Democratic Republic of the Congo Ebola Situation Report 16 May, 2018 SITUATION IN NUMBER Highlights One of three suspected cases in Wangata Health Zone in Mbandaka, the capital of Equator province with a population of more than 1 million inhabitants was confirmed by PCR. 44 suspected cases reported 3 confirmed cases by RT-PCR (MoH, 16 May 2018) Since 3 May 2018, 44 suspected cases of viral hemorrhagic fever have been reported, including 23 deaths (probable cases) in three out of the four health zones under investigation in Equateur province (Bikoro, Iboko, Wangata and Ntondo). A high-level field mission led by the Minister of Health with the Representatives of WHO and UNICEF travelled to Mbandaka and Bikoro on Saturday 12 May to assess the level of response in the field. A follow up mission involving the WHO Director-General followed on Sunday 13 May. 23 deaths were recorded with epidemiological link (MoH, 16 May 2018) 527 contact have been identified and under surveillance (MoH, 16 May 2018) On 13 May 2018, the Ministry of Health signed an agreement on the use of the Ebola vaccine and issued approval for the importation of vaccines. UNICEF is involved in the planning and communication aspect of the vaccination. The initial UNICEF response costed at USD 3.96 million has been used to inform resource mobilization, but the plan is subject to a review based on the confirmed case in Mbandaka, and is expected to be significantly scaled up. 1
Epidemiological Overview Summary Table: Affected Health Zones in the Equateur Province of DRC Bikoro Iboko Wangata Ntondo Total Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Confirmed 2 0 0 0 1 0 0 0 3 0 Probable 18 20 2 3 0 0 0 0 20 23 Suspected 15 0 3 0 3 0 0 0 21 0 TOTAL 35 20 5 3 4 0 0 0 44 23 Humanitarian leadership and coordination The Crisis Management Team - Comite Nationale de Coordination (CNC) continued to meet daily under the leadership of the Ministry of Health with all concerned partners and with the chairs of the different working groups providing thematic updates. UNICEF participates actively in the discussions at the coordination meetings at national, provincial and local level and active in the working groups on communication, WASH, psychosocial care and logistics. A high-level field mission led by the Minister of Health with the Representatives of WHO and UNICEF travelled to Mbandaka and Bikoro on Saturday 12th May to assess the level of response in the field. The delegation met with the Governor of Equateur Province, local authorities and provincial health workers. They travelled with a team of health workers and experts who stayed back in Mbandaka and Bikoro to coordinate the response. A follow up mission involving the WHO Director-General also travelled to the affected site on Sunday 13th May. Two teams of experts are currently on site coordinating the response: (1) a national level team composed of 12 delegates from the Ministry of Health, UNICEF, WHO and MSF in Mbandaka and (2) a second team already deployed in Bikoro as of 12 May, which included 4 UNICEF staff members 1 WASH Officer, 1 C4D Officer, the Head of UNICEF Office in Mbandaka (Doctor) and 1 Epidemiologist from UNICEF Kinshasa. Summary Analysis of Programme Response Overview of the key elements in the response with a special emphasis on UNICEF s response. Epidemiologic Surveillance While contact-tracing has started, line list of all suspected cases is not available as of now and urgent action in this regard is on-going (MOH & WHO). One of three suspected cases in Mbandaka has been confirmed by PCR. Confirmatory testing for the two other samples that were reactive on rapid diagnostic tests is being done at the National laboratory in Kinshasa (INRB). Follow up of 527 contacts continue in villages in the affected health areas of Bikoro (325), Ntondo (30), Wangata (52), and Iboko (120) health zones. Ring vaccination A team comprised of WHO, MSF, UNICEF and other partners met to review the protocol for the vaccination on Saturday 12 May. Existing protocols are being adapted to finalize the national protocol. UNICEF will continue to play lead role on the communication aspect of the vaccination and by providing 4 C4D specialists to work directly with the vaccination team. 2
