DRC Ebola outbreak response struggling one year on
by OCHA, MSF, Mercy Corps, New Humanitarian
Democratic Republic of Congo
1 Aug. 2019
The Ebola epidemic in the Democratic Republic of Congo shows no sign of slowing, a year after the outbreak was declared, on 1 August 2018. To date there have been 2,593 cases and more than 1,700 confirmed deaths.
It’s the rate of spread in northeastern Congo that is most alarming. Whereas the first 1,000 cases took 224 days to arrive, it took only another 71 days to reach the 2,000 mark.
This week two new cases emerged in Goma, a major city and transport hub in eastern Congo that is hundreds of kilometres from the main hotspots of Beni and Butembo and right next to the Rwandan border.
In response, Rwanda has reportedly closed its border with Congo – a move the World Health Organisation asked countries to avoid when it declared the outbreak in Congo’s North Kivu and Ituri provinces a Public Health Emergency of International Concern last month.
This outbreak emerged in a region gripped by years of ongoing conflict. The insecurity, and the deep mistrust communities have for the government and the health response, has complicated the struggle to contain it. Over the past year there have been more than 170 attacks on health centres and aid workers by both armed groups and local people.
We can’t stop Congo’s Ebola outbreak until communities lead the response, writes Amy Daffe - Deputy country director for Mercy Corps in the Democratic Republic of Congo
One year into the Ebola outbreak in the Democratic Republic of Congo and the epidemic is accelerating. There have been more new cases in the last three months than the previous nine – an average of 84 new cases a week – and more than 1,700 people have now died.
Ebola’s spread into new and large population centres in northeastern Congo and beyond remains a real fear. Three cases have now been confirmed in previously unaffected Goma, a city of more than two million people and a major transit hub on the border with Rwanda, hundreds of kilometres away from the main Ebola hotspots of Beni and Butembo. Rwanda responded today by closing the border.
Reflecting the mounting anxiety over the disease’s trajectory, the World Health Organisation on 17 July declared the outbreak in Congo’s North Kivu and Ituri provinces a Public Health Emergency of International Concern.
Why is this outbreak proving so difficult to control? We know that community leadership and mobilisation is integral to stopping the spread of the disease, but not enough emphasis is being placed on building community trust and acceptance of the Ebola response. Neither is there enough investment in human capital, or flexible funding to NGOs supporting the response.
This is coupled with a top-down approach to community engagement that hasn’t used the right channels to reach communities.
Instead of working with local leaders, outsiders arrived spreading messages that have left communities with more questions than answers. Information has not been well-tailored to different community contexts nor appropriately adapted to local languages or social norms.
As a result, cases are being hidden in communities and worryingly the contacts of those that die are largely unknown, making tracing difficult. With a 68 percent fatality rate, this Ebola outbreak is among the deadliest ever (the average rate is 50 percent).
Lack of community engagement and knowledge contributes to the lag in referral time. On average it is taking 5.5 days from the onset of symptoms for a suspected case to report to a health facility and more than half of parents are not referring their children.
North Kivu and Ituri are areas steeped in conflict for the past two decades, with scores of different armed groups vying for control. An average person will have fled their home four or five times in their lifetime due to conflict. That makes an effective Ebola response even more challenging..
http://www.thenewhumanitarian.org/opinion/2019/08/01/Ebola-outbreak-community-response-Congo http://www.thenewhumanitarian.org/news/2019/08/01/year-congo-s-ebola-epidemic-and-no-end-sight http://www.msf.org/drc-ebola-outbreak-response-struggling-one-year http://www.unocha.org/story/drc-urgent-need-strengthened-response-and-increased-donor-investment-end-ebola-outbreak http://www.savethechildren.net/news/save-children-welcomes-highest-alert-ebola-outbreak http://unocha.exposure.co/five-challenges-facing-the-drc
* Access the link below for Medecins sans Frontieres DRC reports on the Ebola crisis.
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Drought in Africa leaves 45 million in need across 14 countries
by Famine Early Warning System Network, agencies
East Africa Food Security Outlook, June 2019 to January 2020. (FEWS-Net)
An estimated 43 million people affected by drought, conflict, and macroeconomic shocks are expected to face Crisis (IPC Phase 3) or worse outcomes across Somalia, Ethiopia, Uganda, Yemen, South Sudan, Sudan, Kenya, and Burundi. These populations in need require urgent humanitarian food assistance to mitigate deterioration in food security outcomes in the outlook period. This figure includes an estimated 11.4 million internally displaced people and 4.3 million refugees throughout the region, many of whom are also expected to be in Crisis (IPC Phase 3) or worse outcomes.
