Congo is running short of health workers to staff treatment centers for history's fastest-growing Ebola outbreak, particularly in the eastern province of North Kivu where cases have surged 73% over three weeks, the World Health Organization said Wednesday.
The warning came despite signs of improvement in other provinces, including Ituri, the outbreak’s epicenter. The outbreak has spread to seven provinces, with 7,773 confirmed cases and 3,759 deaths, according to the latest government figures.
Between Aug. 31 and Sept. 20, cases fell 26% in Ituri province and 15% in Haut-Uele, said Marie Roseline Belizaire, the WHO’s regional emergency director for Africa. But transmission patterns vary widely and the outbreak remains uncontrolled, she said.
“While cases and deaths are declining in some provinces, they continue to rise in others,” The Associated Press quoted Belizaire as saying. “The outbreak is still not under control and remains spread across a wide geographic area.”
The outbreak is spreading under extremely difficult conditions, fueled by insecurity, displacement, a health workers’ strike and intense population movements. The World Health Organization has said it is on track to surpass the 2014-2016 West Africa Ebola outbreak, the deadliest on record, which killed more than 11,000 people, primarily in Guinea, Liberia and Sierra Leone.
Catherine Smallwood, the WHO’s Ebola incident manager, said cases and deaths had begun declining in North Kivu after several weeks of increases. But although treatment beds are being added daily, facilities still lack enough staff and partners to operate them.
“The human resources gap is one of the biggest gaps,” Smallwood said.
WHO representative in Congo Anne Ancia said one Ebola treatment center requires about 300 health professionals, including anesthetists, hygienists, nurses and general practitioners.
“We are building Ebola treatment centers but do not always have the human resources needed to operate them,” Ancia said. “Those health workers must be paid.”
Frontline workers in Ituri previously went on strike over unpaid wages, worsening access to care.
Health Minister Roger Kamba said in July that the government was verifying payroll lists after the names of people not involved in the response were added. Frontline workers said officials promised to pay the arrears, but some workers received nothing and others only part of what they were owed.
Another major challenge in the response is the fatality rate among children, according to the WHO. Children under five have the highest case fatality rate, more than 60% compared with approximately 40% among adults, Belizaire said.
WHO Ebola Incident Manager Smallwood said detecting cases among children under five is also very difficult because the children can’t necessarily explain their symptoms, and the presentation of symptoms can be confusing.
