End of the 11th Ebola outbreak in DRC: an improved medical response

MSF applied the lessons learned during the previous Ebola outbreak in the country to the benefit of patients. Medical teams have worked to be closer and more accessible to the community and to train local health care personnel.

The Ebola outbreak in Equateur’s province has been brought to an end almost six months after it started, thanks to an improved approach to patient care, according to Médecins sans Frontières (MSF).

The outbreak spread relatively slowly after its declaration on 1 June 2020, despite the fact that as many as 13 out of 17 health districts in Equateur province reported confirmed Ebola cases. According to the Ministry of Health, 130 patients were reported, 55 of whom died. The 42.3 per cent mortality rate was significantly lower than the 66 per cent observed during the previous outbreak, which occurred in north-east DRC between August 2018 and June 2002, causing the death of 2,287 people.

According to MSF, the introduction of the latest medical tools, the strengthening of community-based surveillance and a decentralised model of patient care have all contributed to the rolling out of an effective intervention in areas often difficult to reach.

"We took advantage of lessons learned during the previous outbreak: these allowed for a better management of the situation in Equateur, though the two contexts are different," says Dr Guyguy Manangama, one of MSF's emergency managers. "During the previous (10th) outbreak, our intervention sometimes faced challenges in terms of its acceptance by the population because it was too centralised. This time, we favoured a decentralised approach and kept the population informed at all times about the intervention and the surveillance mechanism, to improve access to health care in the region."

MSF's mobile multidisciplinary teams leave remote Lotumbe. They carried out interventions in different targeted villages in the area, including construction of isolation structions, epidemiological surveillance, closer contact and health promotion with the communities, and free medical consultations, among others. © Yves Ndjadi/MSF

MSF responded to the emergency since the beginning of June in the areas affected by the outbreak, supporting the local healthcare system and offering treatment for other diseases such as malaria and acute malnutrition. It adopted innovative strategies, including fixed and mobile sites in its intervention. More than 1,450 consultations were carried out across 28 health centres in five different health districts, among the ones that reported Ebola cases or unexplained deaths in the community. Local medical staff was trained on the management of the disease and donations were made to support local health centres.

New medical tools to prevent and treat the disease also contributed to improve the quality of response. These tools, as well as the adaptation of the medical response to the specific conditions on the ground, are the results of the experience accumulated during the previous interventions. Their ultimate purpose is to produce a better, more integrated and accessible Ebola response in the future.