The latest outbreak of Ebola, in the Democratic Republic of the Congo (DRC), has inspired a broad international response. PATH is supporting the effort to end the epidemic as quickly as possible. Writer Lesley Reed spoke to Trad Hatton, PATH’s country leader in the DRC, to learn more.
Q: Where is this Ebola outbreak happening, and what’s the risk of it spreading to other countries?
A: The outbreak is in an extremely remote part of northeastern DRC called the Likati Health Zone—in the province of Bas Uele—and near the site of the very first recorded case of Ebola in 1976. It also borders the Central African Republic, which puts the region at risk.
It took almost three weeks for the disease to be confirmed because the area is so disconnected from the rest of the world. There’s no telecommunications or electricity. The closest city is around 500 kilometers away by almost impassable dirt road. Even after the first Ebola case was confirmed, it took days more for the first responders to reach the epicenter.
“"Most of the region is mis-mapped or not mapped at all, which means no one knew exactly where villages were located—but to stop an outbreak you need to know where the people are."”— Trad Hatton
Given that this outbreak is in such a remote area and that the DRC has experience with Ebola, we’re hopeful it will be contained quickly. But rapid response is critical because people do travel. With a population scattered over such a large area, it’s challenging to trace suspected Ebola cases as well as all of the people those cases have been in contact with. It’s a race against the clock.
Q: What are you learning now that responders are on the ground?
A: We still don’t know the extent of the outbreak, but we’re starting to hear the stories of who this is affecting—it’s family members and others trying to help each other out. One teenage girl died trying to help her brother.
Because there are no real roads, the first person who came down with Ebola had to take a motorcycle taxi through the rain forest to the hospital in Likati. He had to be strapped to the back of the driver. You can imagine the exposure. The man died before they reached the hospital, and the driver died a few days later.
It’s good people trying to save each other’s lives and paying the ultimate sacrifice.
We’re part of a coordinated response in the DR Congo addressing a new Ebola outbreak. Read the latest on this emerging story.
Q: PATH jumped in quickly to help. What are we doing?
A: PATH was fortunate to be at the right place at the right time. We’re a key partner to the DRC’s Ministry of Health (MOH) on global health security. Together, we’re helping to establish the first emergency operations center (EOC) in the country, which will help deal with public health emergencies like this.
Because we were already in daily conversations with the Ministry, and have strong partnerships with other organizations and some real experts on our staff, we were able to be nimble and make targeted contributions to the first wave of response.
Right now, we’re playing a supporting role for the MOH and the responders. One of the first things we did was use some of our flexible funding to get five of the first ten responders to the epicenter. It took them three days to get to there by plane, 4WD vehicle, motorcycle, and foot.
We also mobilized a group of international partners to support the effort with high-resolution satellite imagery, geospatial mapping capabilities, GPS-enabled smartphones, a satellite communications system, and other tools to help map and investigate the outbreak.
This map shows the progress made by volunteers using the OSM Tasking Manager, an open source tool developed by the Humanitarian OpenStreetMap Team, to map roads and villages in the region of the latest Ebola outbreak. Screenshot: OSM Tasking Manager.
Q: Why was mapping the area important for quick response times?
A: Most of the region is mis-mapped or not mapped at all, which means no one knew exactly where villages were located—but to stop an outbreak you need to know where the people are.
We called on some of our partners with the technical capacity to help out. DigitalGlobe had its satellites take new, high-resolution imagery of the affected area and made available some archived high-resolution imagery for mapping efforts.
Coordinating with the University of California, Los Angeles (UCLA), DRC Research program, the OpenStreetMap DRC and the Humanitarian OpenStreetMap Team crowdsourced the mapping of the outbreak area using DigitalGlobe’s imagery. Hundreds of OSM volunteer contributors, both in the DRC and around the world, then collectively spent thousands of hours mapping the outbreak region. The large area was able to be mapped in a very short amount of time using crowdsourcing.
The mapping is being verified and further completed using GPS coordinates sent from the smartphones we provided to responders now in the field. The government will be able to use that data to plan its response.
“"The country is the size of Western Europe, but is extremely poor and has very little infrastructure or connectivity. As a result, it took way too long for this outbreak to be detected. Congo’s inability to communicate with itself is a potential risk to the world."”— Trad Hatton
I should note that we were already working with UCLA to map DRC’s Bandundu Province as part of an ambitious program to eliminate sleeping sickness. The rapid response we got from partners like these to coordinate with each other to quickly map the area demonstrates what can come from building strong collaborative relationships between partners and sectors.
Q: What else is PATH doing now to help with the outbreak?
A. PATH and our partners are working with authorities in Bas Uele Province to increase community awareness about the outbreak and how to avoid spreading the disease. And as a member of the Ebola Surveillance Commission, we continue to provide technical expertise.
We’re continuing to build the EOC, which will coordinate surveillance with the aim of early detection and quick response to emergencies like this. The EOC will be operable by the end of 2017.
In the meantime, we’re learning from this situation. We’re communicating with the Centers for Disease Control and Prevention and the Ministry on a near-daily basis and asking ourselves, “How could the EOC have done this differently or more efficiently?”
This is what connectivity looks like on the outskirts of Kinshasa, the capital of the DRC. In much of the country there are no electric or telephone lines nor cell coverage. Photo: PATH/Felix Masi.
Q: And your answer? What could the EOC have done differently?
A: Certainly, this outbreak has reaffirmed the need for better in-country preparedness to respond to emergencies. In spite of the DRC having some of the true global experts in the area of Ebola such as the director of the national laboratory, Dr. Jean-Jacques Muyembe Tamfum, and the director of the department of disease control, Dr. Benoit Kebela, these experts could have responded even quicker if they had better tools and more resources to work with. One of the biggest lessons is that Congo needs to be digitized to have better surveillance systems and faster emergency response.
The country is the size of Western Europe, but is extremely poor and has very little infrastructure or connectivity. As a result, it took way too long for this outbreak to be detected. Congo’s inability to communicate with itself is a potential risk to the world.
It wouldn’t cost that much to set up satellite communications systems throughout the DRC so that the country has a fully powered, fully functioning health surveillance and communications infrastructure.
This event is just the latest reminder of why improving epidemic preparedness and prevention are urgent priorities—and, in particular, the importance of investing in the DRC.