Killer virus will have to wait in line

http://capeargus.co.za ^ | 4/17/05 | Benjamin Joffe-Walt

[bitt]

Rows and rows of makeshift huts, with the green tarpaulin roofs of the United Nations Children's Fund, roll along the sides of the hills. Tche looks like a group of mushrooms with a refugee camp on top of it.

Out of nowhere sound two trumpet calls. Loud, incredibly clear, impossible to ignore from any part of the 15 000 strong camp. And a bit out of tune.

"Everyone likes this," says one of the hundreds of onlookers. "Why not? It lifts our spirits."

'We really have enough disease already' A haven for refugees who've suffered incredibly horrific fates, Tche is one of three camps in the war-torn Ituri region of the Democratic Republic of the Congo (DRC) that have suffered large-scale cholera outbreaks over the past few weeks.

Since March 26, more than 800 cases of cholera have been reported and 23 have died in Tche, Kafe and Tchomia.

Doctors Without Borders nurse Anne Sophie Jean Voine in Kafe, says: "There is crowding, they sleep on the ground, it rains all the time, they are poor, there is dirty water, lots of migration in and out - a refugee camp is the perfect place for these diseases."

After years of one of the bloodiest wars on earth and with a still only semi-functioning national government, vulnerability to epidemic levels of disease is nothing new to the DRC.

In a country of more than 50 million, only $12 (about R75) per person per year is spent on healthcare, the lowest figure in the southern half of Africa. So the DRC has the lowest levels of immunisations against TB and measles (about one in two for both diseases) and the highest rates of TB in central and southern Africa.

Simultaneously dealing with a cholera outbreak in the east and the threat of Marburg in the west, DRC health officials are working very hard now, but admit the country's defences are low.

"There are such poor facilities and staff that it's difficult for us to monitor the spread of the disease let alone stop it," says the World Health Organisation's Dr Jean Marie Yameogo about the big outbreak of Marburg virus in neighbouring Angola.

"We're ready but very worried as there's a very realistic chance the disease will cross the border, and it probably already has. Congo is vulnerable to anything."

Hundreds have already died of the Ebola-like fever described by the UN as "the deadliest yet". Centred in northern Angola, over the past two weeks there has been an average of seven new cases a day, with the latest death toll at more than 200.

As the epidemic spread and local officials failed to contain the virus within Angola, all nearby countries began battening down to prevent a regional epidemic.

Congolese health officials claim there are no suspected cases of Marburg in the region yet, but the DRC does share a huge border with Angola, and the danger of Marburg's spread is very real. But after three weeks of dealing with cholera, officials here seem unfazed by Marburg.

"The situation is terrible, but Marburg won't come here," says Massimo Nicoletti of Unicef, fatalistically.

"We really have enough disease already."

[tet68]

March 26, more than 800 cases of cholera have been reported and 23 have died

ONe can only be amazed at a death rate that low, a hundred
years ago it would have been near 90%.

We have not seen the beginnings of Marburg yet.