,,,,,,,,,<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997645182/in/dateposted-public/" title="Nairobi_MisInformation"><img src="https://live.staticflickr.com/65535/48997645182_b235cc39f2_z.jpg" width="640" height="360" alt="Nairobi_MisInformation"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
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<h1><center>Ebola</center></h1>
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Truth | Facts | Lies
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<i>An interactive news story</i>
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[[Start]]
This project aims to help you understand the complexities of Ebola as a disease and how affected populations perceive it.
The game simulates real situations involved in Ebola response, based on reporting.
Tell us, what are you more concerned about?
[[Getting Ebola]]
[[Stopping the spread->Set the scene before data]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997310767/in/dateposted-public/" title="Katwa_Overview"><img src="https://live.staticflickr.com/65535/48997310767_a59a05957c_z.jpg" width="640" height="360" alt="Katwa_Overview"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You live in a region that could be affected by Ebola. Where do you choose to be living?
[[Beni, North Kivu province, Democratic Republic of Congo]]
[[Katwa, North Kivu province, Democratic Republic of Congo->DATA: Katwa]]
[[Nairobi, Kenya->DATA:Kenya]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995496623/in/dateposted-public/" title="WhatsApp Image 2019-11-01 at 16.52.37"><img src="https://live.staticflickr.com/65535/48995496623_b2cdfd9957_z.jpg" width="640" height="359" alt="WhatsApp Image 2019-11-01 at 16.52.37"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You work for an international agency based in Beni, trying to stem the spread. What is the first step you want to take?
[[Research how the population feels about Ebola]]
[[Focus on the medical response]]
[[Work to trace the contacts of those already diagnosed->DATA: Contact tracing]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996106281/in/dateposted-public/" title="Beni_YourHouse"><img src="https://live.staticflickr.com/65535/48996106281_f2c6a141e0_z.jpg" width="640" height="360" alt="Beni_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It’s June, 2018. You live in Beni with your family. You are hearing rumours that some people have started taking ill. What do you want to do:
[[Ask your neighbour]]
[[Ask a community leader]]
[[Ignore the rumours->DATA: Beni]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996940711/in/dateposted-public/" title="Katwa_YourHouse"><img src="https://live.staticflickr.com/65535/48996940711_f6274c8696_z.jpg" width="640" height="360" alt="Katwa_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Two days ago, the government declared an official Ebola outbreak. Today the government reported three confirmed cases in Beni, although no one has died yet.
You live in Katwa, closer to Butembo and the Ugandan border. You have two small children and work in a job that sometimes takes you to the city and the border.
What kind of job do you do?
[[Boda driver->DATA: Katwa, November 13, 2018]]
[[Drive a lorry->DATA: Katwa, November 13, 2018]]
[[Radio reporter->DATA: Katwa, November 13, 2018]]
[[Medical officer->DATA: Katwa, November 13, 2018]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Your neighbour is busy looking after her daughter, who has the measles. “There’s no such thing as Ebola,” she says. “These are just rumours. You should worry about malaria and measles.”
What do you want to do:
[[Believe her]]
[[Ask someone else->Ask a community leader]]
[[Listen to the radio->The news]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995587978/in/dateposted-public/" title="Beni_CommunityLeader"><img src="https://live.staticflickr.com/65535/48995587978_36934ff435_z.jpg" width="640" height="360" alt="Beni_CommunityLeader"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You contact a community leader.
He says he’s been approached by international organisations that have explained to him that there’s a risk of an Ebola outbreak. He believes them.
He tells you about Ebola symptoms, which include things like fever, fatigue, muscle pain or weakness.
He adds the health workers say Ebola can only be transferred once someone is showing the symptoms. It also can only be transmitted through direct contact with infected bodily fluids, such as blood, feces or semen.
He tells you the survival rates upon receiving treatment are significantly higher when people were admitted to a medical facility immediately.
[[Go back home]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996371517/in/dateposted-public/" title="Beni_YourHouse_Radio"><img src="https://live.staticflickr.com/65535/48996371517_628a873233_z.jpg" width="640" height="360" alt="Beni_YourHouse_Radio"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Two days ago, the government declared an official Ebola outbreak.
You turn on the radio and hear a program about Ebola. What do you want to do:
[[Turn off the radio->DATA: Beni, Oct 1, 2018]]
[[Listen to the radio->The news]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Your neighbour isn’t completely wrong. Measles and malaria have killed more people in DRC than Ebola.
However, the problem with Ebola is how quickly it spreads and how high the death rate is.
But you and your neighbour don’t know that.
[[Go back home]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996106281/in/dateposted-public/" title="Beni_YourHouse"><img src="https://live.staticflickr.com/65535/48996106281_f2c6a141e0_z.jpg" width="640" height="360" alt="Beni_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You're at home with your children. What do you feel like doing:
[[Listen to the radio->The news]]
[[Go to church]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996371517/in/dateposted-public/" title="Beni_YourHouse_Radio"><img src="https://live.staticflickr.com/65535/48996371517_628a873233_z.jpg" width="640" height="360" alt="Beni_YourHouse_Radio"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You're choosing to avoid the news of Ebola, but that doesn't mean the outbreak will stop.
You get offered a job as a driver between Beni and Kasese, Uganda. You need the money, so you accept.
[[Start working->Driving between Beni, DRC and Kasese, Uganda]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996444893/in/dateposted-public/" title="Katwa_PeopleRefuseTreatment"><img src="https://live.staticflickr.com/65535/48996444893_f18660f94e_z.jpg" width="640" height="360" alt="Katwa_PeopleRefuseTreatment"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
One study conducted in September 2018 found that 25 per cent of people didn't believe Ebola was real. Less than a third trusted that local authorities represent their interest.
The research has shown many people in the region are skeptical about Ebola. How do you want to address this:
[[Create a radio program->Tactics to counter Ebola misinformation]]
[[Send people door-to-door->Tactics to counter Ebola misinformation]]
[[Set up a mobile cinema->Tactics to counter Ebola misinformation]]
[[Focus on the medical response]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996371517/in/dateposted-public/" title="Beni_YourHouse_Radio"><img src="https://live.staticflickr.com/65535/48996371517_628a873233_z.jpg" width="640" height="360" alt="Beni_YourHouse_Radio"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It's August 7, 2018.
The radio news is giving an update on Ebola.
The report says the national laboratory (INRB) has confirmed that the Ebola outbreak is the Zaire Ebola virus, the most deadly strain and the same one that affected West Africa during the 2014-2016 outbreak.
Zaire Ebola was also the virus found in the outbreak in Equateur province, in western DRC earlier in 2018, although a different strain than the one affecting the current outbreak.
What do you want to do:
[[Learn more about Ebola]]
[[Ignore the radio report->DATA: Beni, Oct 1, 2018]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996371517/in/dateposted-public/" title="Beni_YourHouse_Radio"><img src="https://live.staticflickr.com/65535/48996371517_628a873233_z.jpg" width="640" height="360" alt="Beni_YourHouse_Radio"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
One of the challenges for people in the Ebola-affected regions of the DRC is getting access to accurate information.
Online and on the radio there is a lot of false information circulating - people saying Ebola isn't real, people arguing it's used for political purposes, people saying the vaccines are actually dangerous.
[[Next->Approach a health worker]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993319176/in/dateposted-public/" title="Oct10_2019_DRC"><img src="https://live.staticflickr.com/65535/48993319176_2ee21bcdab_z.jpg" width="640" height="446" alt="Oct10_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
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[[Next->Conclusion quote]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You've sent teams to the homes of people who may have come into contact with someone who has tested positive for Ebola.
You're on a team in Mabalako, North Kivu.
You're at the house of a family who interacted with a known Ebola patient - a priest at her church who said he shook hands with everyone after the service.
What do you want to ask the mother?
[[Who have you come into contact with?]]
[[Do you have any symptoms of Ebola?]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
This is called "contact tracing." One element of that is finding recent contacts of new cases.
The goal is to stay ahead of transmission by finding people who are likely to have gotten Ebola through contact with someone who was infected.
Health officials need to find those people - quickly - and then monitor them for symptoms.
Anyone who appears to be sick should be quickly isolated to reduce the chances they'll transfer it to others.
[[Next->While at the house]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
This is part of "contact tracing." It includes proactive efforts to identify and follow up with known contacts of new cases.
Asking people who may have contracted Ebola about their symptoms is important, but many people are scared or skeptical and may not answer honestly.