The Ministry of Health has approved the use of the Ebola vaccine, which will be carried out as a ring vaccination. 5,400 doses were received in Kinshasa on 16 May. Up to 4,000 additional doses are currently available in WHO Geneva, and the cold chain equipment for the vaccination have been deployed to the DRC. Communication and social mobilization (C4D) UNICEF C4D is co-presiding the national Social Mobilization Commission (pillar) in Kinshasa and the Communication Task- Force in Mbandaka. UNICEF C4D has been asked by the MoH to coordinate international partners for social mobilization and support the national pillar. The UNICEF C4D presence in Mbandaka was reinforced, with the deployment of a national C4D specialist to be part of the regional coordination. In Bikoro Health Zone, a communication commission is in place composed of six experts sent by the Ministry of Health at the central, provincial, and health zone level, and three experts from partners (UNICEF, WHO and Red Cross). On 14 May 2018, 16 local facilitators were briefed by the communication commission. The commission members briefed local facilitators on preventive measures against Ebola and to put in place village committees (CACs), and / or reinforce existing ones. In the six affected health areas of Bikoro health zone, 282 out of 420 required local facilitators are operating in 36 CACs. At the territory level, these teams are supported by the local coordination committee, supported by UNICEF, which is composed of the Territorial Authorities, sector chief, the police commander, and the immigration chief. These committee members play key role in the dissemination of messages. UNICEF has finalized a PCA with Red Cross and extended the PCAs with Caritas and Oxfam to train and activate 30 master trainings, including staff from government, international and local NGOs, who will further facilitate trainings of village CACs, including over 200 social mobilizers and 94 school managers 1. The mapping of the field teams of partner NGOs in the three affected Health Zones is on-going to guide the planning of community engagement and improve information dissemination through radio, religious, schools, youth associations, M&E and documentation. UNICEF will work with national authorities to adapt the messages for a child audience and ensure these messages are transferred to children appropriately. A knowledge, attitude and behaviour (KAP) survey, organized by UNICEF, is planned for 16 May targeting taxi and motorcycle drivers, indigenous people, students, churches and markets (traders) to further refine the communication approach. A message development workshop led by the national coordination team and UNICEF is being held on 16 and 17 May on Ebola vaccine messaging, and another workshop on 18 May will brief media agencies and independent journalists. Water, Hygiene and Sanitation (WASH) (a) WASH in Ebola Treatment Centers Ebola Treatment Centers (ETC) in Bikoro and Mbandaka 2 were provided with WASH supplies and material by UNICEF. Situation reports on access to potable water in Bikoro and ETC sites indicate an inoperable water pump at the Regional Hospital of Bikoro. (b) WASH in institutions (Schools/health facilities) Hand washing points are already installed in 50 targeted 3 (100%) schools in affected areas of Bikoro health zone of Mbandaka. WASH supplies are being delivered for similar action in 72 targeted schools in the affected areas in Bikoro. 1 The school managers are being supported to train teachers 2 This site is not well equipped and being assessed by UNICEF and partners 3 The target is subject to further review as the epidemic evolves 3
UNICEF is planning to reach 100% of schools in all the affected areas with a minimum package, including hand washing facilities. Four disinfection points were installed at health facilities (1 general hospital, 2 health centers in Ikoko Impinge and 1 health center in Itipo). The hand pump was repaired at the general hospital of Bikoro, with a bed occupancy rate of 60%, allowing access to safe water. (c) WASH in communities Of the 36 water pumps identified at Bikoro, only 10 are functional, and there are 178 unprotected wells in eight areas assessed so far in Bikoro. UNICEF WASH section has finalized PCA with Red Cross to distribute Aquatabs in the affected communities and with Oxfam to repair non-functional water points, as well as support WASH in school/wash in health centers. Child Protection The CP strategy is critical to stopping Ebola, by ensuring that children are cared for, including contacts and survivors, as well as children whose parents may have been infected. With the Government, UNICEF