki is confident that the outbreak in his province will be contained: “It is a question of political will. I am confident that we will achieve it.
That sentiment is not yet shared by exhausted doctors like Dr Karanzo at Lwiro hospital, but they are at least encouraged that awareness of smallpox appears to be growing in their area.
People seem to come to the clinic as soon as they have symptoms rather than going to traditional healers first, meaning the hospital has yet to suffer a single death from smallpox.
Yet with 5,049 cases confirmed so far this year in the Democratic Republic of Congo, clinic staff say speed is of the essence – only with a combination of vaccines, medicines and other supplies that enable better hygiene can the outbreak be stopped.
Crédit photo, Getty Images/BBC