[[Next->Mother's answer]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995587978/in/dateposted-public/" title="Beni_CommunityLeader"><img src="https://live.staticflickr.com/65535/48995587978_36934ff435_z.jpg" width="640" height="360" alt="Beni_CommunityLeader"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
One of the many challenges of this Ebola response are the distances and the scale of people affected.
Right now the outbreak may be focused in Mabalako, a small community near the town of Beni, but it could quickly spread.
Since the tea seller works in a trading area, the people she touched may have already crossed an international border into Uganda.
Others live in villages far away and difficult to access, especially since the rainy season is about to start.
[[Next->WHO funding for Ebola response]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996450552/in/dateposted-public/" title="Beni_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996450552_d565da706e_z.jpg" width="640" height="360" alt="Beni_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You work with a team prioritizing where to set up medical facilities.
One of the challenges of this response is how far apart and inaccessible the region is.
Many people who could be infected are in villages or rural areas that are hard to reach because of the weather, insecurity, and poor infrastructure.
You assign team members to find solutions to these issues, and return to the main response centre.
[[Next->DATA: September 25, 2018]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993451802/in/dateposted-public/" title="Sept25_2018_DRC"><img src="https://live.staticflickr.com/65535/48993451802_8de1e89cb8_z.jpg" width="640" height="446" alt="Sept25_2018_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
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[[Next->Go to a meeting for an update on the response]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You try to pressure her to go into isolation. You think she has Ebola, and don't understand why she won't listen.
Unfortunately, many people in this region of the DRC are skeptical of health responders - especially ones from outside their community.
For years, people in this area have struggled with conflict, neglect, and diseases such as measles and malaria. They often feel abandoned by the international community.
[[Next->Mother's fears]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You tell her about Ebola symptoms, that include things like fever, fatigue, muscle pain or weakness.
You explain that it's believed Ebola can only be transferred once someone is showing the symptoms.
You tell her it also can only be transmitted through direct contact with infected bodily fluids, such as blood, feces or semen.
[[Next->Survival rates]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Your gentle approach has worked. She agrees to go into a voluntary isolation to protect herself and her children.
After getting tested, it's confirmed that she does have Ebola, but your insistence that she gets treated made sure she got help right away. She recovers well, and none of her children have tested positive for Ebola.
Later, she's brought onto a regional health team to convince others from her community to seek medical help if they have symptoms. This technique, of using survivors to gain community trust, has proven effective.
You return to your response centre.
[[Next->DATA: September 25, 2018]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996551168/in/dateposted-public/" title="Katwa_Hospital"><img src="https://live.staticflickr.com/65535/48996551168_4b8d455f2b_z.jpg" width="640" height="360" alt="Katwa_Hospital"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
This is a crucial part of the Ebola response efforts in this region.
At the same time as health workers are trying to stop the spread of Ebola, people are more worried about the deadly diseases they already experience: for example measles, malaria, cholera.
You implement a strategy targeting these diseases as well as the Ebola response, hoping it will help protect the health workers and gain community trust.
[[Hear an update on the Ebola outbreak]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995587978/in/dateposted-public/" title="Beni_CommunityLeader"><img src="https://live.staticflickr.com/65535/48995587978_36934ff435_z.jpg" width="640" height="360" alt="Beni_CommunityLeader"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Disinformation is a significant challenge in this Ebola response.
People are suspicious or afraid of health workers, hospitals, and the disease itself.
At the same time, armed groups and politicians are making use of Ebola for their own purposes.
A first step is to understand the false information that's circulating.
[[Research how the population feels about Ebola]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997259482/in/dateposted-public/" title="Katwa_HospitalDamage"><img src="https://live.staticflickr.com/65535/48997259482_0161e34139_z.jpg" width="640" height="360" alt="Katwa_HospitalDamage"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
On April 19, a militia group attacked a hospital in Katwa, an area near Butembo that has seen a lot of violence. A WHO epidemiologist was killed, and two other health workers were injured.
This is after attacks in February that led MSF to suspend its activities in Katwa.
The UN says it's increasing security around health workers residences and the sites, developing the response capabilities of the police and UN security forces, ensuring staff follow curfews and other safety rules, and engaging with the community to try to reduce the threat.
[[A state of emergency is declared->DATA: A state of emergency is declared]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997533096/in/dateposted-public/" title="MilitiaAttack"><img src="https://live.staticflickr.com/65535/48997533096_8888e6e606_z.jpg" width="640" height="360" alt="MilitiaAttack"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
On April 19, a militia group attacked a treatment centre in Katwa, an area near Butembo that has seen a lot of violence. A WHO epidemiologist was killed, and two other health workers were injured. This is after attacks in February that led MSF to suspend its activities in Katwa.
The UN and other international agencies say they are trying to build relationships with the armed groups to try to prevent violence against health workers.
[[A state of emergency is declared->DATA: A state of emergency is declared]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996940711/in/dateposted-public/" title="Katwa_YourHouse"><img src="https://live.staticflickr.com/65535/48996940711_f6274c8696_z.jpg" width="640" height="360" alt="Katwa_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The challenges of distrust, poor access and insecurity have made efforts much harder - and now the number of cases and deaths is rising fast.
By the end of March, 2019, more than <b>1,000 cases</b> have been confirmed, and nearly <b>700 people</b> are dead.
By the end of April, there are nearly <b>1,500 cases</b> and more than <b>900 dead</b>.
By mid-June, there are <b>2,000 cases</b>, and <b>1,300 people</b> have died.
[[A state of emergency is declared->DATA: A state of emergency is declared]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996993776/in/dateposted-public/" title="Katwa_ChurchLeader"><img src="https://live.staticflickr.com/65535/48996993776_98cac38bce_z.jpg" width="640" height="360" alt="Katwa_ChurchLeader"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
There are many tools being used to build community trust and counter disinformation.
Volunteers go door-to-door conducting surveys or gathering feedback. They run mobile cinemas and radio programs designed to education people on Ebola: the symptoms, the way it spreads, and what to do when you fear you could be infected.
Organisations are also targeting religious leaders, journalists, youth leaders, and others who can help convince the community of the risks of Ebola.
But the distrust remains prevalent, especially as some groups make use of it for their own purposes.
[[It's now December, and the presidential election will be held->DATA: Election time]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997195822/in/dateposted-public/" title="Katwa_Election"><img src="https://live.staticflickr.com/65535/48997195822_4bb3b8dd7f_z.jpg" width="640" height="360" alt="Katwa_Election"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Felix Tshisekedi has just been declared president of the DRC - more than a week after contested elections.
But some international organisations have been forced to suspend their work after violence against health workers in Ebola-affected areas like Beni.
During the election, officials blamed Ebola and insecurity for delayed voting.
[[Next->Election block quote]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993306661/in/dateposted-public/" title="July17_2019_DRC"><img src="https://live.staticflickr.com/65535/48993306661_d61b7b2694_z.jpg" width="640" height="446" alt="July17_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->A state of emergency declared]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996449143/in/dateposted-public/" title="Katwa_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996449143_9ac313669e_z.jpg" width="640" height="360" alt="Katwa_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The WHO says it needs another <b>$324 million</b> for response and preparedness - almost three times how much has been committed.
After the declaration of a global health emergency, donations begin to be announced.
The World Bank committed another $300 million, USAID $38 million, and the EU €30 million.
According to the WHO, that will cover about half of the funds needed.
[[The news in October->DATA: Conclusion, October 10, 2019]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996450552/in/dateposted-public/" title="Beni_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996450552_d565da706e_z.jpg" width="640" height="360" alt="Beni_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Now that funds are coming in, you have to prioritize where they should go.
The WHO has released a report with the Congolese government announcing a plan for July to December 2019.
It divides the funds up between areas such as: coordination, risk communication and community engagement, surveillance, contract tracing, vaccination, safe and dignified burials, infection prevention, laboratory and clinical care, and other areas.
[[Next->Funding recommendations]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997259482/in/dateposted-public/" title="Katwa_HospitalDamage"><img src="https://live.staticflickr.com/65535/48997259482_0161e34139_z.jpg" width="640" height="360" alt="Katwa_HospitalDamage"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Unfortunately, the elections amplified the violence against health workers, even as conflict in the region and the long-standing distrust were already leading to the same.
Two days ago in Katwa, North Kivu, there was a violent attack against an Ebola treatment centre that killed the brother of an Ebola patient.
Attackers threw stones at the centre, then set parts of the building on fire and destroyed wards and equipment.
Médecins Sans Frontières suspended its services in the area.
What next?
