This past week, news was received of the death of two unrelated women in the North Kivu Province of the Democratic Republic of Congo (DRC) due to Ebola.  This is a sad reminder of one of the grave health concerns that hover over the people of this part of eastern DRC—because it keeps coming back.   The last of this past decade’s several outbreaks in this region was declared over in June of 2020.  But the reprieve was short-lived.

Ebola is one of many hemorrhagic fever illnesses in the world today.  It is caused by the Ebola virus, named after the Ebola River in northern Democratic Republic of Congo. 

Discovered in 1976 by researchers in a village on that river, Ebola is endemic to this part of sub-Saharan Africa.  Thankfully, it is rare outside of equatorial Africa.  But with world travel continuing to expand as it is, it would not take long for one sick person on a plane flying to another continent to spread it far and wide.

The disease itself usually starts with nonspecific symptoms of fever, headache, and muscle pain.  Some patients later develop diarrhea, difficulty breathing, confusion, and seizures.  But about 1/3 of the patients go on to the dangerous symptoms of bleeding from the intestines, vomiting blood, coughing up blood, or bleeding from almost any opening of the body.  Often this bleeding persists, leading to shock, and often death.  They need intensive supportive care, IV fluids, and blood transfusions.  There are only a very few new, expensive medicines that may have any impact on the virus at all. It is a very deadly disease, with fatalities in some outbreaks reaching 70% to 90% of those infected.  And if that was not frightening enough, it is also highly contagious.

The Ebola virus usually resides in the bodies of different animals of equatorial Africa—such as the monkeys, chimpanzees, gorillas, and fruit bats found in eastern DRC.  These bats are strongly suspected to be the usual place where the virus resides.  These animals may transmit the virus amongst themselves.  But if a human comes in contact with the body fluids or tissues of an infected animal, for example by collecting and preparing bush meat for human consumption, then the virus can easily find its way into human populations.  Despite educational efforts, this still happens intermittently in this part of the world. And when it does happen, Ebola can spread like wildfire.  It is transmitted from human-to-human by body fluids and by direct contact.  So, unsuspecting health care workers can easily contract it, as can family members—even when touching the body or clothing of a loved one who has died of the illness.  And in this part of the world, large community funerals can end up rapidly spreading the disease.  Quick recognition of its presence in a population and strict isolation of patients and suspected patients is vital to containing this disease.  (A vaccine against Ebola was only just licensed last year and would likely be used by an international health team in a rapid vaccination campaign in such an outbreak.)

The Global Refuge Projects workers and partners in eastern DRC face the same dangers and challenges as the displaced, poverty-stricken people they serve.   If the threats of rebel violence and common deadly diseases like malaria were not enough, then, intermittently recurring outbreaks of Ebola add even another major obstacle for them all.  Let us support our workers and pray for them as they seek to help the people of North Kivu to have even the basic opportunity for a healthy life.  

-Lynn Fogleman, MD