An estimated 6.96 million people in South Sudan and 17 million people in Yemen are facing Crisis (IPC Phase 3) or worse outcomes in the presence of planned humanitarian food assistance. This includes some households in Jonglei and Upper Nile of South Sudan that are likely in Catastrophe (IPC Phase 5).
Although food assistance is mitigating more extreme outcomes, the reach of assistance remains below the estimated need and access to populations in need remains a significant concern. In South Sudan, the risk of Famine (IPC Phase 5) will persist through January 2020 despite an anticipated increase in 2019/20 crop production compared to 2018/19, given existing high levels of acute food insecurity and the potential for conflict to quickly shift and restrict household movement and humanitarian access.
In Yemen, Famine (IPC Phase 5) would be likely in a worst-case scenario where commercial imports significantly decline far below requirement levels or conflict cuts off populations from trade for a prolonged period.
In the Horn of Africa, Crisis (IPC Phase 3) or worse outcomes are anticipated through January 2020 due to drought and two consecutive poor production seasons in 2018/19, though some improvements will likely be realized during the October – December 2019 rainy season.
In Somalia, Crisis (IPC Phase 3) and Emergency (IPC Phase 4) outcomes are expected in central and northern pastoral areas and several northern and southern agropastoral areas.
In Ethiopia, Crisis (IPC Phase 3) is expected in the lowlands of Oromia, northeastern Afar, northeastern Amhara, and the Somali region. A likely safety net pipeline break in the worst-affected areas of Ethiopia would also result in an increase in the number of households in Emergency (IPC Phase 4), elevating the already high prevalence of acute malnutrition.
In Kenya, outcomes are expected to improve from Crisis (IPC Phase 3) to Stressed (IPC Phase 2) in late 2019, but some poor households may remain in Crisis (IPC Phase 3).
Among populations displaced by conflict and civil unrest in Ethiopia and Sudan, food gaps indicative of Crisis (IPC Phase 3) are likely to persist throughout the outlook period and some households may deteriorate to Emergency (ICP Phase 4) in the ongoing lean season. About one million people remain displaced in Benishangul Gumuz, Oromia, SNNPR, and Somali regions of Ethiopia.
In Sudan, 2.0-2.6 million people are displaced, including protracted internally displaced persons (IDPs) in SPLM-N-controlled areas of South Kordofan and SPLA-AW-controlled areas of Jebel Marra in Darfur States of Sudan. Conflict-displaced households have lost access to typical livelihoods while population movements, trade flows, and access to humanitarian assistance are restricted.
http://fews.net/east-africa/food-security-outlook/july-2019 http://fews.net/east-africa/yemen/alert/july-24-2019 http://reliefweb.int/report/south-sudan/drought-and-conflict-leave-87-million-people-hungry-somalia-and-south-sudan http://bit.ly/2YgCxSe http://www.fao.org/giews/country-analysis/external-assistance/en/
Drought in Africa leaves 45 million in need across 14 countries. (New Humanitarian)
Failed rains across eastern Africa, southern Africa, and the Horn of Africa are seeing another dire season for farmers, increasing food prices and driving up the aid needs of tens of millions of already vulnerable people across the three regions.
All told, more than 45 million people will struggle to find enough food across 14 countries in 2019, many feeling the compounded effects of years of drought.
It’s the second time in three years that an El Niño event has disrupted weather patterns. In 2017 – a year in which the UN labelled the crisis the worst in decades – some 38 million people were in need.
Drought again in 2018 was followed by significantly below-average rains at the beginning of this year – down by 50 percent in parts of southern Africa.
In the Horn and eastern Africa, delayed rains finally arrived in May, allowing some regrowth of pasture for grazing. But it has not been enough to offset the damage to people’s livelihoods and overall food security.
“We need to move to a system where we act much earlier on the warning signs of drought and hunger so that we can cut response times and costs, and reduce deaths and human suffering,” the UN’s Emergency Relief Coordinator, Mark Lowcock, said in reference to the drought in the Horn.
The UN’s Central Emergency Response Fund has released $45 million to encourage major donors to do more to combat the effects of drought in parts of Somalia, Ethiopia, and Kenya.