[[Focus your response efforts elsewhere->DATA: Focus your response efforts elsewhere]]
[[Ensure your health workers have security training and protection]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996449143/in/dateposted-public/" title="Katwa_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996449143_9ac313669e_z.jpg" width="640" height="360" alt="Katwa_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You have focused efforts on other regions, including dealing with the measles outbreak, while still trying to ensure the response continues in affected areas like Katwa.
The challenges of access and insecurity have made efforts much harder - and now the number of cases and deaths is rising fast.
By the end of March, more than <b>1,000 cases</b> have been confirmed, and nearly <b>700 people</b> are dead.
By the end of April, there are nearly <b>1,500 cases</b> and more than <b>900 dead</b>.
By mid-June, there are <b>2,000 cases</b>, and <b>1,300 people</b> have died.
[[A state of emergency is declared->DATA: A state of emergency is declared]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997016208/in/dateposted-public/" title="Vaccination"><img src="https://live.staticflickr.com/65535/48997016208_e8e8e3a375_z.jpg" width="640" height="360" alt="Vaccination"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The Congolese health authority announces a second experimental Ebola vaccine, manufactured by Johnson & Johnson.
The vaccine will be given in two doses, 56 days apart, to people in at-risk areas that don't have active Ebola transmission. The goal is to prevent further spread.
The vaccination campaign will start mid-October.
[[The latest update in October->DATA: Conclusion, October 10, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993287581/in/dateposted-public/" title="June11_2019_DRC"><img src="https://live.staticflickr.com/65535/48993287581_867efd595c_z.jpg" width="640" height="446" alt="June11_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Now there's measles]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997016208/in/dateposted-public/" title="Vaccination"><img src="https://live.staticflickr.com/65535/48997016208_e8e8e3a375_z.jpg" width="640" height="360" alt="Vaccination"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It's July 11, 2019.
You're running a measles vaccination campaign with UNICEF. The goal is to vaccinate 67,000 children in Ituri province, one of the Ebola-affected regions.
According to UNICEF, nearly 2,000 people have died from measles across DRC so far this year, more than two-thirds of them children under five.
[[Next->Measles vaccination campaign]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994187068/in/dateposted-public/" title="Nov13_2018_Katwa_DRC"><img src="https://live.staticflickr.com/65535/48994187068_60fb3c8be4_z.jpg" width="640" height="446" alt="Nov13_2018_Katwa_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Katwa ebola spreading]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996397543/in/dateposted-public/" title="Katwa_HealthworkerHouse"><img src="https://live.staticflickr.com/65535/48996397543_0b9c94a19e_z.jpg" width="640" height="360" alt="Katwa_HealthworkerHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You tell the health worker that you haven't been feeling well and they recommend that you go into voluntary isolation.
This means that for the length of the incubation period of Ebola - the 21 days from contact in which symptoms can develop - you would be kept securely away from the public and your children to help avoid the spread.
But you don't like hospitals. What do you say?
[[Yes, I'll go]]
[[No, I refuse]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996397543/in/dateposted-public/" title="Katwa_HealthworkerHouse"><img src="https://live.staticflickr.com/65535/48996397543_0b9c94a19e_z.jpg" width="640" height="360" alt="Katwa_HealthworkerHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Many people are skeptical of health workers. There are rumours that Ebola is a made up disease, that the health workers aren't really there to help, or that the only reason the international community is responding is because of fear that it will spread to their countries.
In this part of the DRC, people have felt neglected during decades of conflict. Many more people die from diseases such as measles and malaria, and yet the international response is much stronger for Ebola.
You decide to lie and stay at home.
Unfortunately, your symptoms worsen and soon your daughter also develops symptoms.
What do you do?
[[Go see your church leader to ask advice]]
[[Seek treatment]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996397543/in/dateposted-public/" title="Katwa_HealthworkerHouse"><img src="https://live.staticflickr.com/65535/48996397543_0b9c94a19e_z.jpg" width="640" height="360" alt="Katwa_HealthworkerHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
This is the ideal way the system called "contact tracing" works. Health workers identify people who may develop Ebola, monitor them for symptoms, and prevent them from spreading the disease.
Ebola symptoms include things like fever, fatigue, muscle pain or weakness.
It's believed Ebola can only be transferred once someone is showing the symptoms. It also can only be transmitted through direct contact with infected bodily fluids, such as blood, feces or semen.
And the survival rates upon receiving treatment are significantly higher when people were admitted to a medical facility immediately.
[[Go to isolation]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996444893/in/dateposted-public/" title="Katwa_PeopleRefuseTreatment"><img src="https://live.staticflickr.com/65535/48996444893_f18660f94e_z.jpg" width="640" height="360" alt="Katwa_PeopleRefuseTreatment"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The health worker warns you that Ebola symptoms include things like fever, fatigue, muscle pain or weakness.
They tell you it's believed Ebola can only be transferred once someone is showing the symptoms. It also can only be transmitted through direct contact with infected bodily fluids, such as blood, feces or semen.
You still refuse to go.
[[Next->More info on refusals]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996449143/in/dateposted-public/" title="Katwa_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996449143_9ac313669e_z.jpg" width="640" height="360" alt="Katwa_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You are monitored while under isolation and the health workers confirm that you do have Ebola. However, because you've been in touch with them, you receive treatment quickly and recover well.
In part because you were isolated quickly, you are fortunate that no one else in your family gets sick.
When you are released, the health workers ask if you'd be willing to volunteer as a survivor to convince others to seek treatment or go into isolation.
[[Agree to volunteer]]
[[Refuse]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996993776/in/dateposted-public/" title="Katwa_ChurchLeader"><img src="https://live.staticflickr.com/65535/48996993776_98cac38bce_z.jpg" width="640" height="360" alt="Katwa_ChurchLeader"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You go see your church leader and ask for advice. You explain the symptoms that both you and your child are presenting.
To your surprise, he also recommends seeking treatment from an Ebola centre and to go into isolation.
In some cases, the difficulty of response is in part due to lack of education and illiteracy - many people aren't in a position to research the information to understand exactly what Ebola is and how to respond. And with distrust of outsiders, they are unlikely to be convinced.
That's why the UN and other international organisations have included targeting religious and community leaders as a way to gain trust. They provide resources and education to those likely to be believed.
You decide to listen to his advice.
[[Seek treatment]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996449143/in/dateposted-public/" title="Katwa_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996449143_9ac313669e_z.jpg" width="640" height="360" alt="Katwa_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You are taken to a treatment facility where both you and your daughter recover.
While there, you make friends with a young woman who was brought to the facility several weeks after his first symptoms appeared. Sadly, she passes away. Her family invites you to be a part of the funeral.
At the same time, health officials ask if you'd be willing to volunteer as a survivor. They want you to appear on a radio program to tell your story.
[[Go to the funeral]]
[[Agree to volunteer]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996990336/in/dateposted-public/" title="Katwa_Funeral"><img src="https://live.staticflickr.com/65535/48996990336_8e6d26a48b_z.jpg" width="640" height="360" alt="Katwa_Funeral"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Ebola can only spread through contact of infected bodily fluids - but that means that touching the bodies of victims can spread the disease.
In this region of DRC, it's customary to wash the body before burial and braid the hair of the deceased.
You've agreed to take part in the funeral. Do you and the family:
[[Accept the advice of health workers on how to modify traditional practices]]
[[Ignore them]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997195822/in/dateposted-public/" title="Katwa_Election"><img src="https://live.staticflickr.com/65535/48997195822_4bb3b8dd7f_z.jpg" width="640" height="360" alt="Katwa_Election"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Efforts to reduce stigma and disinformation include getting survivors involved in informing their community.
You share your story of isolation and treatment during some public events and through public radio programs to help people understand what you went through, and to reduce their fears.
Your work encourages several people who were reluctant to seek medical care, and likely saves some lives.
[[The presidential election is coming->DATA: Presidential election]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996940711/in/dateposted-public/" title="Katwa_YourHouse"><img src="https://live.staticflickr.com/65535/48996940711_f6274c8696_z.jpg" width="640" height="360" alt="Katwa_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
There is a lot of stigma against Ebola survivors.
Sometimes people don't want to interact with them, or touch them. They may also be suspicious of survivors.
That can make survivors more reluctant to take part in public education campaigns.
[[The presidential election is coming->DATA: Presidential election]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996990336/in/dateposted-public/" title="Katwa_Funeral"><img src="https://live.staticflickr.com/65535/48996990336_8e6d26a48b_z.jpg" width="640" height="360" alt="Katwa_Funeral"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You and your friend's family agree to follow the safe burial procedures, run through the Red Cross.
