Sarah Bagheni had been having a headache, high temperature, and itchy and uncommon eruptions on her skin for several days now without realizing that she could have MPOX or even one among many in the world’s health crisis. She doesn’t know where to look for medical help either.
Bagheni and her husband live in Bulengo Displacement camp in East Congo, which is arguably the epicenter of successive bouts of MPOX outbreaks in Africa.
A drastic increase in cases this year, including a new virus strain identified by scientists from Eastern Congo has led to its declaration as a global health emergency by WHO on Wednesday. A day before Sweden announced its first case of the new strain, it was timely information that the disease may spread beyond five African countries already detected with this new variant.
In the largest country in Central Africa; Congo, over 96% of approximately 17,000 reported cases mpox infections (with around 500 deaths resulting from it) were recorded this year and yet most of those at greatest risk seem oblivious to both its existence and dangers posed by it.
“We do not know anything about it,” said Habumuremyiza Hire who is Sarah Bagheni’s husband about mpox on Thursday. “I’m seeing my wife deteriorating every day because I don’t know what to do. We still share the same room.”
Many people are believed to be cut off from medical help or advice across eastern DRC where there are dozens of rebel groups which have been fighting against Congolese army troops for years over areas rich in minerals leading to great displacement crisis. In Goma alone there are hundreds of thousands more people like Bagheni and her husband who have ended up being pushed into cramped displacement camps whereas others have sought refuge within townships.
The conditions here are harsh with almost no medical facilities available at all.
According to Mahoro Faustin, who manages Bulengo camp, about three months ago the camp administrators started noticing people with fever, body pain and chills – symptoms that may imply malaria or measles or mpox.
There is no way to know how many cases of mpox may be in Bulengo due to lack of testing, he said. Faustin also added that there have not been any recent health campaigns in the tens thousands of residents in the camps to educate them about mpox and fears there could be many undiagnosed people.
“Look at this overcrowding,” he said, pointing towards a sea of huts put together from scraps. “ If nothing is done we will all get infected here or maybe we are already infected.”
Dr Pierre Olivier Ngadjole who works as a Health Advisor for Congo’s international aid agency Medair at Goma’s treatment center where over 70% new cases of MPOX recorded in last two months were detected among displaced people. The youngest patient was one month old and oldest ninety years old according to him.
In some severe MPOX cases, lesions can develop on the face, hands, arms, chest and genitals. While originating in animals, it has been transmitted between individuals through close body contact including sex during the past few years.
In order to obtain a diagnosis for her lesions, the only alternative that Bagheni has is a government hospital located two hours away. This seems unlikely as she already struggles to move around because she lost both of her legs at the knee.
The UN refugee agency report states that seven million people are internally displaced in Congo, with more than 5.5 million of them in the east of the country. Africa’s largest and one of the world’s biggest displacement camp populations belong to Congo.
According to Dr. Chris Beyrer who is the director of Duke University’s Global Health Institute, there are almost all possible complications related to MPOX outbreak which makes it difficult to stop such an epidemic in regard to humanitarian crisis in Eastern Congo.
It incorporates war, illegal mining industries that attract sex workers, transient populations near border regions, and entrenched poverty. He added that multiple warning signs had been ignored by global community.
“But mpox has been spreading since 2017 in Congo and Nigeria,” Beyrer said noting also that vaccines have long been begged to be given out for free on Africa by experts but without success. More than a dozen countries were affected before WHO declared its emergency according to him.
Beyrer noted that unlike Covid-19 or HIV, there’s “a good vaccine” and “good treatments” and “diagnostics” for mpox but “the access issues are worse than ever” especially in eastern Congo.
By 2022, outbreaks had occurred in over 70 nations globally including USA which made WHO declare emergency until mid-2023 as well. The use of vaccines and treatments allowed wealthy countries’ economies to mostly reopen within months while very few doses have been available in Africa.
This new form of mpox may be more infectious; it was first identified this year in an eastern Congolese mining town about four hundred fifty kilometers southwards from Goma . It remains unclear how much is this due to the new strain but Congo currently faces its biggest epidemic yet with at least thirteen African countries reporting cases, including four for the first time.
In fact, Doctors Without Borders said Friday that Congo’s surge “threatens a major spread of the disease” to other countries. The outbreak in these four countries: Burundi, Kenya, Rwanda and Uganda is connected to Congo’s.
It has been noted that there is a particularly worrying change in this Congo outbreak according to Salim Abdool Karim who chairs Africa Centers for Disease Control and Prevention’s emergency committee being an infectious disease expert. According to Africa CDC’s report children under fifteen years account for 70% of all cases and 85% of fatalities in the country.
MPox appears not only among gay and bisexual men as it did during the global epidemic of 2022 but also in heterosexual populations now.
According to the official news agency, there are mpox cases in all of Congo’s 26 provinces. Nonetheless, on Thursday the Health Minister Samuel-Roger Kamba disclosed that the country has not even one dose for vaccination and thus pleaded “vigilance in all directions from all Congolese.”
That is why they turn, according to Dr Rachel Maguru who work at multi-epidemic center at North Kivu Provincial hospital situated in Goma Town, to dermatologists for advice because they do not possess any pharmacology or established treatments for mpox. She warned against a bigger outbreak within the city and its many overcrowded camps where an influx of people is already putting it under pressure.
She identified a central dilemma: poor and displaced individuals must prioritize other concerns such as how to make money to eat; or survive. Assistance organizations and overstretched local authorities are already struggling with providing food, sheltering them as well as giving medical care to millions who have been displaced while dealing with flare-ups of ailments like cholera.
