Last week, an Ebola treatment unit in eastern Congo lost eight patients. All of them were under five years old. The unit has 30 beds. Tonight, according to NPR, every single one of them is full.
The Numbers Are Already Historic — And Getting Worse
Since May, the DRC has recorded at least 6,800 confirmed Ebola cases and more than 3,310 deaths, according to NPR. That pace puts this outbreak on track to surpass the 2014 West Africa crisis — which killed 11,310 people and was, until now, the worst Ebola event in recorded history.
The strain driving this outbreak is Bundibugyo ebolavirus. Here is the brutal part: there is no approved antiviral medication for it. There is no approved vaccine. Roughly 30% of adults who get diagnosed are dead within two weeks. For children, whose immune systems are still developing, the death rate is higher. For newborns, NPR reports, the virus is almost always fatal.
Children make up one in four confirmed cases in this outbreak. They account for one in three deaths. Sit with that ratio for a second.
The Doctor in the Room
Dr. Rupa Narra is a U.S. pediatrician who arrived in Butembo in August to work for Doctors Without Borders. She responded to the 2014 West Africa Ebola outbreak as an epidemiologist. She worked in a Brooklyn emergency department when COVID-19 hit. She deployed with Doctors Without Borders to Haiti. The woman has seen things.
"I've never seen anything like this," she told NPR. "The speed of transmission, along with other aspects of a fragile healthcare system."
Her days are spent doing what she can, which isn't much against this particular virus without targeted treatments available. Running IV fluids. Giving oxygen. Blood transfusions. Treating fever and hypothermia and the secondary infections that pile on while a child's immune system is overwhelmed. She is also training around a dozen Congolese doctors and nurses on how to adjust those protocols for pediatric and newborn patients. NPR reports that she and her colleagues can spend only about an hour at a time inside the treatment unit, because working in full protective gear any longer than that becomes both physically dangerous and functionally impossible.
What It Actually Looks Like to Treat a Scared Five-Year-Old in a Hazmat Suit
Narra described to NPR what it means, practically, to be a pediatrician inside an Ebola treatment unit. She cannot bring toys. She cannot wear a funny hat. She cannot pick a child up, bounce them on her hip, or hold their hand through the night when things get bad. When she walks in, every inch of her is covered. Only her eyes are visible.
"You're 5 years old, and these people walk in with what looks like a spacesuit," she said. "Of course you're going to scream."
She told NPR about one five-year-old girl in quarantine, waiting on test results, whose father sat with her letting her watch Bollywood movies on his phone. Narra's family is from southern India. She recognized a song from the film Desi Boyz. After her shift, she stripped off her gear, ran to the girl's window from outside, and performed her best Bollywood dance moves — largely improvised — until the girl was laughing and clapping. NPR reports the test results came back a few days later, but does not say what they showed. That silence in the article is doing a lot of work.
A Newborn, Alone, and a Stranger Who Stayed
Shortly after Narra arrived in Butembo, NPR reports, a young mother died in the treatment unit shortly after giving birth. Her newborn daughter had no family members who had been exposed to the virus, which meant no one could safely enter to care for her. There was a serious chance the baby herself had Ebola.
When Narra entered the room, there was already a woman there, holding the baby. An Ebola survivor. Someone who didn't know the family at all, and had agreed to care for this infant anyway. Her own prior infection left her with immunity.
The baby lived for 10 days. She died from the virus. Her caregiver, NPR reports, never left her side. There is no way to write that sentence that makes it easier to read.
Why Eastern Congo Is the Worst Possible Place for This to Happen
The outbreak is concentrated in the eastern border region where the DRC, Rwanda, and Uganda meet. That area has been shredded by ongoing armed conflict between the Congolese army and Rwandan-backed paramilitary forces, according to NPR, which has pushed hundreds of thousands of displaced families into cities like Butembo. The healthcare system there was already operating at its limits, managing regular outbreaks of malaria, measles, and chronic child malnutrition.
Now add Ebola with no vaccine and no antiviral. Then add this: NPR reports that cuts to foreign aid have disrupted routine vaccination programs and other basic health services across the region. The conflict made it worse. The aid cuts made it worse. Both of those things happened at the same time, and here we are.
"I don't know how this is going to slow down," Narra told NPR. "It's the most devastating thing I've ever seen in my life."
The Dingo Take
You are supposed to believe that foreign aid cuts are an abstraction. A budget line. A policy debate for think tanks and cable news roundtables. What NPR is reporting from Butembo is what those cuts look like when they hit the ground: routine childhood vaccinations stopped, health infrastructure hollowed out, and then a strain of Ebola with no vaccine and no approved treatment tearing through a population of displaced, malnourished children while a 30-bed treatment unit runs out of space.
The Bundibugyo strain not having an approved vaccine is not some immovable fact of nature. Vaccine research costs money. Sustained global health funding costs money. Maintaining the kind of regional health infrastructure that can catch an outbreak before it reaches 6,800 cases costs money. The people who cut that money made a choice, and children in eastern Congo are dying at a rate of one in three confirmed cases because of it. That causal chain is not complicated. It just requires caring enough to follow it.
Narra is dancing Bollywood moves outside a quarantine window for a five-year-old who might be dying, because it is the only thing she can physically do to make that child smile. She gave up holding their hand at night. She gave up the toys and the funny hats and everything else in a pediatrician's toolkit. What she has left is dancing badly outside a window, hoping the kid can see her eyes crinkle above the hazmat suit. That is what's happening in Butembo right now. The least the rest of us can do is look at it directly.
Comments