As infection rates rise, health workers urge vaccination

Medics on the frontline of the battle against Mphox in eastern Democratic Republic of Congo told the BBC a vaccine was desperately needed to curb new infections.

The BBC visited a treatment centre in South Kivu province, the epicentre of the outbreak, where more patients are arriving each day, particularly babies, and there is a shortage of essential equipment.

Empox, formerly known as monkeypox, is a highly contagious disease that has killed at least 635 people in the Democratic Republic of Congo this year.

Last week, 200,000 doses of vaccine donated by the European Commission were airlifted to the capital Kinshasa, but have not yet been transported across the vast country. It could take weeks for them to reach South Kivu.

“We found out through social media that the vaccine was already available,” Emmanuel Picciri, a nurse who works at a hospital that has been converted into a specialist centre to fight the virus, told the BBC.

He said this was the first time he had treated a patient with Empox, and he feared every day that he would contract the disease and pass it on to his children, aged 7, 5 and 1.

“You saw me touching patients. That’s my job as a nurse. That’s why I’m asking the government to give me the vaccine first.”

The reason it takes time to transport the vaccine is because it needs to be stored at the correct temperature (below freezing point) to maintain its effectiveness, and also because it needs to be sent to rural areas in South Kivu, such as Kamituga, Kavumu and Rwiro, where the outbreak is widespread.

With poor infrastructure and bad roads, some vaccines may have to be dropped by helicopter, further increasing costs for countries already struggling financially.

At the local hospital, Dr. Pacific Caranzo appeared exhausted and depressed after not being able to walk all morning.

He wore a face shield, but you could see sweat running down his face. He said it was sad to see patients sharing a bed.

“You’ll also see patients sleeping on the floor,” he said, clearly annoyed.

“The only support we have received so far is some medicine and water for the patients. As for other challenges, there is still no motivation among the staff.”

Another problem, he said, is that there is not enough personal protective equipment (PPE) for health care workers.

“We do what we can to care for the sick, and we try not to put ourselves at risk. We are not immune from disease.”

Two important facts stand out when you enter the Rwiro District Hospital, about an hour’s drive north of South Kivu’s main city of Bukavu.

First is the baby’s crying and loud noise. Second is the stench. It is a stench of urine and stagnant water.

In hospitals, clean water is running low, so people have to use only limited amounts of water from small containers under their beds.

The hospital, which usually sees about 80 patients a month, has seen close to 200 patients in the past three weeks. The patients are getting younger.

“It’s sad to see my first child suffering from this strange disease. It breaks my heart,” said 18-year-old Paraja Lucara.

Her son Murhula is currently the youngest mpox patient in the hospital. He is just four weeks old. Like many others here, she first encountered mpox, which is caused by a virus in the same family as smallpox.

The disease causes loss of appetite, leaving many children malnourished.

In the room next door, there were nearly 20 women and children crammed into a small room, sharing only seven beds and two mattresses on the floor.

The hospital’s first MPOX case recovered: 10-month-old Amenifa Kabuya. But shortly after she was discharged, her mother, Yvette Kabuya, returned with MPOX.

People who have witnessed the disease’s effects on their bodies – painful, pus-filled lesions, fever, weight loss – are desperate for a vaccine, something that is not uncommon in areas where vaccines have been hesitant in the past.

Beatrice Cachera, 50, said she was so shocked that she gently stroked the cheek of her 3-year-old granddaughter, who she had brought here. “I just saw that she was sick, and I didn’t even know what the disease was.

“We can’t wait for children and adults to die. Bring on the vaccine,” she told the BBC.

However, some fear that this will not be easily resolved due to ongoing armed conflict between the military and various armed groups, particularly the M23 rebel group, in eastern Democratic Republic of Congo.

“The conflict is having a huge impact on the overall immunization programme,” Dr Gaston Bulambo, North Kivu provincial health director, told the BBC.

“Not only the Mpox vaccination, but all vaccination programs are struggling because of the difficulty in getting the vaccine to healthy areas. This is due to anxiety.”

South Kivu governor Liwiro, who is from Liwiro, told the BBC that intense fighting had forced many people from their homes and into his state, which was helping spread the disease.

“We are hosting thousands of IDPs (internally displaced persons) but they are still struggling with many problems,” said Jacques Porousi Sadiki.

“Most of the money is going into fighting the ongoing war, buying military equipment and feeding the military,” he said.

“The country is losing a lot of money trying to solve this war rather than investing it in areas including social development and health.”

But the governor believed the rebels would not interfere with the vaccine supply because MPOx was also affecting people in rebel-controlled areas.

He said the government was doing everything it could to provide the medical staff with what they needed. “I will be going to Libiro myself in the next two days. I will make sure that we provide what we can in terms of emergency support for the population until the Kinshasa government can provide more support.”

Authorities said they plan to start administering the vaccine in October, with children under 17 and people in close contact with infected people being the first to be vaccinated.

Governor Purusi Sadiki is confident the outbreak in his province will be contained. “It is a question of political will. I am confident we will succeed.”

It’s a sentiment not yet shared by weary medical staff like Dr. Karanzo at Lwiro Hospital, but it’s reassuring to see that awareness of mpox is at least growing in the area.

More people are seeking medical attention as soon as symptoms appear, while fewer are seeking medical advice from traditional healers first. This means that there have been no deaths at this hospital due to Empox.

But with 5,049 confirmed cases in the Democratic Republic of Congo since the start of the year, hospital workers say speed is of the essence. They won’t be able to contain the outbreak without getting vaccines, medicines and other supplies for better hygiene.