GENEVA, 16 July 2019 – I returned from the Democratic Republic of the Congo (DRC) on Sunday. While I was there, I spent 10 days in North Kivu and Ituri, the two provinces affected by Ebola, and spent time in Goma, Beni, Butembo, and Bunia.
I’ll start with the reasons why the Ebola outbreak response needs to focus on children.
This outbreak is infecting more children than previous outbreaks. As of 7 July, there had been 750 infections among children. This represents 31% of total cases, compared with about 20% in previous outbreaks.
Young children – those below five years old, are especially hard hit. Of the 750 cases among children, 40 per cent were among under-fives. They, in turn, are infecting women. Among adults, women comprise 57 per cent of cases. According to the latest data I have, the case fatality ratio for under-fives is 77 per cent, compared with 67 per cent for all age groups.
Preventing infection among children must be at the heart of the overall Ebola response.
Young children are at higher risk than adults – which is why they need specialized attention. But Ebola also affects children very differently from adults, and the response needs to also factor in their very specific psychological and social needs.
Children infected with Ebola need child-specific medical care. Same drugs, but different dosages, but also need zinc to treat diarrhea, as well as treatment against intestinal parasites. Already malnourished children – which is far too common in the DRC – require treatment with food specifically formulated for children.
Children who are separated, often abruptly and brutally, from their parents due to Ebola, need dedicated care and attention while their parents undergo treatment.
Children who are orphaned due to Ebola need longer-term care and support. This includes mediation with extended families that refuse to take them in; health and nutrition support to make sure they stay healthy; and, for those who need it, school fees and other material aid to enable children to go back to school, which is so critical to their overall well-being.
Virtually all of them need help to counter the debilitating effects of the stigma and discrimination that taints children affected by Ebola, so that they are accepted, valued and loved by their families and communities.
Now I’ll move on to what we’ve done in response.
We have dedicated paediatricians working within the Ebola Treatment Centres to provide child-specific medical care. Every child under treatment has a dedicated caregiver who is also an Ebola survivor.
We provided the equipment and supplies to convert one of the treatment “cubes” at the Beni Ebola Treatment Center (ETC) into a delivery room for pregnant mothers, and are procuring similar material for the ETC in Katwa, which also handles similar cases from Butembo.
We have incorporated teams of nutritionists to work alongside the Ebola Treatment Centers to provide individualized, specialist nutritional care for children (and adults) who are suspected or confirmed to have Ebola. This is the first time an Ebola outbreak response has included this kind of care, and there is growing recognition among responders that it plays a vital role in the overall health status of patients.
We have provided every child known to us who has been separated from their parents or orphaned due to Ebola with dedicated care at specially set up childcare facilities located alongside the Ebola Treatment Centres. To soften the trauma of separation, the facilities are staffed with Ebola survivors, who are now immune to the disease, and able to hold children, and bring them to see their parents at the Ebola Treatment Centers.
We work with trusted community-based psychosocial workers to counsel children and families before, during, and after treatment, to explain the process and support them every step of the way.