Facing a New Ebola Threat, a Goma Clinic Steps Up

Since an outbreak of Ebola was announced in the Democratic Republic of the Congo, the Jericho Road Wellness Clinic in Goma, in the country's east, has seen an influx of frightened patients.

"They don't come to test for Ebola" at this point, said director Chantal Mandro. "They come to be sure that they are doing well."

Hundreds of cases had been confirmed in the DRC, and seven in Uganda, as of last week.

Historically, hospitals and clinics have become more dangerous during Ebola outbreaks, leading many patients to avoid them, as they did during the Covid-19 pandemic.

Still, Mandro and her staff screen every patient for fever and other symptoms of Ebola before they can enter the facility. Anyone who has symptoms or has traveled to Ituri Province, the center of this new outbreak, has to be kept separate from other patients. Potential cases will be sent on to a nearby hospital.

In North Kivu province, where Goma is located, government officials and healthcare providers are gearing up for a large-scale response. Putting together enough medicine, personal protective equipment, or PPE, and medical supplies to run an effective containment center is an urgent concern.

"They don't have enough PPE. They don't have enough anything," Mandro said of local responders.

A shipment from Direct Relief , containing $2.5 million in personal protective equipment, medicine, diagnostics, and supportive care treatments, has been prepared for the Wellness Clinic, which is part of long-time Direct Relief partner Jericho Road.

Included in the shipment are coveralls for biological protection, respirators, and goggles; antibiotics for coinfection; diagnostics; IV fluids, oral rehydration salts, and electrolytes; safety equipment; and chronic disease medications, because diseases like diabetes must be carefully managed in Ebola patients to prevent worse outcomes.

When it arrives, Mandro said, much of the PPE and medicine will be distributed to the district government to be used in an Ebola containment center in Goma, which officials are currently working to set up.

Dr. Myron Glick, a Buffalo, New York physician who founded Jericho Road, said that years of instability - civil war, an active volcano, a major Ebola outbreak in 2019, and widespread displacement - have made Goma especially vulnerable in the current health emergency.

About 800,000 people internally displaced by conflict are currently sheltering in the area, and even the 1.1 million residents experience widespread poverty, instability, and lack of access to healthcare.

"Goma's a really tough place to run a hospital," he said, noting that it's often cited as one of the most dangerous cities in the world. "It's already challenging, and now on top of it you put Ebola."

While current measures require anyone who's come in contact with a possible Ebola patient to quarantine at home, Dr. Glick said poverty and crowding make that less effective.

"I've seen families with eight or 10 kids [in Goma] live in spaces that are no bigger than my kitchen in Buffalo," he told Direct Relief.

Receiving a shipment of this size will be key to an effective response, Dr. Glick said.

"There's never enough of that stuff in stock," he said. "The most important items right now are the PPE, the IV fluids, the soaps."

But he noted that unmanaged conditions and coinfections will also pose life-threatening danger. Dehydration is a deadly concern in Ebola cases, making patients more vulnerable to coinfections that, in turn, lessen their odds of survival.

The Wellness Clinic's most urgent priority is to remain a safe place for patients to come, Dr. Glick said.

"The goal is to screen well, transfer the sick, and protect our team so we can keep doing primary care, the hospital, and maternal care," he said. Patients who are afraid to go to the clinic to manage chronic diseases, deliver babies, and receive vaccines are at greater risk too.

"That's something we saw in the past, in West Africa in 2014," during the most deadly Ebola outbreak yet seen, he recalled. Clinic visits and vaccinations "all fell pretty dramatically in that first year after Ebola."

Dr. Glick is hopeful that this outbreak will be more like that of 2019, which, though extremely deadly, was confined within the Democratic Republic of the Congo and resulted in about 2,200 deaths, a fraction of the 11,300 people who died in the 2014 West Africa outbreak.

But he noted that there is no vaccine for this strain of Ebola, and that testing models don't appear to be as effective. (Oxford University scientists have said they may be ready to begin clinical trials for a vaccine within two to three months.)

"There's some worry that this will end differently from the 2019 outbreak," he said.

Mandro said that years of instability have taken their toll on the community's outlook. "People in Goma are very, very tired because there are many catastrophes," she said.

Still, she said, people are gearing up to meet this new threat.

"We are all afraid, but we are resilient," she told Direct Relief. "There's nothing else to do."