The WHO has a 12-step guide.
First, they meet with you and the family to discuss the different ways they can be involved, while still preventing the spread of Ebola.
[[You attend the funeral]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996990336/in/dateposted-public/" title="Katwa_Funeral"><img src="https://live.staticflickr.com/65535/48996990336_8e6d26a48b_z.jpg" width="640" height="360" alt="Katwa_Funeral"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Although it's common practice for families to touch the body of their deceased family member, this is very risky in the case of Ebola.
Ebola spreads through direct contact with blood or body fluids of a person who is sick with or has died from the disease, as well as objects contaminated with body fluids from a sick person or the body of an Ebola victim.
[[Next->Funeral victims]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994717811/in/dateposted-public/" title="Jan10_2019_DRC"><img src="https://live.staticflickr.com/65535/48994717811_368483790c_z.jpg" width="640" height="446" alt="Jan10_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Elections won]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
<center>
<h1>Sources</h1>
<a href="https://www.afro.who.int/news/who-supports-ebola-vaccination-high-risk-populations-democratic-republic-congo">WHO supports Ebola vaccination of high risk populations in the Democratic Republic of the Congo</a>
<a href="https://www.who.int/news-room/detail/23-09-2019-second-ebola-vaccine-to-complement-ring-vaccination-given-green-light-in-drc">Second Ebola vaccine to complement “ring vaccination” given green light in DRC</a>
<a href="https://apps.who.int/iris/bitstream/handle/10665/137379/WHO_EVD_GUIDANCE_Burials_14.2_eng.pdf?sequence=1">How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola or Marburg virus disease</a>
<a href="https://apps.who.int/iris/bitstream/handle/10665/185258/WHO_EVD_Guidance_Contact_15.1_eng.pdf;jsessionid=B5F2C40ED40E6C41432BAABDE4E49F47?sequence=1">Implementation and management of contact tracing for Ebola virus disease</a>
<a href="https://www.afro.who.int/news/uganda-steps-ebola-preparedness-response-22-high-risk-districts">Uganda steps up Ebola preparedness response in 22 high-risk districts</a>
<a href="https://news.un.org/en/story/2019/10/1048951">Ebola on the run in DR Congo, ‘now we have to kill the virus’: UN health agency</a>
<a href="https://news.un.org/en/story/2019/03/1034381">DR Congo: Following second brutal assault on Ebola clinic, UN health chief vows to continue serving ‘most vulnerable’</a>
<a href="https://www.msf.org/medical-activities-suspended-after-ebola-treatment-centre-attack">Medical activities suspended after Ebola treatment centre attack</a>
<a href="https://www.unicef.org/drcongo/en/stories/combatting-stigmatization-ebola-survivors">Combatting the stigmatization of Ebola survivors</a>
<a href="https://reliefweb.int/report/uganda/ebola-prevention-intensified-uganda-s-borders">Ebola prevention intensified at Uganda’s borders</a>
<a href="https://reliefweb.int/report/uganda/screening-ebola-uganda-democratic-republic-congo-border">Screening for Ebola on the Uganda-Democratic Republic of the Congo border</a>
<a href="https://news.un.org/en/story/2019/07/1043501">UN working ‘intensively’ to stop Ebola in eastern DR Congo, following second case in major border town</a>
<a href="https://www.afro.who.int/news/kenya-steps-its-ebola-contingency-plan-training-trainers">Kenya steps up its EBOLA Contingency Plan with training of trainers</a>
<a href="https://reliefweb.int/report/kenya/kenya-responded-fast-ebola-scare-cross-border-risk-remains-high">Kenya responded fast to Ebola scare, but cross-border risk remains high</a>
<a href="https://www.cdc.gov/globalhealth/resources/reports/accomplishments/2018/outbreaks-and-energency-response.html">Ebola Outbreak in the Democratic Republic of the Congo</a>
<a href="https://reliefweb.int/report/democratic-republic-congo/drc-faith-leaders-were-not-consulted-soon-enough-help-halt-spread">In DRC faith leaders were not consulted soon enough to help halt the spread of the Ebola virus</a>
<a href="https://www.who.int/ebola/historical-outbreaks-drc/en/">Ebola virus disease: History of Ebola in Democratic Republic of the Congo</a>
<a href="https://www.cdc.gov/vhf/marburg/resources/outbreak-table.html">Chronology of Marburg Hemorrhagic Fever Outbreaks</a>
<a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30063-5/fulltext">Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey</a></center><a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994708941/in/dateposted-public/" title="Feb27_2019__Katwa_DRC"><img src="https://live.staticflickr.com/65535/48994708941_7ec4c56a11_z.jpg" width="640" height="446" alt="Feb27_2019__Katwa_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Attacks in Katwa]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996595522/in/dateposted-public/" title="Beni_Church"><img src="https://live.staticflickr.com/65535/48996595522_1a0f686521_z.jpg" width="640" height="360" alt="Beni_Church"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You attend a church service, where the priest tells everyone not to worry about this Ebola disease. He says God will protect you.
After the service, he stands by the door and shakes everyone's hands.
Do you:
[[Shake his hand->DATA: Beni, Oct 1, 2018]]
[[Decline to shake his hand, and decide to learn more about Ebola->Learn more about Ebola]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997259482/in/dateposted-public/" title="Katwa_HospitalDamage"><img src="https://live.staticflickr.com/65535/48997259482_0161e34139_z.jpg" width="640" height="360" alt="Katwa_HospitalDamage"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It takes several weeks before the suspended health facilities are able to re-open.
In neighbouring Butembo, there have been more attacks.
On February 27, an MSF Ebola Treatment Centre was attacked.
In April, an attack on a hospital killed a WHO epidemiologist.
It's now July 31, 2019.
There are more than 2,700 confirmed cases of Ebola. At least 1,700 people have died.
[[Next->DATA: Conclusion, October 10, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
For a day or two after you receive the vaccine, you feel quite sick and stay home in bed.
But as the health workers advised, you recover quickly and get back to work.
[[Next->DATA: After the vaccine]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
As a health worker, you're asked to get a vaccination against Ebola.
You know some people who've received it, and they were very sick for several days after.
Others have warned you the vaccine is risky, untested, just a ploy by the international company make it to get money, or that it could be intended to harm the population.
[[Next->Learn more about the vaccine]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996398456/in/dateposted-public/" title="Beni_TruckUgandaBorder"><img src="https://live.staticflickr.com/65535/48996398456_661f3619ca_z.jpg" width="640" height="360" alt="Beni_TruckUgandaBorder"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You've been doing deliveries between Beni and Kasese for a few months now. It's a tiring job, but you're earning enough to support your family.
At the Mpondwe border crossing point in Kasese, travellers must wash their hands to prevent the spread of Ebola.
Each time you cross, health volunteers check your temperature. But it can be difficult for those workers to clinically distinguish Ebola from other infectious diseases such as malaria, typhoid fever and meningitis.
[[Next->Feeling unwell]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996394726/in/dateposted-public/" title="Beni_DeliveryTruck"><img src="https://live.staticflickr.com/65535/48996394726_c316ecf328_z.jpg" width="640" height="360" alt="Beni_DeliveryTruck"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The health workers thank you for being honest. They test you for malaria and Ebola, and monitor you for a few days. They release you when it's clear you don't have Ebola.
You're frustrated to miss some days at work, but are relieved to be certain you're not infected.
[[Get back to work->DATA: Ebola in Uganda]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996394726/in/dateposted-public/" title="Beni_DeliveryTruck"><img src="https://live.staticflickr.com/65535/48996394726_c316ecf328_z.jpg" width="640" height="360" alt="Beni_DeliveryTruck"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You cross the border without an issue, since you don't have a fever and you hid your symptoms well.
You were lucky, your symptoms turn out just to be exhaustion from work. After a good night's rest, you feel much better. But if you'd been wrong, you could have infected the many people you interacted with in Uganda.
It's now December 25, 2018.
You've taken some days off for Christmas with your family.
They're saying more than 200 people have Ebola in Beni, and more than 120 people have died. But you don't know anyone personally affected.
[[The holidays are over, time to go back to work->DATA: Ebola in Uganda]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996457142/in/dateposted-public/" title="Beni_WelcomeParty"><img src="https://live.staticflickr.com/65535/48996457142_cb9f48929e_z.jpg" width="640" height="360" alt="Beni_WelcomeParty"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
This is a strategy being used to help integrate survivors back into their communities. There is a lot of misinformation and stigma about Ebola, and survivors can struggle to return home comfortably.