With an El Niño forecast more than six months ago, World Food Programme climatologist Jesse Mason argues there should have been time for governments and aid agencies to put in place risk-reduction measures: drought-resistant seeds, irrigation systems, and cash transfers to cushion the impact on farmers.
It can no longer be business as usual, Mason told The New Humanitarian. Southern and eastern Africa are on the front lines of climate change, and mitigation measures must now be much more data-driven, comprehensive, and innovative.
“We need to recognise the seasons are changing and we need to adapt,” said Mason, project manager at WFP’s forecast-based financing initiative. “The pieces need to come together, from the global forecasting to the way we interact with farmers on the ground based on that information.”
The following is a snapshot of needs across southern, eastern, and the Horn of Africa.
Angola - In need: 2.3 million
The government declared an emergency in the three southern provinces of Cunene, Huila, and Namibe in January. Angola has been pursuing a humanitarian self-reliance policy but the response has been inadequate and the situation is deteriorating.
Ethiopia - In need: 8.3 million
The most vulnerable communities have suffered consecutive years of drought. This season’s Gu long rains (March to May) were poor or delayed. Although a late burst of rainfall has helped replenish pasture in the south and southeast, it came too late for some crop-producing areas and the food security situation is expected to deteriorate.
Numbers in need are exacerbated by mass internal displacement as a result of inter-communal violence – affecting some 2.6 million. Concerns are also rising over potential food aid pipeline breaks that could interrupt life-saving operations. It’s $1.3 billion aid appeal is only 15 percent funded.
Kenya - In need: 2.5 million
The long rains were similarly poor – less than half the expected amount fell by April. By July the number of severely food insecure is projected to more than double from the current 1.1 million to 2.5 million. Below-average terms of trade and reduced household incomes during the July to September dry season could push parts of eastern Kenya into crisis by August.
Lesotho - In need: 640,000
Four districts are at crisis or emergency levels – Mohale’s Hoek, Maseru, Quthing, and Qacha’s Nek. A total of 640,000 people are projected to be food insecure over the next 12 months. Lesotho has a population of 2.2 million.
Madagascar - In need: 1.3 million
By March, 1.3 million people were severely food insecure. Although the vulnerable southern region received fair rainfall this season, the harvest is forecast to be well below average. The south is yet to recover from the effects of the 2015/16 El Niño and the 2017/18 drought, and the number of children who are acutely malnourished is expected to rise in 2019.
Malawi - In need: 3.3 million
Some 2.8 million people are projected to be in crisis and 450,000 at emergency levels of food needs during the October to March lean season in the country’s southern and central districts.
Mozambique - In need: 1.85 million
More than 1.7 million people were identified as in crisis between September and December 2018 across 11 provinces. As a result of Cyclone Idai in March and Cyclone Kenneth in April, an estimated 1.85 million are now in need of aid.
Namibia - In need: 550,000
At the beginning of May the government declared a drought-induced state of emergency – the third time in six years. All regions of the country are affected, with 24 percent of the 2.3 million population facing food shortfalls.
Somalia - In need: 5.4 million
After two consecutive poor rainy seasons Somalia is facing yet another drought. The 2019 Gu rains (April to June) have failed, on top of a poor 2018 Deyr season (October to December), contributing to widespread crop failure and lower livestock productivity.
Pastoral communities in the worst-affected areas – in the north and centre of the country – are facing acute food insecurity. Drought-related displacement is underway and malnutrition rates are rising. Food aid levels have “significantly declined” compared with last year. A $700 million drought response plan has been launched.
South Sudan - In need: 7.1 million
Conflict and drought has created a disastrous situation. Some 6.9 million people – close to 60 percent of the population – are currently facing severe food insecurity with an estimated 50,000 in “famine-like” conditions.
In many areas, malnutrition levels remain critical, with some 860,000 children under the age of five estimated to be severely malnourished. Out of the overall 7.1 million people in need, only 5.7 million are targeted for aid. The aid appeal stands at $1.5 billion, but so far only $346 million has been received.
Sudan - In need: 5.6 million
Around one million people are facing emergency conditions – concentrated in the states of Khartoum and South Darfur. The Darfur region accounts for 45 percent of all Sudanese in need (crisis and emergency levels).
Sudan’s crisis is less weather-related and more a consequence of food price rises. Overall, prices of grains were at record or near-record levels in March despite an above-average 2018 harvest.
