Democratic Republic of Congo: As Ebola disease spreads, MSF expands treatment capacity in Nia Nia and Kisangani
New treatment centres strengthen care while teams respond to fear and misinformation.
In northeastern Democratic Republic of Congo (DRC), Doctors Without Borders/Médecins Sans Frontières (MSF) is expanding our Ebola disease response as the outbreak spreads from the remote town of Nia Nia in Ituri province to Kisangani, the busy capital of neighbouring Tshopo province.
In Kisangani, MSF has been running the Ebola Treatment Centre (ETC) at Cinquantenaire hospital in collaboration with the Ministry of Health since the end of June. In the first week of September, patients were transferred to a new 22-bed ETC built and run by MSF, increasing treatment capacity in Kisangani.
“In an Ebola Treatment Centre, what we can do is care for the individual patient, but epidemics are stopped in the community.”
Miriam Alia, MSF medical coordinator
In Nia Nia, MSF teams started working alongside the Ministry of Health at the ETC in the local hospital since early August. This week, MSF opened a new 50-bed ETC next to the hospital, further expanding access to Ebola care in the area.
The two locations are closely connected. Nia Nia is situated in an area with significant movement of people and goods between Ituri, Tshopo and Haut-Uele provinces. Since the first cases were reported there, people infected in or linked to Nia Nia have travelled to other areas, including Kisangani, where 13 of the 14 positive cases recorded as of Sept. 1 had an epidemiological link to Nia Nia.
Responding where the outbreak is spreading
Nia Nia has become a major focus of the outbreak in southern Ituri. The town recorded its first cases at the end of June, but the response has faced significant challenges, including limited access to healthcare, gaps in infection prevention and control and fear and misinformation within the community.
MSF teams began working in Nia Nia in early August. As of Sept. 1, the Nia Nia ETC had admitted 85 people with symptoms matching Ebola. Of these, 59 were confirmed Ebola cases, including 15 patients who died. MSF has now opened a 50-bed ETC next to the existing facility, with 16 beds for suspected cases and 34 for confirmed cases. The new centre is designed to provide safer and more effective care, with the protocols and biosafety measures needed to treat patients with Ebola disease.
“In an Ebola Treatment Centre, what we can do is care for the individual patient, but epidemics are stopped in the community,” says Miriam Alia, MSF medical coordinator.
When fear prevents people from seeking care
During the first weeks of the outbreak in Nia Nia, fewer patients were reaching the ETC than the number of confirmed deaths reported in the community. Many people remained at home rather than seeking care.
There are now signs of change. More people are reaching the treatment centre alive, giving them the opportunity to receive early supportive treatment.
“Three weeks ago, we started receiving patients rather than only alerts about deaths in the community,” says Alia. “This is a major change because it means people are coming to the ETC earlier, when they develop symptoms.”
“During Ebola outbreaks, we used to talk about two epidemics: the epidemic itself, and the epidemic of fear. Now we have a third one: the epidemic of misinformation.”
Miriam Alia, MSF medical coordinator
From the beginning, the response in Nia Nia has faced strong resistance, with rumours and misinformation fuelling fear. These have included claims Ebola did not exist or medical staff were bringing the disease into communities. Health workers were threatened, and an earlier treatment centre in the region was attacked and destroyed on June 30.
“I didn’t believe that Ebola existed,” says Maurice, a recovered Ebola patient that was treated by MSF in Kisangani. “But when I was tested and found out that I had Ebola, that’s when I understood that it exists. But people still say that Ebola isn’t real. In my neighbourhood, in people’s homes, that’s what I used to hear.”
MSF teams are working with community leaders, health workers and other local agencies to understand concerns, address misinformation and build acceptance of the response.
“During Ebola outbreaks, we used to talk about two epidemics: the epidemic itself, and the epidemic of fear,” says Miriam Alia. “Now we have a third one: the epidemic of misinformation.”
From Nia Nia to Kisangani
The link between Nia Nia and Kisangani shows why containing the outbreak in hard-to-reach areas is critical. “In the past month, two other people were infected in Kisangani after coming into contact with a body that had arrived from Nia Nia,” says Amy Low, a Canadian MSF project medical advisor in Kisangani. Also, over the past week, three patients with an epidemiological link to Nia Nia died at the MSF-supported ETC in Kisangani.
MSF is expanding our capacity in both locations connected by the spread of the outbreak.
But treatment centres alone cannot stop Ebola disease. Surveillance, testing, contact tracing, infection prevention and control, early isolation, treatment and community engagement all need to work together to reduce transmission and ensure communities in areas such as Nia Nia are not left behind.