You organize a party, playing music and welcoming him back to the community.
The tactic works - his neighbours aren't afraid to interact with him, and some even ask him about his experience and learn more about Ebola treatment.
[[Latest situation in Beni->DATA: Beni, July 17, 2019]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996450552/in/dateposted-public/" title="Beni_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996450552_d565da706e_z.jpg" width="640" height="360" alt="Beni_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
He returns to his house, but is facing a lot of stigma from his community. Many people are afraid to approach him, or don't want to touch him.
Stigma against survivors is a challenge that can worsen the response - when people are afraid to speak with survivors, they miss an opportunity to learn the truth about Ebola and about the treatment methods.
[[Latest situation in Beni->DATA: Beni, July 17, 2019]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996398456/in/dateposted-public/" title="Beni_TruckUgandaBorder"><img src="https://live.staticflickr.com/65535/48996398456_661f3619ca_z.jpg" width="640" height="360" alt="Beni_TruckUgandaBorder"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Everyone is talking about the first confirmed Ebola case in Uganda.
A 5-year-old from DRC crossed the Bwera border with his family on June 9. He was taken for treatment at Kagando hospital where health workers suspected it could be Ebola. Two days later it was confirmed.
At the border, people seem more worried about the disease. Some friends of yours are posting their worries on social media.
How do you respond?
[[Share funny posts you've found online]]
[[Try to figure out what's true]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996106281/in/dateposted-public/" title="Beni_YourHouse"><img src="https://live.staticflickr.com/65535/48996106281_f2c6a141e0_z.jpg" width="640" height="360" alt="Beni_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
One of the challenges of stemming disinformation about this Ebola outbreak is the prevalence of false information shared on social media.
You're at home and just shared posts of several conspiracy theories with your friends, only adding to the rumours about Ebola.
In some cases, these rumours and fake news stories are leading to attacks against hospitals, treatment centers, and health workers.
[[Latest situation in Beni->DATA: Beni, July 17, 2019]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996371517/in/dateposted-public/" title="Beni_YourHouse_Radio"><img src="https://live.staticflickr.com/65535/48996371517_628a873233_z.jpg" width="640" height="360" alt="Beni_YourHouse_Radio"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It can be hard to get to the truth with so much disinformation circulating. You try to find posts online, but can't tell which one is accurate.
You listen to radio programs and watch television, but the news and experts often contradict other things you've heard.
[[Latest situation in Beni->DATA: Beni, July 17, 2019]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993306661/in/dateposted-public/" title="July17_2019_DRC"><img src="https://live.staticflickr.com/65535/48993306661_d61b7b2694_z.jpg" width="640" height="446" alt="July17_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Global health emergency]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996295386/in/dateposted-public/" title="Beni_Neighbor1Dead"><img src="https://live.staticflickr.com/65535/48996295386_3b7b1df11d_z.jpg" width="640" height="360" alt="Beni_Neighbor1Dead"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
She is finally convinced by health workers and friends to go for treatment - but unfortunately she delayed so long that health workers aren't able to save her. She passes away a few days after arriving in the treatment center.
Her death reinforces the fears of many people in the community that people who go for treatment don't come back.
[[Next->DATA: Conclusion, October 10, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996295386/in/dateposted-public/" title="Beni_Neighbor1Dead"><img src="https://live.staticflickr.com/65535/48996295386_3b7b1df11d_z.jpg" width="640" height="360" alt="Beni_Neighbor1Dead"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Unfortunately, she dies a few days later. It's very common for people to fear seeking health care - very few of the people they see going for treatment return.
But without treatment, chances of survival from Ebola are even lower.
[[Next->DATA: Conclusion, October 10, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996413976/in/dateposted-public/" title="Beni_Overview"><img src="https://live.staticflickr.com/65535/48996413976_d1c44283e9_z.jpg" width="640" height="360" alt="Beni_Overview"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
<center>This news project was designed using reporting and data from agencies reporting in Ebola-affected regions, including interviews with responders and victims. Data of confirmed cases and deaths are from the Democratic Republic of Congo's Ministry of Health, through the World Health Organization.</center><p>
<center><em style="color:DarkSlateGray;">This project was funded by the International Center for Journalists (ICFJ) through the 2019 News Corp Digital News Innovation Grant.</em></center><p>
[[Begin]]</center><a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997416981/in/dateposted-public/" title="Nairobi_Overview"><img src="https://live.staticflickr.com/65535/48997416981_9475278815_z.jpg" width="640" height="360" alt="Nairobi_Overview"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You're a health worker in Nairobi. What job do you want?
[[I'm a doctor->Kenya update]]
[[I'm a nurse->Kenya update]]
[[I'm an emergency room worker->Kenya update]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996872493/in/dateposted-public/" title="Nairobi_Home"><img src="https://live.staticflickr.com/65535/48996872493_9aaefef230_z.jpg" width="640" height="360" alt="Nairobi_Home"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The Democratic Republic of Congo has declared an Ebola outbreak.
It's not the first time you've heard this. In fact, the DRC has experienced 10 outbreaks since 1976.
But this one has broken out in North-Kivu - a highly-populated region with a lot of cross-border travel, a history of conflict, and many access challenges.
Your spouse is worried. What do you say?
[["Don't worry, there's never been Ebola in Kenya"]]
[["I'm sure the Congolese government and international organisations have it under control"]]
[["If it gets to a border city, I don't think they'll be able to stop it"]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993451802/in/dateposted-public/" title="Sept25_2018_DRC"><img src="https://live.staticflickr.com/65535/48993451802_8de1e89cb8_z.jpg" width="640" height="446" alt="Sept25_2018_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Increasing security]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993232536/in/dateposted-public/" title="Aug3_2018_DRC_v3"><img src="https://live.staticflickr.com/65535/48993232536_5bfe0a0111_z.jpg" width="640" height="446" alt="Aug3_2018_DRC_v3"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Stopping the spread]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993232536/in/dateposted-public/" title="Aug3_2018_DRC_v3"><img src="https://live.staticflickr.com/65535/48993232536_5bfe0a0111_z.jpg" width="640" height="446" alt="Aug3_2018_DRC_v3"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Ignore the rumours]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993232536/in/dateposted-public/" title="Aug3_2018_DRC_v3"><img src="https://live.staticflickr.com/65535/48993232536_5bfe0a0111_z.jpg" width="640" height="446" alt="Aug3_2018_DRC_v3"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Katwa, North Kivu province, Democratic Republic of Congo]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993232536/in/dateposted-public/" title="Aug3_2018_DRC_v3"><img src="https://live.staticflickr.com/65535/48993232536_5bfe0a0111_z.jpg" width="640" height="446" alt="Aug3_2018_DRC_v3"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Nairobi, Kenya]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993265656/in/dateposted-public/" title="Oct1_2018_Beni_DRC"><img src="https://live.staticflickr.com/65535/48993265656_5af12f3ec5_z.jpg" width="640" height="446" alt="Oct1_2018_Beni_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Working in the Ebola Centre]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48992735568/in/dateposted-public/" title="Dec17_2018_Beni_DRC"><img src="https://live.staticflickr.com/65535/48992735568_d667f434b4_z.jpg" width="640" height="446" alt="Dec17_2018_Beni_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Driving between Beni, DRC and Kasese, Uganda]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993287581/in/dateposted-public/" title="June11_2019_DRC"><img src="https://live.staticflickr.com/65535/48993287581_867efd595c_z.jpg" width="640" height="446" alt="June11_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Ebola in Uganda]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The WHO declares the outbreak a global health emergency, after the first case was reported in Goma, on the border with Rwanda.
In Beni, there are 485 confirmed cases, and 310 deaths.
The mother of a family living near you has been sick for several days, but she insists it's a curse from someone who is jealous of her. She's sought advice from a local healer, but is refusing to go to an Ebola treatment centre.
Health workers keep visiting her, but she won't agree. She says they'll kill her if she goes with them.
What do you do?
[[Encourage her to go for treatment]]
[[Support her decision to stay at home]]<blockquote><i>“It is impossible to say outbreak is over, it’s not.”
“It is impossible to predict where the outbreak is going to go next…but we have significantly contained the virus in a much smaller geographic area; now we have to kill the virus.”
- Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme head</i>
[[Next->Conclusion ending]]</blockquote><center>These three people are living in Ebola-affected regions of the DRC.
