Nearly a month into one of the world’s largest ever Ebola outbreaks, medics in eastern Democratic Republic of Congo are struggling to secure basic equipment to stay safe and prevent further spread of the disease, according to more than a dozen doctors, humanitarian workers and public health officials.
While major donors are surging funding, the size of the outbreak, reductions in pre-positioned stocks due to aid cuts, and logistical problems have caused shortages and driven up costs for personal protective equipment.
The International Rescue Committee aid group warned on Tuesday that stocks of essential protective equipment are expected to run out within days.
In North Kivu, one of three affected provinces that have confirmed over 550 cases and 100 deaths, medical teams are close to exhausting items like chlorine and often lack equipment including boots, said Pablo Lwanzo Paluku, chief doctor for the Butembo zone.
A suspected Ebola victim’s body was wrapped in a blue tarpaulin and transported on a taxi roof due to the lack of a body bag or ambulance, he said.
“What little we have is improvised,” said Paluku.
As of June 4, only a quarter of critical supplies needed for the next three months had arrived in Congo and Uganda, which has reported 19 cases, with face shields and alcoholic gel particularly short, according to the Africa Centres for Disease Control and Prevention.
STEEP RISE IN PRICE OF PROTECTIVE EQUIPMENT
Already, 34 healthcare workers have been infected with the rare Bundibugyo strain of the virus and seven have died, just over three weeks after the World Health Organization declared an international emergency.
Costs for the PPE that is available have surged, in part due to the ripple effects of the Strait of Hormuz closure, which has disrupted imports from Dubai warehouses and driven up transport costs on other routes, five people involved in the response said.
Some organisations have procured PPE locally, but the cost of high-protection suits has jumped 40% since last month to around $35, said Frantz Celestin, the International Organization for Migration’s regional director in Nairobi.
Procurement is complicated by eastern Congo’s limited transport infrastructure and insecurity due to armed conflict. The airport in Bunia, at the outbreak’s epicentre, is closed, and Uganda — where many supplies are ordinarily sourced — shut its border with Congo last month to try to reduce spread.
Major donors have been scaling up support. The U.S. has delivered 150 tons of medical supplies and pledged over $200 million directly to the affected countries, a State Department spokesperson said, making it the largest financial contributor to the Ebola response.
U.S. CUTS MEAN RESPONDERS ARE PLAYING CATCH-UP, SOURCES SAY
The spokesperson did not comment on a question about the U.S. role in supply shortages.
But first responders say they are playing catch-up because of the late detection of the outbreak — which health officials think was circulating for at least two months before being declared in mid-May.
The U.S. was previously the lead provider of PPE in emergencies, working alongside WHO and aid groups to pre-position stocks and ramp up delivery quickly. The response to the 2018-2020 Ebola epidemic in Congo, to which the U.S. contributed around $600 million, was “one of the fastest and best equipped in history”, a WHO report said.
But U.S. funding cutbacks, plus its withdrawal from WHO, have challenged the response to the current Ebola outbreak, according to five aid sources and two U.S. officials.
“I wish I could say we had stock, but in reality we did not have any,” said Amadou Bocoum, CARE’s country director in Congo, whose largely U.S.-funded budget was cut back by a third, adding that it took 10 days after the outbreak was declared to start distributing PPE.
‘BUILDING THE PLANE AS WE FLY IT’
Some supplies were in place. Abdou Sebushishe, a senior adviser at the International Medical Corps, said IMC deployed PPE in Bunia within 24 hours of the outbreak being declared, thanks to U.S. funding, although he witnessed a total lack of water basins and thermometers elsewhere.
The U.S. foreign assistance agency USAID, which President Donald Trump dismantled last year, previously had an agreement with WHO allowing the release of funds for PPE within 48 hours of an outbreak, two former USAID officials said.
“USAID had these systems. They weren’t perfect but they were pretty damn good. Now we are literally building the plane as we fly it,” said a third U.S. official, who asked not to be named.
Professor Salim Abdool Karim, who is advising Africa CDC on the response, said USAID’s logistics expertise was sorely missed.
“If you needed ten trucks with fuel and drivers, they had the wherewithal to procure that,” said Karim, who was due to travel to Congo this week.
On the frontlines, protective suits are slowly arriving, but too late for some.
“We are dying like flies,” said Denis Urwothun Rwothng’a, a medic in Bunia who has lost three colleagues to the virus.
(Additional reporting by Jessica Donati and Clement Bonnerot)
