DRC Emergency: MSF organizes to fight malaria in Orientale Province
July 31, 2012
An outbreak of malaria has struck several regions of Orientale Province in northwest Democratic Republic of Congo. In early June, MSF sent an emergency team into the Ganga-Dingila health region, home to approximately 118,000 people living in isolated, hard-to-reach communities lacking access to medical care.
"She can't speak – she is too sad," explains a neighbor of Jeanne, a young mother. "Her children died." Two tiny caskets covered with fresh dirt lay in front of her house, located on the road connecting Dingila, the administrative center of the area, and Zobia. More than 18 people in this little village have died in five months. Most were children. Last year, no one died from malaria, which is endemic in the area.
Since the beginning of the year, an unusual number of people suffering from malaria and severe anemia, and exceptionally high mortality rates, have been recorded in Ganga-Dingila. "People say they have never seen anything like this," says Dr. Narcisse Wega, MSF's emergency coordinator, who arrived in June to launch medical activities. "Some parents have lost two or three children in just a few weeks.”
The situation has created a profound sense of loss within the communities. "Other regions of the province seem to be affected by this as well, but we cannot yet explain it," says Dr. Mathieu Bichet, MSF's medical director in Geneva. "An investigation is underway. However, we can say that it is exacerbated by problems related to access to health care facilities and the lack of drugs."
Since June, MSF has been using all available resources to provide free care to people throughout the health region, setting up treatment and intensive care units, supplying drugs to health care facilities and organizing the transfer of seriously ill patients to MSF-supported hospitals. MSF is also training national health care employees to provide a very effective artemisinin-based treatment for malaria. It is injected intravenously to treat the most severe cases. Children who receive it recover in a few days.
MSF is the only medical humanitarian organization in the area and is working with the Ministry of Health to make this treatment available in the most isolated regions so that patients do not have to travel more than 60 kilometers to receive care. Treatment delays increase the risk of serious medical complications and death.
MSF's logistical teams have rebuilt bridges and a landing strip, allowing motorcycles and planes to supply the area on a regular basis. "The needs are enormous and Zobia is very out of the way, so it's difficult to get supplies there," explains Gilles Koukpo, the doctor in charge of the malaria team in Zobia. "Motorcycles have to travel more than six hours on a narrow, windy road and cross a series of broken-down bridges to deliver a small quantity of medicine."
Health care facilities in the Zobia-Dingila area that receive MSF support have observed a sharp drop in mortality since June. However, other distant communities continue to contact MSF, which is currently expanding its activities.
An appeal was issued in early July for additional resources from other humanitarian organizations working in Orientale Province to stop the spread of the illness, primarily through prevention activities. "We cannot currently carry out mass distributions of insecticide-treated mosquito nets, which are a good way to prevent the transmission of malaria," says Dr. Bichet. "We have to focus all our resources on treating as many people as possible. However, it is critical that other actors organize quickly."
Between June 20 and July 20, 2012 MSF treated more than 7,000 people on an outpatient basis in the Ganga-Dingila health region, and hospitalized over 740, including more than 180 who received transfusions for severe anemia. In 2011, MSF treated over 158,000 people throughout the country suffering from malaria.