Who do you want to meet?
[[Masika Rebecca, an Ebola survivor, 41 years old]]
[[Andres Hamuli, a driver, 31 years old]]
[[Fabrice Mulwahale, a student, 26 years old]]
[[Or, see what an Ebola treatment centre looks like.]]
<center>
For more stories on Ebola response, go to <p> <h2><a href="theelephant.info">The Elephant</a></center></h2>
<p>
<center><p style="color:DarkSlateGray;"></center>
<center><em>This project was funded by the ICFJ through the 2019 News Corp Digital News Innovation Grant</center></p></em>
[Align center]
[[Next->Credits]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997259482/in/dateposted-public/" title="Katwa_HospitalDamage"><img src="https://live.staticflickr.com/65535/48997259482_0161e34139_z.jpg" width="640" height="360" alt="Katwa_HospitalDamage"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You're on your way to work when you hear people talking about an incident that happened two nights ago.
People attacked the an Ebola treatment centre in Katwa, throwing stones at the facility and then setting the building on fire. They destroyed wards and equipment. One person - the brother of someone being treated - died.
Médecins Sans Frontières is announcing the decision to suspend services.
Someone has come to you - an Ebola survivor - to ask what you think.
What do you say?
[[Don't worry, I'm sure they'll reopen soon->The update]]
[[We need to be concerned->The update]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997195822/in/dateposted-public/" title="Katwa_Election"><img src="https://live.staticflickr.com/65535/48997195822_4bb3b8dd7f_z.jpg" width="640" height="360" alt="Katwa_Election"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Felix Tshisekedi has just been declared president of the DRC - more than a week after contested elections.
But some international organisations have been forced to suspend their work after violence against health workers in Ebola-affected areas like Beni.
During the election, officials blamed Ebola and insecurity for delayed voting.
[[Next->Elections quote]]
<blockquote><i>"When the DRC election commission used Ebola as a reason to delay elections in Beni and Butembo, areas known to have more supporters of the opposition candidates, they politicized the outbreak and put a target on the back of Ebola responders working to combat the outbreak."
"It is unacceptable that this disease is being used as a political ploy, putting aid workers in immediate danger."
- Bob Kitchen, Vice President of the Emergency Unit at the International Rescue Committee, in a statement released on Dec. 29, 2019.
</blockquote></i>
You can feel tensions increasing in your area, but unfortunately because of your work you need to stay in the community.
[[Next->DATA: Katwa, Feb 26, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996397543/in/dateposted-public/" title="Katwa_HealthworkerHouse"><img src="https://live.staticflickr.com/65535/48996397543_0b9c94a19e_z.jpg" width="640" height="360" alt="Katwa_HealthworkerHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
A health worker comes to your house and tells you it's likely you were in contact with someone who has a confirmed case of Ebola. They want to know whether you have had any symptoms.
You don't think you have Ebola, but you have been feeling unwell - a slight fever and overly tired. You don't think the worker can see that from speaking with you, though.
What do you want to do?
[[Tell the truth]]
[[Lie]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994226073/in/dateposted-public/" title="Sept23_2019_DRC"><img src="https://live.staticflickr.com/65535/48994226073_0897692542_z.jpg" width="640" height="446" alt="Sept23_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Lead a vaccination campaign]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994966117/in/dateposted-public/" title="Aug2_2019_DRC"><img src="https://live.staticflickr.com/65535/48994966117_0b6f957d1b_z.jpg" width="640" height="446" alt="Aug2_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Campaign for more money to help with the response]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The WHO declares the outbreak a global health emergency.
The declaration came after the first case was reported in Goma, a large city on the border with Rwanda.
What do you want to do now?
[[Campaign for more money to help with the response]]
[[Scale up response efforts]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996397543/in/dateposted-public/" title="Katwa_HealthworkerHouse"><img src="https://live.staticflickr.com/65535/48996397543_0b9c94a19e_z.jpg" width="640" height="360" alt="Katwa_HealthworkerHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The World Health Organization has a lot of funding for this Ebola response, but it's still not possible to send teams to investigate every possible case.
You'll have to prioritize the most likely cases or the closest ones that are easier to access, and wait for reports of symptoms from new places.
You head back to the response headquarters in Beni.
[[Next->DATA: September 25, 2018]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997533096/in/dateposted-public/" title="MilitiaAttack"><img src="https://live.staticflickr.com/65535/48997533096_8888e6e606_z.jpg" width="640" height="360" alt="MilitiaAttack"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Two days ago, militias killed 12 people in Beni, close to the area with the most Ebola cases. That makes the response much more complicated.
This region of the DRC has struggled with conflict for decades. There are numerous militias in the region, and threats that they could attack health workers and institutions.
[[Next->Also mining area]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996413976/in/dateposted-public/" title="Beni_Overview"><img src="https://live.staticflickr.com/65535/48996413976_d1c44283e9_z.jpg" width="640" height="360" alt="Beni_Overview"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
<center>
<b>Concept, reporting and writing:</b> <p>
Carolyn Thompson, Muyisa Kamathe Seros, Juliet Atellah, and Halima Gikandi
<p>
<b>Illustrator:</b> <p>
Kayee Au, PixelStory.co
<p>
<b>Editor:</b> <p>
Stellar Murumba
<p>
<b>Developer:</b> <p>
Gabriel Soare
</center>
<p>
[[Sources]]
<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
To get to the truth, you decide to approach a health worker in Beni directly.
During your discussion, the health worker learns you used to work as a nurse, and offers you a job working in the Ebola treatment center.
You need work, but you've also had an offer to do deliveries between Beni and Kasese, Uganda.
Which job do you accept?
[[Working in the Ebola Centre->DATA:Beni, Oct 1, 2018]]
[[Driving between Beni, DRC and Kasese, Uganda->DATA: Beni, Dec 17, 2018]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993265656/in/dateposted-public/" title="Oct1_2018_Beni_DRC"><img src="https://live.staticflickr.com/65535/48993265656_5af12f3ec5_z.jpg" width="640" height="446" alt="Oct1_2018_Beni_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[Align center]
[[Next->Turn off the radio]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996398456/in/dateposted-public/" title="Beni_TruckUgandaBorder"><img src="https://live.staticflickr.com/65535/48996398456_661f3619ca_z.jpg" width="640" height="360" alt="Beni_TruckUgandaBorder"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You've been feeling unwell for the past few days. A slight headache, muscle aches, weakness and exhaustion.
It's probably just from your work - and you have another delivery to make tomorrow. You need the money, especially as Christmas is coming.
What do you tell the health workers?
[[Tell them about your symptoms]]
[[Lie to keep working]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997416981/in/dateposted-public/" title="Nairobi_Overview"><img src="https://live.staticflickr.com/65535/48997416981_9475278815_z.jpg" width="640" height="360" alt="Nairobi_Overview"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
This is true, as far as is known, although there have been other outbreaks of similar types of diseases in Kenya, including the Marburg virus in 1980 and 1987.
But that doesn't mean Kenya is immune. It's partly thanks to lessons learned from the outbreak in West Africa that countries are better prepared to stop the spread.
[[Next->DATA: Kenya 1]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996394726/in/dateposted-public/" title="Beni_DeliveryTruck"><img src="https://live.staticflickr.com/65535/48996394726_c316ecf328_z.jpg" width="640" height="360" alt="Beni_DeliveryTruck"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
After the deadly outbreak in West Africa that killed more than 11,000 people, the response has improved.
There are screening systems being put in place at land border and airports, and health facilities are preparing to accept patients presenting signs of Ebola.
But nothing can completely prevent people from lying at the border, or from presenting symptoms after entering another country. There is still a risk.
[[Next->DATA: Kenya 1]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997418216/in/dateposted-public/" title="Nairobi_CarPlane"><img src="https://live.staticflickr.com/65535/48997418216_4f021ce669_z.jpg" width="640" height="360" alt="Nairobi_CarPlane"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You need to travel to Rwanda for work. You're attending a health conference in Kigali.
How do you want to travel?
[[By road]]
[[By plane]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997418696/in/dateposted-public/" title="Nairobi_Car"><img src="https://live.staticflickr.com/65535/48997418696_31f9a0cc4b_z.jpg" width="640" height="360" alt="Nairobi_Car"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Countries that border the DRC - and those that worry about Ebola spreading - have implemented safety checks at border crossings.
When crossing into Uganda and Kenya by land, you're checked for symptoms of Ebola.
The health workers don't find anything concerning.
