A. SITUATION ANALYSIS
Description of Disaster
This DREF operation was launched on 30 June 2020, to support Central African Red Cross (CARC) to implement preparedness actions to prevent an Ebola Virus Disease (EVD) outbreak in country, as well as prepare the National Society to respond in the unfortunate event that an outbreak was declared.
Indeed, on 30 May 2020, the Provincial Director of Health of Equateur Province informed of four suspected EVD deaths in the Air Congo district of the Mbandaka health zone in the Democratic Republic of Congo (DRC).
This suspicion was confirmed on 01 June 2020, and the Ministry of Public Health of the Democratic Republic of Congo (DRC) declared the 11th outbreak of Ebola Virus Disease (EVD) in the Equateur province. Due to their geographical proximity, CAR and DRC share significant trade and social links over approximately 1,300 Km on either side of the Oubangui River. These exchanges, take place through river navigation, United Nations Humanitarians Air Services (UNHAS) between Bangui, capital of the CAR-Bandaka -Kinshaha in DRC, and are part of the secular and ancestral links between these countries.
Though the operation was initially launched for a three months timeframe, an Operation Update was published on 21 September 2020, extending the operation by three additional months. This was because of delays registered in implementation due to COVID-19 lockdowns imposed by the Government as a containment measure for the pandemic.
Summary of Response
Overview of the Operating National Society Response
At national level, 18 entry points remained operational along the Ubangui River, that is 10 in Bangui and 8 in the Moungoumba area, within Mbaïki health district. The 8 surveillance sites at these entry points were built by CRCA/IFRC while the 10 at Bangui were merely reinforced with surveillance equipment (non-contact frontal thermometers, handwashing devices, passenger check-in registers).
Soon after the outbreak was declared in the DRC, the national headquarters of the Central African Red Cross alerted local committees in the health districts close to the border with affected areas to ensure that they were aware and could reactivate volunteers who were trained in 2018. This response was initially slow due to the constraints imposed by the COVID-19 pandemic, which required physical distancing to be observed everywhere and restricted movement of people.
As a result, the following measures were taken:
Regarding public health, an emergency health mission was carried out in the localities of central Mongoumba, Ikoumba, Gouga, Sabourou, Embouchure, Zinga, Mongo and Sedale, which were the main entry points for people coming from the epidemic zone in the DRC to the CAR. The objective of this mission was to explore the Ebola Virus Disease screening system at the above-mentioned entry points in the Mbaiki health district, which is considered a priority zone No 1 by the CAR Health Authorities. This enabled the Central African Red Cross to:
Collect updated information on the Ebola Virus Disease surveillance system adopted in 2018;
Assess the needs of the entry points in terms of infrastructure and equipment required to re-operate the entry points;
Update the list of volunteers who should participate in follow-up activities in collaboration with the local committee of the Central African Red Cross in Mongoumba,
Present the project to local authorities and discuss implementation modalities.
To carry out surveillance activities at the entry points, 320 volunteers were trained, that is, 80 in the Moungoumba health district and 240 in Bangui, Bimbo and Bégoua. Twelve (12) community supervisors were also trained to supervise these volunteers.
At the end of the operation, a total of 15 entry points were operational, 10 in Bangui and 5 in the Mbaïki health district.
For Zila and Cedalé, the range of activities carried out in each of these localities and around these entry points are summarized as follows:
Training of 80 CARC volunteers in Community Engagement and Accountability (CEA), Community Based Surveillance (CBS), Safe and Dignified Burials (SDB), Protection, Gender and Inclusion (PGI), that is, 60 in Bangui and 20 in the district of Mabaïki - Case management at and around entry points for early detection and notification of alerted cases;
Assistance to Ministry of Health investigation teams by CARC volunteers;
Support for the referral of suspected cases to care facilities;
Passenger awareness at entry points and in communities.
For adequate monitoring of activities, tools were developed to facilitate data collection and analysis. These were:
Passenger registers with information on the identity of the passenger, the place of origin, the temperature and the clinical signs if any;
The daily summary sheet of passenger movements, which summarizes information on the number of passengers by age group;
The daily summary sheet of the temperature readings (using non-contact frontal thermometers);
The entry point information collection form;
Case alert notification form.
Logistics: The procurement process was immediately launched for the purchase of all equipment needed for response (SDB kits, hand washing kits, cleaning equipment etc.).
Regarding strengthening of the National Society's operational capacities, 320 volunteers and 8 supervisors were identified from the local committees of the CARC concerned. The training modules were updated and the trainings were organized with the facilitation of the Ministry of Health.
In terms of coordination, the Central African Red Cross and IFRC participated in all meetings organized by Public Health Emergency Operations Centre (COUSP) that brought together all stakeholders involved in the preparation.
IFRC/CARC were represented in the Communication and Social Mobilization, Infection Prevention and Control (IPC),
Prevention and Surveillance and Contact Follow-up Commissions.