Goma/the Democratic Republic of Congo — Ebola cases in the Democratic Republic of Congo’s densely populated eastern city of Goma rose from one to five this week, raising fears of a wider outbreak of the deadly virus that has already cost more than 1,800 lives in the past 12 months.
Key to containing the spread will be tracing and vaccinating everyone known to have come into contact with the five people infected, and then the contacts of those contacts. A ministry of health presentation seen by The New Humanitarian lists 538 cumulative contacts traced in Goma.
Kate White, emergency medical manager for Médecins Sans Frontières, said ongoing efforts to engage Goma communities in the response and to improve awareness of the disease, its signs and symptoms, needs to be “scaled up” quickly.
“The problem is that Goma is massive and… the level of preparedness is not always there,” she said.
Interviews with multiple Goma residents – many of whom were unaware or refused to accept there were new Ebola cases in the city – suggest more outreach work is necessary.
“We need to see a person with Ebola before we can confirm it is here,” Edson, a motor taxi driver, told TNH.
Goma, the capital of North Kivu province, has a population of roughly two million people and is a major transit hub with an international airport and a porous border with Rwanda. Roughly 15,000 people cross between the two countries every day, including local traders and travellers en route to Rwanda’s capital city, Kigali.
The rising cases here have left aid workers and local residents questioning whether the sprawling lakeside city is prepared for a wider outbreak. Just 54 beds – 30 of those confirmed today – are currently available for Ebola patients, and the general population has varying levels of awareness about the virus and how to prevent it from spreading.
In response to the new cases, Rwanda temporarily closed its border with Goma on Thursday for a few hours, citing efforts to “reinforce screening procedures”.
The closure caused some food prices to surge and triggered panic among local residents who rely on cross-border trade. The World Health Organisation has said border closures could encourage people to use unofficial crossings, where they may not be tested for Ebola symptoms, and warned that restrictions on travel or trade could negatively affect Congo’s economy and the wider Ebola response.
The epidemic – which is now the second deadliest on record and shows no signs of slowing – remains concentrated in the North Kivu cities of Beni and Butembo, hundreds of kilometres north of Goma. Militia violence, attacks on health workers and treatment centres, and community distrust continue to hamper relief efforts.
“In the last three months, we’ve seen more cases than in the previous nine,” said Amy Daffe, deputy country director for Mercy Corps in Congo. “We cannot deny that the pace and scale are escalating.”
The bustling city of Goma has been preparing for a possible outbreak since last year. Health workers have been vaccinated and trained on understanding the signs and symptoms of Ebola, while a contact tracing system – which identifies people who have encountered an infected person -has been set up.
Hand-washing stations and infrared thermometer guns are now a permanent feature outside hotels, restaurants, and cafes as well as border crossings and roads in and out of Goma.
But as cases rise there are concerns the city is not yet ready for a major outbreak of the virus. As of Thursday night, there was just one functioning Ebola treatment centre in the city, offering just 24 beds for a population of two million people.
On Friday morning, MSF said it had added a further 30 beds in a second treatment centre – a construction site just 24 hours earlier – and added that capacity would rise to 72 within the next few days.