[[Return home->DATA: Return home]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997418216/in/dateposted-public/" title="Nairobi_CarPlane"><img src="https://live.staticflickr.com/65535/48997418216_4f021ce669_z.jpg" width="640" height="360" alt="Nairobi_CarPlane"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Kenya has implemented new measures to protect the country from Ebola.
At the airport, passengers coming from regions that could be affected by Ebola are asked to fill out a form detailing their travel history.
A scanner also checks whether they may have temperature - a symptom of Ebola.
You pass the checks without an issue.
[[Return home->DATA: Return home]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996872493/in/dateposted-public/" title="Nairobi_Home"><img src="https://live.staticflickr.com/65535/48996872493_9aaefef230_z.jpg" width="640" height="360" alt="Nairobi_Home"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You've been home for a few weeks and back at work after your conference.
Then one day, you see the headlines:
<blockquote><i>"Kenya on high alert after suspected Ebola case in Kericho"
"Suspected Ebola results out today"
"Patient with Ebola-like symptoms quarantined in Kericho, lab results due Tuesday"</blockquote></i>
What do you think?
[[It's probably true. This outbreak was bound to come to Kenya]]
[[This is irresponsible reporting. It's not a confirmed case yet]]
[[Thank goodness the media is covering this so the government has to respond]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48993306661/in/dateposted-public/" title="July17_2019_DRC"><img src="https://live.staticflickr.com/65535/48993306661_d61b7b2694_z.jpg" width="640" height="446" alt="July17_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Return home]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997645182/in/dateposted-public/" title="Nairobi_MisInformation"><img src="https://live.staticflickr.com/65535/48997645182_b235cc39f2_z.jpg" width="640" height="360" alt="Nairobi_MisInformation"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Many people believe the news right away - even wondering whether Kenya's government would hide the truth to protect the tourism sector.
You're a health care worker at Kenyatta National Hospital, where a temporary isolation facility was created to prepare for confirmed Ebola cases.
As a staff member who may interact with those patients, you're offered the chance to get training, and to be vaccinated.
What do you want to do?
[[Get the vaccine and training->Kenya vaccination]]
[[Decline]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997645182/in/dateposted-public/" title="Nairobi_MisInformation"><img src="https://live.staticflickr.com/65535/48997645182_b235cc39f2_z.jpg" width="640" height="360" alt="Nairobi_MisInformation"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You may be right. Many people are worried, especially people in Kericho. On social media, conspiracy theories are being shared, and media outlets are struggling to challenge the disinformation.
You're a health care worker at Kenyatta National Hospital, where a temporary isolation facility was created to prepare for confirmed Ebola cases.
As a staff member who may interact with those patients, you're offered the chance to get training, and to be vaccinated.
What do you want to do?
[[Get the vaccine and training->Kenya vaccination]]
[[Decline]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997645182/in/dateposted-public/" title="Nairobi_MisInformation"><img src="https://live.staticflickr.com/65535/48997645182_b235cc39f2_z.jpg" width="640" height="360" alt="Nairobi_MisInformation"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It's true that accurate media coverage is a crucial part of the Ebola response. But not everyone who read the headlines read the follow-up saying the patient didn't have Ebola.
You're a health care worker at Kenyatta National Hospital, where a temporary isolation facility was created to prepare for confirmed Ebola cases.
As a staff member who may interact with those patients, you're offered the chance to get training, and to be vaccinated.
What do you want to do?
[[Get the vaccine and training->Kenya vaccination]]
[[Decline]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997448506/in/dateposted-public/" title="Nairobi_HospitalWork"><img src="https://live.staticflickr.com/65535/48997448506_c780921a86_z.jpg" width="640" height="360" alt="Nairobi_HospitalWork"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You're busy with patients and other work, so you don't take part in the training.
Luckily, part of Kenya's Contingency Plan is the training of medical professionals who can later train their own staff.
You get the chance to learn about Ebola response from your supervisor and are prepared were a patient to arrive.
[[Next->DATA: Conclusion, October 10, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997448506/in/dateposted-public/" title="Nairobi_HospitalWork"><img src="https://live.staticflickr.com/65535/48997448506_c780921a86_z.jpg" width="640" height="360" alt="Nairobi_HospitalWork"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Many countries - including Kenya - have vaccinated and prepared core teams of health professionals to ensure they can respond if there are Ebola cases confirmed.
Kenya ran a countrywide Ebola training in all 47 counties, targeting 60 per cent of all health personnel.
They also created an Ebola Task Force, charged with preparations including proper health facilities, trainings, and screenings at border points.
[[Next->DATA: Conclusion, October 10, 2019]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994762176/in/dateposted-public/" title="April25_2019_DRC"><img src="https://live.staticflickr.com/65535/48994762176_cc40ee04cc_z.jpg" width="640" height="446" alt="April25_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Ensure your health workers have security training and protection]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994762176/in/dateposted-public/" title="April25_2019_DRC"><img src="https://live.staticflickr.com/65535/48994762176_cc40ee04cc_z.jpg" width="640" height="446" alt="April25_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Communicate with leaders of the militias to try to get them on your side]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
While at the house, you see that the mother is showing Ebola symptoms. You encourage her to go into isolation, and trace her contacts.
The mother gives you a list of everyone she's been in contact with.
She's a tea seller at the regional market - the list of people who she has touched in the days since she was in contact with the priest is very long, and she's not even sure of everyone.
What do you want to do now?
[[Send out teams to follow up with everyone she named on her list]]
[[Focus on the medical response]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You show her the survival rates upon receiving treatment - they're significantly higher when people were admitted to a medical facility immediately.
You add that based on your assessment, you'd recommend she enter a voluntary isolation period to be sure she's healthy and to protect her loved ones and her community.
[[Ask her whether knowing all this information, she'd be willing to go into isolation]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997632541/in/dateposted-public/" title="Mining"><img src="https://live.staticflickr.com/65535/48997632541_99a8b7c538_z.jpg" width="640" height="360" alt="Mining"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The region is also a mining area - and in many cases there could be illegal activity making people afraid to come forward or hard to find.
How do you want to approach this?
[[Ensure your health workers have security training and protection->DATA: Training]]
[[Communicate with leaders of the militias to try to get them on your side->DATA: Communications]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Experts recommend prioritizing transparency about where the money is going, using low-cost options that are effective, efficient, and scalable, dedicating some funds to neighbouring countries to prevent further spread of Ebola outside of the DRC, and preparing for future outbreaks.
What should you do next?
[[Lead a vaccination campaign->DATA: Lead a vaccination campaign]]
[[Campaign for more money to help with the response->DATA: Campaign for more money]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994205913/in/dateposted-public/" title="Aug14_2018__Mabalako_DRC"><img src="https://live.staticflickr.com/65535/48994205913_613499057c_z.jpg" width="640" height="446" alt="Aug14_2018__Mabalako_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Work to trace the contacts of those already diagnosed]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The mother hesitates, and then says "No. Everyone here is healthy."
Still, you see some evidence that she is presenting symptoms.
What do you want to do?
[[Try to convince her to go into a voluntary isolation until you can be sure she doesn't have Ebola]]
[[Explain more about what the symptoms of Ebola are and how to know whether to seek help]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996107426/in/dateposted-public/" title="Beni_Neighbor1"><img src="https://live.staticflickr.com/65535/48996107426_a86373413c_z.jpg" width="640" height="360" alt="Beni_Neighbor1"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
"You're not here to help us," she says. "How do I even know Ebola is real?"
She tells you to leave and refuses to answer any more questions.
What do you want to do now?
[[Work on a comprehensive response, that includes providing treatment for malaria and measles]]
[[Focus on countering disinformation]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996990336/in/dateposted-public/" title="Katwa_Funeral"><img src="https://live.staticflickr.com/65535/48996990336_8e6d26a48b_z.jpg" width="640" height="360" alt="Katwa_Funeral"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Your friend's family didn't follow the health workers' guidelines, wanting to braid their daughter's hair and wash her body.
Unfortunately, now two people who were part of the funeral have symptoms of Ebola and have to be sent for treatment.
Meanwhile, many people are distracted from Ebola by the political environment.
[[Next->DATA: Presidential election]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996990336/in/dateposted-public/" title="Katwa_Funeral"><img src="https://live.staticflickr.com/65535/48996990336_8e6d26a48b_z.jpg" width="640" height="360" alt="Katwa_Funeral"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
Between January and early August 2019, according to MSF, more than 145,000 people have been infected and 2,758 have died. That's far more than those affected by Ebola.
