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Violent Conflict In The Congo Is Hampering Efforts To Fight Ebola Outbreak


In Central Africa, there's a terrible convergence. A violent conflict that's been going on for years meets a deadly outbreak of the Ebola virus. This is all happening in the Democratic Republic of the Congo, which is where we reached Dr. Janet Diaz. She's with the World Health Organization's Health Emergencies Programme.

And she's been working at the center of the Ebola outbreak in the city of Beni, where eight U.N. peacekeepers were killed yesterday. There are reports of another attack on peacekeepers today. I asked Dr. Diaz how the dangerous conditions affect her daily work.

JANET DIAZ: So our day starts where we have security reports in the morning about 7 o'clock or 6:30 in the morning telling us what the security situation is, whether or not we can move or not move, what time we can move if it's safe. Usually, if things are OK, I go straight to the treatment unit, where I work with national doctors, doctors from Beni. During the day, there may be security problems that we hear of. If things change or we have to move or leave the treatment unit, then we just do what we're told to make sure that everyone stays safe.

SHAPIRO: Treating Ebola is complicated and involves risks even without the threat of violence. I understand you're taking some new approaches in the Democratic Republic of the Congo. Tell us what you're doing differently and whether it's having an impact.

DIAZ: So the major things that we've done as an international community is to try to bring optimal supportive care to an Ebola outbreak. And so one of the most novel things that has happened is with a new type of isolation unit which is called a cube, where you can actually provide very close monitoring and very intensive care to the patients that are being cared for there. And that has really improved the quality of care that we are able to provide.

SHAPIRO: The disease transmits through body fluids. And so typically doctors would be wearing a big body suit so they don't get infected. And you're saying now doctors don't always have to put on a body suit. The person can be in kind of, like, a plastic - almost like a box, and the doctor uses gloves through that isolation chamber.

DIAZ: Yes. So there is doctors inside that are wearing that full protective gear. And then there's other doctors or nurses outside that can be talking to the doctor inside and to the patient and supporting them without having to be inside in all the protective gear and also physically being able to put their hands inside and adjust in fusion monitors or drips or take a blood pressure without having to be inside. So that makes us able to give better supportive care.

SHAPIRO: I understand you're using new drugs and vaccines as well. Tell us about that.

DIAZ: The new medicines that we're using, they're not approved for Ebola because there's not enough clinical trials to show they're effective. So when you have drugs that have not been shown yet and approved for a disease, then you use them under a compassionate use protocol. And these drugs have promising studies based on animal data and laboratory data. So what we got was permission from the committee - ethical committee of the Congo to use these potentially lifesaving therapeutics in patients in the DRC. So so far, we've used this in about 151 patients.

SHAPIRO: And the vaccines?

DIAZ: In regards to the vaccine, the vaccine is also an investigational intervention. And they're using the same protocol that they used in West Africa, which has vaccinated contacts and contacts of contacts.

SHAPIRO: I've read that people living in areas affected by Ebola don't trust government officials or health workers. Tell us about that and what impact it has on your efforts to fight this disease.

DIAZ: That is one of the most difficult challenges I think the outbreak has faced, the distrust. I think the worst part is that patients don't come. They are scared. Or they don't believe, and then they don't come seek care. And if they finally do seek care, they seek care when it's too late. And Ebola is a devastating disease. So if you arrive too late, like, then the odds of surviving are very, very low.

And in the interim, you know, while they're scared and not coming to the center and they're sick, that risks exposing other people in the community or their families to the disease and then spreading the infection. So the distrust or the resistance is a major player in keeping the epidemic going.

SHAPIRO: Dr. Janet Diaz of the WHO's Health Emergencies Programme, thank you so much for speaking with us today.

DIAZ: My pleasure. Thank you. Transcript provided by NPR, Copyright NPR.