The depreciation of the local currency, fuel shortages and input costs combined to push up the cost of living - one of the triggers for the protests that led to the toppling of former president Omar al-Bashir in April.
Uganda - In need: Unknown
The arid Karamoja region – bordering Kenya, Uganda, South Sudan, and Ethiopia – has been hit by a second failed rainy season. Numbers in need are not yet known, but staple food prices are expected to remain high through to September, well above the five-year average.
Zambia - In need: 1.3 million
Maize producing areas in the south experienced their worst drought since 1981. Maize production is estimated to have dropped to two million tonnes from approximately 2.4 million tonnes last season and exports have been banned – which will impact prices in the region. The projected number of households needing food aid from July to February 2020 is 220,000 – a 38 percent increase from last season.
Zimbabwe - In need: 5.3 million
Total cereal production this season was estimated at 852,000 tonnes, against a national requirement of 1.8 million tonnes for human consumption and 450,000 tonnes for livestock. Compared to the 2017/18 season, the provinces of Manicaland, Matabeleland South, and Matabeleland North all saw their maize production drop by more than 70 percent. Climate shocks have compounded severe economic difficulties. By September, most of the country is expected to be in “crisis”.
http://www.thenewhumanitarian.org/analysis/2019/06/10/drought-africa-2019-45-million-in-need http://www.unocha.org/story/cerf-allocates-us45m-stave-famine-risk-horn-africa http://www.actionagainsthunger.org/story/drought-east-africa-fuels-worsening-hunger-crisis http://www.acaps.org/special-report/horn-africa-drought http://reliefweb.int/report/somalia/international-complacency-puts-lives-risk-drought-hits-horn-africa-oxfam http://bit.ly/2KoKU6S http://bit.ly/2WN7Aj7 http://reliefweb.int/report/mozambique/food-security-southern-africa-end-season-update-201819-and-overview-food-security
FEWS Net: East Africa: Humanitarian food assistance needs remain high, primarily driven by conflict & drought
Food insecurity is likely to remain elevated through September, driven by a conflict, drought, macroeconomic shocks, and inflationary pressures. 42.4 million people in Yemen, Ethiopia, South Sudan, Sudan, Somalia, Kenya, and Uganda’s Karamoja sub-region are in Crisis (Phase 3) or worse.
Urgent humanitarian food assistance is required to mitigate widening food gaps and accelerated depletion of livelihood assets.
In addition, an estimated 12 million internally displaced people in Ethiopia, Somalia, Sudan, South Sudan, Burundi, and Yemen, coupled with an estimated 5.3 million refugees hosted by Burundi, the DRC, Ethiopia, Kenya, Sudan, Uganda, and Tanzania, are experiencing Stressed (IPC Phase 2) or Crisis (IPC Phase 3) outcomes.
A risk of Famine (IPC Phase 5) persists in Yemen and South Sudan. Conflict, the primary driver of acute food insecurity, has displaced or disrupted the livelihoods of up to 23 million people, who are currently in Crisis (IPC Phase 3) or worse.
Most households are unable to access normal livelihood strategies, while access to commodity and labor markets and access to humanitarian assistance are constrained.
Catastrophe (IPC Phase 5) outcomes are already likely among populations in Canal/Pigi and Pibor in Jonglei, Panyikang in Upper Nile, and Cueibet in Lakes of South Sudan.
In Yemen, Emergency (IPC Phase 4) outcomes continue in Hajjah and Sa’ada governorates, where households are facing large food gaps and/or extreme depletion of livelihood assets.
WFP reports four districts (Haradh, Mustaba, Midi, and Hayran) of Hajjah remain inaccessible for delivery of humanitarian assistance due to increased conflict.
Delayed or below-average rainfall at the onset of the March to May rainfall season in the greater Horn of Africa has caused considerable concern for a consecutive poor production season.
According to satellite-derived data, cumulative rainfall is significantly below-average in northern, southern, and eastern Kenya, southern and central Somalia, and southern and eastern Ethiopia. Resurgence of rainfall in late April is likely to partially recharge surface water sources and partially regenerate pasture and browse, providing some relief for pastoral livelihoods.
However, crop production is expected to be below average in many agropastoral and marginal agricultural areas, and near total crop failure would be likely if rainfall is below-average in May and/or ceases by mid-May. An increase in the Crisis (IPC Phase 3) or worse population is expected through September.