The outbreak is the deadliest the country has experienced since 2011-2012.
What should you do now?
[[Check back on the Ebola situation]]
[[Work on a comprehensive response, that includes providing treatment for malaria and measles]]
[[Run a measles vaccination campaign]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It can be hard to respond to the measles outbreak since the symptoms – fever, redness around the eyes, diarrhoea – are similar to those of Ebola patients.
To be sure health workers don't contract Ebola, they often have to give out vaccines wearing full surgical gowns to prevent contact with blood or other bodily fluids.
But when health workers arrive wearing such outfits, it can sometimes worsen the fear and distrust of the population.
[[Check back on the Ebola situation]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48997016208/in/dateposted-public/" title="Vaccination"><img src="https://live.staticflickr.com/65535/48997016208_e8e8e3a375_z.jpg" width="640" height="360" alt="Vaccination"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
In the meantime, the Congolese Ministry of Health has declared a measles outbreak.
Measles is a highly contagious viral disease for which no treatment exists.
The only way to prevent the spread of measles is through vaccination, according to MSF.
[[Next->More about measles]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994802776/in/dateposted-public/" title="Feb26_2019_DRC"><img src="https://live.staticflickr.com/65535/48994802776_472a498182_z.jpg" width="640" height="446" alt="Feb26_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->Pause your work until the situation is under control]] <a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994717811/in/dateposted-public/" title="Jan10_2019_DRC"><img src="https://live.staticflickr.com/65535/48994717811_368483790c_z.jpg" width="640" height="446" alt="Jan10_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next->It's now December, and the presidential election will be held]] <blockquote><i>"When the DRC election commission used Ebola as a reason to delay elections in Beni and Butembo, areas known to have more supporters of the opposition candidates, they politicized the outbreak and put a target on the back of Ebola responders working to combat the outbreak."
"It is unacceptable that this disease is being used as a political ploy, putting aid workers in immediate danger."
- Bob Kitchen, Vice President of the Emergency Unit at the International Rescue Committee, in a statement released on Dec. 29, 2019.
</blockquote></i>
What do you want to do?
[[Ensure your health workers have security training and protection]]
[[Pause your work until the situation is under control->DATA: Pause work]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995701113/in/dateposted-public/" title="Beni_MeetHealthWorker"><img src="https://live.staticflickr.com/65535/48995701113_0120d2ffbb_z.jpg" width="640" height="360" alt="Beni_MeetHealthWorker"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The international organisations say that it's common to experience a few days of side-effects, including headache, fatigue, and muscle pain, after receiving the vaccine.
They admit that it is an experimental vaccine, but say that it's the best solution to preventing the spread of this deadly disease.
The vaccine, rVSV-ZEBOV, is not commercially licensed, but the WHO says it is being used under “compassionate use.” The same vaccine was used in the Ebola outbreak in Equateur in May-July 2018.
What do you want to do?
[[Get the vaccine]]
[[Refuse and instead take the job as a driver->DATA: Beni, Dec 17, 2018]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48994802776/in/dateposted-public/" title="Feb26_2019_DRC"><img src="https://live.staticflickr.com/65535/48994802776_472a498182_z.jpg" width="640" height="446" alt="Feb26_2019_DRC"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
[[Next-> A survivor leaves the centre]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996450552/in/dateposted-public/" title="Beni_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996450552_d565da706e_z.jpg" width="640" height="360" alt="Beni_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
You're getting nervous at work, since in many neighbouring cities and towns there have been attacks on health workers. The rumours and disinformation about treatment centres and the disease concern you.
One of your patients at the treatment centre has recovered and is about to return home. He's from your neighbourhood.
He just finished a meeting with a psycho-social assistant and was given a document certifying that he no longer poses a risk.
What do you want to do?
[[Organise him a welcome party]]
[[Wish him luck]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996940711/in/dateposted-public/" title="Katwa_YourHouse"><img src="https://live.staticflickr.com/65535/48996940711_f6274c8696_z.jpg" width="640" height="360" alt="Katwa_YourHouse"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The survival rates upon receiving treatment are significantly higher when people were admitted to a medical facility immediately.
You stay at home, but now notice that your child has also developed symptoms.
What now?
[[Go to a treatment facility->Seek treatment]]
[[Go see your church leader to ask advice]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996444893/in/dateposted-public/" title="Katwa_PeopleRefuseTreatment"><img src="https://live.staticflickr.com/65535/48996444893_f18660f94e_z.jpg" width="640" height="360" alt="Katwa_PeopleRefuseTreatment"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
One of the challenges of this Ebola response is convincing people to go into isolation and to receive treatment. Many people are afraid of health workers or distrustful of the response.
In some cases people have only seen people go for treatment, not return. They fear that if they too go for treatment, they'll die in the facility.
[[Next->Reality of Ebola treatment]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996990336/in/dateposted-public/" title="Katwa_Funeral"><img src="https://live.staticflickr.com/65535/48996990336_8e6d26a48b_z.jpg" width="640" height="360" alt="Katwa_Funeral"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
At the funeral, health workers wear protective equipment covering their entire bodies, and only they are allowed to touch the body.
They place your friend's body in a body bag, and place that inside a coffin.
They've listened to the family's requests, and placed your friends' favourite clothes and a bible inside the coffin with her.
At the cemetery, the coffin is lowered into the grave.
Everyone - including the health workers - takes part in a community prayer.
[[Return home to your community->DATA: Presidential election]]{embed YouTube video: 'https://www.youtube.com/watch?v=TnQ3vu3jWY4'}
<center>
For more stories on Ebola response, go to <p> <h2><a href="https://www.theelephant.info">The Elephant</a></center></h2>
<p>
<center><p style="color:DarkSlateGray;"></center>
<center><em>This project was funded by the ICFJ through the 2019 News Corp Digital News Innovation Grant</center></p></em>
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[[Credits]]{embed YouTube video: 'https://www.youtube.com/watch?v=XFJ6dpirdMY'}
<center>
For more stories on Ebola response, go to <p> <h2><a href="https://www.theelephant.info">The Elephant</a></center></h2>
<p>
<center><p style="color:DarkSlateGray;"></center>
<center><em>This project was funded by the ICFJ through the 2019 News Corp Digital News Innovation Grant</center></p></em>
[Align center]
[[Credits]]{embed YouTube video: 'https://www.youtube.com/watch?v=wuxAWLYWRG4'}
<center>
For more stories on Ebola response, go to <p> <h2><a href="https://www.theelephant.info">The Elephant</a></center></h2>
<p>
<center><p style="color:DarkSlateGray;"></center>
<center><em>This project was funded by the ICFJ through the 2019 News Corp Digital News Innovation Grant</center></p></em>
[Align center]
[[Credits]]{embed YouTube video: 'https://www.youtube.com/watch?v=G0LvLkvWjLM'}
<center>
For more stories on Ebola response, go to <p> <h2><a href="https://www.theelephant.info">The Elephant</a></center></h2>
<p>
<center><p style="color:DarkSlateGray;"></center>
<center><em>This project was funded by the ICFJ through the 2019 News Corp Digital News Innovation Grant</center></p></em>
[Align center]
[[Credits]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48996449143/in/dateposted-public/" title="Katwa_EbolaTreatmentCenter"><img src="https://live.staticflickr.com/65535/48996449143_9ac313669e_z.jpg" width="640" height="360" alt="Katwa_EbolaTreatmentCenter"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
It may be true that the Congolese government and organisations like the Center for Disease Control, World Health Organization and Red Cross have plans in place, but they are also warning that this outbreak will be hard to stop.
There is a lot of mistrust making it harder to get people to treatment centres, access to affected villages and towns is difficult, worsened by conflict in the region, and the strain of Ebola is the same as the deadly one in West Africa.
They will need a lot of health workers, facilities, and funds to be effective.
[[Next->DATA: Kenya 1]]<a data-flickr-embed="true" href="https://www.flickr.com/photos/185255796@N05/48995496623/in/dateposted-public/" title="WhatsApp Image 2019-11-01 at 16.52.37"><img src="https://live.staticflickr.com/65535/48995496623_b2cdfd9957_z.jpg" width="640" height="359" alt="WhatsApp Image 2019-11-01 at 16.52.37"></a><script async src="//embedr.flickr.com/assets/client-code.js" charset="utf-8"></script>
The Democratic Republic of Congo (DRC) has just declared an official Ebola outbreak.
[[Next->DATA: AUG 3, 2018]]