Caroline Voûte is coordinator of Médecins Sans Frontières’ response to the measles epidemic in Katanga, Democratic Republic of Congo (DRC). She provides an update on the current situation, warning that other provinces are now at great risk of outbreaks.
"If the epidemic of measles is now considered to be declining in Katanga, we remain very worried about the persistence of measles cases in most other provinces of the DRC and, consequently, the risk of new outbreaks. The DRC has experienced a continuous epidemic situation since 2010.
Enormous human and financial resources are repeatedly made to combat measles, a largely preventable disease, through vaccination. This new health crisis again raises the question of the effectiveness of previous vaccination campaigns. It is urgent to learn from this epidemic and take the necessary steps to improve routine immunization to prevent a new outbreak in coming years. As a reminder, in 2011, Katanga faced one of the largest outbreaks of measles. Médecins Sans Frontières then vaccinated 2.1 million children. Officially at the end of November 2015, more than 39,000 cases and nearly 500 deaths were reported in Katanga since the beginning of 2015, but these figures are underestimated, as retrospective mortality surveys already show in some areas.
"Especially in rural areas, the health system has lost its legitimacy and credibility"
Especially in rural areas, the health system has lost its legitimacy and credibility. Health centres are experiencing "chronic" failures – medicines and trained medical personnel are scarce, and the cost of care is exorbitant, discouraging people from seeking treatment. In this context, epidemiological surveillance fails, delaying both the recognition of the epidemic and the response.
Médecins Sans Frontières started its intervention in April in Malemba Nkulu health zone. As the epidemic gained ground, we quickly had to expand our activities to other areas. We vaccinate children between 6 months and 15 years and support the health centres to manage simple cases through donations of medicines, and training and supervising staff. We also have teams in hospitals to treat children with complications. Around Manono for example, severe malnutrition rates are alarming, affecting over 10 per cent of children in some areas. And 90 per cent of the children we hospitalise have malaria. That is why we decided to focus on these two pathologies as well.”