Areas affected by conflict and social unrest in Ethiopia and Sudan are likely to remain in Crisis (IPC Phase) or deteriorate to worse outcomes through late 2019.
Conflict-displaced households in Oromia and SNNPR regions of Ethiopia missed the agricultural season and access to humanitarian assistance is restricted. Rising inflationary pressures coupled with constrained domestic grain supply is likely to narrow household food access, widening consumption gaps.
In Sudan, the change in government leadership and related social unrest are likely to disrupt livelihoods and increase macroeconomic instability. This would limit access to normal sources of food and income, especially from May onward, which coincides with the lean season.
In addition, Emergency (IPC Phase 4) is likely among IDPs in SPLM-N controlled areas in South Kordofan and in Jebel Mara in Darfur.
* Global Food Assistance Outlook Brief - FEWS NET: Projected Food Assistance needs to November 2019: http://bit.ly/31r09BI
Global Report on Food Crises: Acute hunger still affecting 113 million people in 53 countries who experienced high levels of food insecurity in the world’s most severe food crises in 2018. (FAO, WFP, EU, IPC, agencies)
A report presented today jointly by the European Union, the Food and Agriculture Organization of the United Nations (FAO), and the UN World Food Programme (WFP) finds that around 113 million people in 53 countries experienced acute food insecurity in 2018, compared to 124 million in 2017.
Commissioner for International Cooperation and Development Neven Mimica said, "Food insecurity remains a global challenge. Today''s Global Report highlights the need for a strengthened cooperation between humanitarian, development and peace actors to reverse and prevent food crises. A stronger Global Network can help deliver change on the ground for the people who really need it."
Christos Stylianides, EU Commissioner for Humanitarian Aid and Crisis Management, said "Food crises continue to be a global challenge, which requires our joint efforts. Food crises are becoming more acute and complex and we need innovative ways to tackle and prevent them from happening. The Global Report provides a basis to formulate the next steps of the Global Network by improving our coordination mechanisms."
The figure of 113 million people facing food crises is down slightly from the 124 million figure for 2017. However,the number of people in the world facing food crises has remained well over 100 million in the last three years, and the number of countries affected has risen. Moreover, an additional 143 million people in another 42 countries are just one step away from facing acute hunger.
Nearly two-thirds of those facing acute hunger are in just 8 countries: Afghanistan, the Democratic Republic of the Congo, Ethiopia, Nigeria, South Sudan, Sudan, Syria and Yemen. In 17 countries, acute hunger either remained the same or increased.
Climate and natural disasters pushed another 29 million people into acute food insecurity in 2018. And 13 countries - including North Korea and Venezuela - are not in the analysis because of data gaps.
"It is clear from the Global Report that despite a slight drop in 2018 in the number of people experiencing acute food insecurity - the most extreme form of hunger - the figure is still far too high. We must act at scale across the humanitarian-development-peace nexus to build the resilience of affected and vulnerable populations. To save lives, we also have to save livelihoods," said FAO Director-General José Graziano da Silva.
"To truly end hunger, we must attack the root causes: conflict, instability, the impact of climate shocks. Boys and girls need to be well-nourished and educated, women need to be truly empowered, rural infrastructure must be strengthened in order to meet that Zero Hunger goal. Programmes that make a community resilient and more stable will also reduce the number of hungry people. And one thing we need world leaders to do as well: step up to the plate and help solve these conflicts, right now," said WFP Executive Director David Beasley.
The report''s findings are a powerful call for strengthened cooperation that links together prevention, preparedness and response to address urgent humanitarian needs and root causes, which include climate change, economic shocks, conflict and displacement. It further highlights the need for a unified approach and action across the humanitarian and development dimensions of food crises, and for more investment in conflict mitigation and sustainable peace.
* Acute food insecurity is when a person''s inability to consume adequate food puts their lives or livelihoods in immediate danger. It draws on internationally accepted measures of extreme hunger, such as the Integrated Food Security Phase Classification (IPC).
Chronic hunger is when a person is unable to consume enough food to maintain a normal, active lifestyle over an extended period. The FAO''s most recent State of Food Security and Nutrition report, in September 2018, found that 821 million people on the planet are going hungry.
http://www.fao.org/news/story/en/item/1187744/icode/ http://www.fao.org/state-of-food-security-nutrition/en/ http://www.fsinplatform.org/global-report-food-crises-2019 http://www.ipcinfo.org/
* Access the full report (200pp): http://bit.ly/2uHg67x
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