co-chairs the commission on psychosocial care with a focus on (a) Paediatric care for infected children; (b) Care for children in quarantine, (c) Care for separated children who have lost their parents or caregivers, and (d) Psychosocial support for children. The child protection component is being implemented by LIZADEL (local NGO) with a focus on the following activities: Training of 67 child protection actors in psychosocial support for affected families (Wangata and Bikoro) Psychosocial support to affected families (30 counseling sessions per site) Direct case management to the most at risk children and families Family Tracing and Reunification UNICEF is currently reviewing lessons learned on child protection from the West African outbreak to inform the current response. The UNICEF team in Mbandaka has been reinforced with a child protection specialist, with additional reinforcement during the week of 18 May. Health/cases management Today, MOH at provincial level requested UNICEF s support to equip the Ebola Treatment Center (ETC) in Wangata Health Zone (Mbandaka Town), following which UNICEF deployed a construction engineer to take forward the required construction works. Meanwhile, UNICEF provided medicines for case management to Mbandaka ETC. Supply & Logistics To date, UNICEF has deployed to Mbandaka 4,585 Kgs of WASH supplies (soap, tarpaulins, buckets, chlorine) to support the response. Two (2) vehicles have been deployed for staff mobility, in addition to 400 Kg of health supplies and individual protective kits (155 kits) to Mbandaka, which are being transported to Bikoro and Iboko as needed. UNICEF provided six motorbikes to support the provincial health division in the affected areas, of which three were deployed in Bikoro and the remaining being used for surveillance in Mbandaka. 80 metric tons of supplies, mainly WASH and Health supplies, are being shipped from Sierra Leone warehouse to support UNICEF s Ebola response in the DRC. Three generators and a boat engine have been acquired for deployment in Mbandaka. Two supply staff members have been deployed as of 15 May, (1 NOB Logistics and 1 NOA construction engineer). 4
Following discussion with MONUSCO, MONUSCO flights have been availed to support Kinshasa Mbandaka travel (two rotations per day), and a MONUSCO helicopter in Mbandaka is available to make connection flights to the affected areas. Information, Communication and Telecommunication (ICT) Following an ICT assessment undertaken by the office, an additional BGAN for data and voice is being deployed in Bikoro. ICT emergency KITs (3G domino modem for internet, Individual solar light with 2 USB port for phone and Power Bank charging, 10000mAh power bank) were also deployed. Two additional Thuraya Sat phones (total 5 Thuraya in Mbandaka) were sent to ensure each field mission is equipped with at least one satellite phone. Others regular ICT materials were sent to Mbandaka to ensure the office can support more staff during this emergency situation. External Communication A UNICEF video communication team participated in the high-level mission to the affected area on 12 May. https://weshare.unicef.org/c.aspx?vp3=searchresult&dnid=2amzi498b75d&dm=distribution A joint press release (MOH, WHO and UNICEF) was issued on 12 May focusing on the joint visit of the Minister of Health of the DRC, WHO and UNICEF Representatives. http://ponabana.com/en/ebola-epidemic-drc/ UNICEF CO has been communicating on social media about UNICEF s response to the Ebola outbreak since the declaration of the epidemic. Human Resources UNICEF is present with an office in Mbandaka with 17 staff members. At present, 8 UNICEF staff are deployed in Bikoro, 6 staff from Kinshasa are deployed in Mbandaka. 12 additional staff are being recruited locally to support the response. Funding: USD 200,000 has been allocated by the office for first response needs. The Country Office has also developed funding proposals which were shared with donors. An agreement was reached with Gavi to re-programme funding from the Immunization Programme to support communication efforts around vaccination. Who to contact for further information: Gianfranco Rotigliano Representative a.i. Tel: + (243) 996 050 399 E-mail: grotigliano@unicef.org Tajudeen Oyewale Deputy Representative Tel : +(243) 996 050 200 E-mail : toyewale@unicef.org Hamady Ba Health Specialist (Emergency) Tel: + (243) 817 096 787 E-mail: hba@unicef.org 5