BUNIA, Congo — Congo is experiencing a shortage of health workers to staff treatment centers for the ongoing Ebola outbreak, which has been identified as the fastest-growing in history. This shortage is particularly acute in the eastern province of North Kivu, where cases have surged by 73% over the past three weeks, according to a statement from the World Health Organization (WHO) on Wednesday.
Despite improvements in other provinces, including Ituri, which is the outbreak's epicenter, the situation remains critical. The outbreak has now spread to seven provinces, with current government figures reporting 7,773 confirmed cases and 3,759 deaths.
Between August 31 and September 20, cases in Ituri province decreased by 26%, and by 15% in Haut-Uele, as stated by Marie Roseline Belizaire, the WHO’s regional emergency director for Africa. However, she noted that transmission patterns vary significantly, and the outbreak remains uncontrolled.
“While cases and deaths are declining in some provinces, they continue to rise in others,” Belizaire said. “The outbreak is still not under control and remains spread across a wide geographic area.”
The spread of the outbreak is exacerbated by challenging conditions, including insecurity, displacement, a health workers’ strike, and significant population movements. The WHO has indicated that the current outbreak is on track to surpass the 2014-2016 West Africa Ebola outbreak, which was the deadliest on record, claiming more than 11,000 lives primarily in Guinea, Liberia, and Sierra Leone.
Catherine Smallwood, the WHO’s Ebola incident manager, reported that cases and deaths in North Kivu have begun to decline after several weeks of increases. However, despite the addition of treatment beds, facilities still lack sufficient staff and partners to operate them.
“The human resources gap is one of the biggest gaps,” Smallwood stated.
Anne Ancia, the WHO representative in Congo, explained that one Ebola treatment center requires approximately 300 health professionals, including anesthetists, hygienists, nurses, and general practitioners. “We are building Ebola treatment centers but do not always have the human resources needed to operate them,” Ancia said, emphasizing the need for adequate compensation for health workers.
Frontline workers in Ituri previously went on strike due to unpaid wages, which has further complicated access to care. Health Minister Roger Kamba mentioned in July that the government was reviewing payroll lists after discrepancies were found, including names of individuals not involved in the response.
Frontline workers reported that officials had promised to pay the outstanding wages, but many received nothing or only partial payments.
Another significant challenge in the response is the high fatality rate among children. According to the WHO, children under five have the highest case fatality rate at over 60%, compared to approximately 40% among adults. Smallwood highlighted that detecting cases among young children is particularly challenging, as they may not be able to articulate their symptoms, and the presentation of symptoms can often be misleading.