Index Case: ‘Moment we were dreading’

By | June 16, 2019

This week, the ebola contagion reached crisis point.

A five-year-old boy, who became the first confirmed ebola case outside the Democratic Republic of the Congo during the current outbreak, died in Uganda on Tuesday night.

With the World Health Organisation warning there is a very high risk of the disease spreading regionally, agencies including World Vision are working tirelessly to contain the outbreak.

Now, World Vision CEO Claire Rogers has penned a heartbreaking open letter, pleading with the Australian government to assist with the humanitarian challenges of containing the Ebola virus.


When a five-year-old boy died of ebola in Uganda this week I knew the moment we’d all been dreading had arrived. Ebola has jumped the border from the Democratic Republic of Congo to East Africa.

This little boy — Uganda’s so-called Index Case — crossed with his mother and his younger brother back into Uganda from the DRC where there have been more than 2000 cases. The boy’s grandmother has since passed away and his little brother is infected, and at least four other cases are suspected.

Make no mistake: Ebola is a frightening and horrific illness.

Contagion occurs when victims become symptomatic with fever, intense weakness, throat and muscle pain. Ebola can be mistaken for typhoid or malaria until it swerves into the horror symptoms of projectile vomiting, diarrhoea and bleeding through skin, nose or even eyes. Patients die of dehydration and multiple organ failure.

The spread to Uganda is a crushing blow for humanitarians working around the clock to contain ebola to rural areas in DRC’s volatile North Kivu zone.

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No-one wants an epidemic but this is what we’re facing.

Most outbreaks are over quickly but this is the worst we’ve seen since the 2013-16 crisis in West Africa, which took more than 11,000 lives and several years to bring under control. With most people dying at home and not in health centres it’s clear there’s still widespread community distrust.

Responders want to act fast and adopt a command and control approach but to beat ebola, communities must lead the fight or we have no hope.

In recent weeks we’ve been talking with village chiefs, women and faith leaders — Christian and Muslim — to educate them on preventing Ebola’s spread.

Messages given by pastors, priests and imams are trusted by their congregations. This was the approach that turned the tide in the West African outbreak three years ago.

World Vision is training community health workers and providing thousands of sanitation kits. Around 90 per cent of those at risk have agreed to be vaccinated, according to the World Health Organisation. And the simple act of hand washing is reducing exposure.

However, with one in four cases going undetected according to WHO, the threat of ebola raging through East Africa is real. DR Congo can’t face this alone but it’s complicated.

Eastern DRC is a war zone where 13 million people need humanitarian assistance, measles has killed 1,500 people, and violence — including the use of child soldiers in more than 100 armed groups — is widespread. Border trade and movement is fluid. There are sudden refugee flows of thousands out of DRC every month, especially when fighting breaks out.

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This ongoing insecurity is one of our biggest challenges. It’s partly because of this that despite millions of dollars poured into the response, and issuing grave warnings for almost a year, we’ve got a frightening cross-border spread of the Ebola virus.

Aid workers have been deliberately targeted in outbreak hot spots like Butembo, and in more than 100 violent incidents, including attacks on ebola treatment centres.

Since the start of the year, 85 workers have been killed or injured.

Delivering lifesaving treatment and prevention without safe access is very difficult. Armed security forces escorting health workers are tainted by association in DRC. This is not surprising in an explosive part of the world racked by conflict between government, rebel and internationally backed armed groups.

Misinformation can spread fast, with some leaders denying ebola exists, some using it as a political tool and others even accusing aid workers of introducing the virus!

This is why it’s critical that local people lead the fight.

Back in 2013-16 communities were distraught and angry when they could not bury their dead according to local customs. The risk of ebola transmission during a burial was extremely high so World Vision worked with local leaders to adapt the burial ceremony so the dead could be buried safely but crucially, with dignity.

Our community-centred approach to ebola prevention proved so effective that research with America’s John Hopkins University found that not one of the 59,000 people we support in West Africa with long-term development work died from the disease.

The principles that the international community learned from the outbreak in West Africa now need to be funded and scaled up in the DRC — and rapidly.

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Australia has an international obligation to pay attention to the ongoing DRC crisis, both as a good global citizen and because it’s in our interests: Ebola knows no borders. If the outbreak is not contained cases could emerge all over the world, including here.

Together, governments, INGOs, and concerned citizens can make huge strides towards assisting the people of the DRC, especially the children.

I call on our Australian Government to provide funding to the DRC humanitarian


— To donate to World Vision, visit the website.

— Claire Rogers is World Vision Australia’s CEO. Continue the conversation @WVAnews

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