00:00New York Times Chief Africa Correspondent Declan Walsh has been reporting what this outbreak looks like live on the ground
00:05in the Democratic Republic of Congo. Take a listen.
00:09When we walked into this Ebola ward, it was very striking that in this confined space you had a grown
00:18man being treated, you had this young child who just arrived, and you had a person who had died of
00:23Ebola lying in that same space.
00:26The hospital doesn't even have the resources to feed patients. People's relatives have to come to the Ebola ward just
00:33to bring them bottles of water and food.
00:36Declan Walsh joins us now from Bunia, the capital of the Eturi province in the Democratic Republic of the Congo,
00:40which is the epicenter of this Ebola outbreak.
00:42It's great to speak with you, Declan. Thank you very much for being here.
00:46We see you in that video. You're wearing a Tyvek suit. You have PPE.
00:49It's clear that those visiting patients in that medical facility do not have Tyvek suits or PPE.
00:56Can you just talk about the capacity of this hospital to deal with what is still a nascent outbreak in
01:01the DRC?
01:03That particular hospital was, I would say, completely overwhelmed when we arrived.
01:08It's the main public hospital in a gold mining town called Mongboalu that's about 50 miles north of here.
01:15That's where this outbreak is believed to have started as long as two months ago.
01:20And when we arrived there, frankly, the public health facilities appeared to be in crisis.
01:27As you see, there was only protective equipment for medical staff like doctors, but otherwise those wards were not secured.
01:37There was very minimal care being given to patients.
01:40And then you had relatives and other folk just walking in and out, and they seemed to be entirely unprotected.
01:48And, of course, that was putting them at great risk and, of course, increasing the possibility that the hospital itself
01:55would be a source of transmission back out into the community.
01:58Yeah, it looks – I mean, it makes sense now that you're saying that's the general hospital because it looks
02:03to me like TB wards I've been in in places.
02:05It doesn't look like a purpose-built facility, which I guess is part of the problem.
02:09I do want to ask you briefly how you got there.
02:12And then David was pointing out to me earlier this morning that you said that you hadn't really planned on
02:16going in to this extent.
02:18Why did you change your mind once you were on the ground?
02:22We were there for several days.
02:23We'd spoken with the medical staff, got their permission.
02:27We got the permission from the patients to enter that ward.
02:29And, you know, I just felt it was very important to witness firsthand and to show the reality of care
02:38in the Congo, particularly in this frontline area.
02:41Here in the main city, Bunya, the head of the WHO has been here the last couple of days, Dr.
02:49Tedros Ghebyesus.
02:51There are, you know, aid agencies are present here.
02:54There are certainly some supplies coming in.
02:56I was at the opening of a new isolation ward in the city this morning.
03:01But up there in those rural areas where the greatest number of cases are found for a whole combination of
03:08factors, it's extremely difficult.
03:11Very little aid has reached there so far.
03:13And, you know, they're in a crisis situation, which, of course, is bad, terrible news for the people who are
03:18already sick.
03:19But it also means that the spread of this virus is, frankly, unknown and probably still uncontained.
03:27Declan, something we've spoken about with Jeremy Conondyke, public health official from the U.S., with Tom Frieden, former head
03:32of the CDC, as well as just about the cultural difficulties here,
03:36conveying to the population the seriousness of this outbreak.
03:39And you point to something very worrisome in your piece.
03:41You say many refused to accept the virus was real.
03:43You continue, some said the outbreak was a money-making plot concocted by Congolese doctors and foreign aid workers.
03:49Others call it a curse.
03:51As we talk about the deficit in the public health response to this crisis, how acute is this problem in
03:57particular just conveying to the population how dangerous this is
04:01and trying to explain in light of those sense of what's happening here that that, in fact, is not the
04:07case.
04:07This is a very serious virus.
04:10It's an absolutely crucial point.
04:12When you speak to aid workers, the first thing they'll tell you is they need equipment.
04:16The second thing they'll say they need is education and engagement with these communities.
04:21Some of these communities are extremely hostile to the virus.
04:25It's not just, or sorry, to the idea of the virus.
04:28It's not just that they don't believe it exists.
04:30They have carried out attacks against hospitals.
04:32The hospital that I visited had an isolation ward that was under construction, burned down.
04:38It came under attack the first night we were there from a group of over 100 people who wanted to
04:44retrieve the body of a local spiritual leader who had just died of Ebola.
04:48And what that all gets to is the whole practice of funerals.
04:52I think, as you noted, you know, the body of a person, a person is most contagious at the last
04:59stages of the disease and after they have died.
05:02So how the dead are buried is absolutely crucial.
05:06Otherwise, funerals can turn into super spreader events.
05:09So you see these really courageous local health workers and Red Cross officials who are doing their best to educate
05:16people to try and carry out safe burials of bodies.
05:20But because, frankly, the effort is so far behind the curve, as I said, this outbreak is thought to have
05:28started probably six weeks, maybe two months ago, but was only discovered and declared two weeks ago.
05:35So the entire effort is far behind the curve, which means there's very little reliable data about how much it
05:42has spread.
05:43And that's only feeding into this suspicion among local communities who, as far as they're concerned, see people going into
05:50hospitals just to die.
05:52Declan, I also want to ask you, I want to focus on something you talk about because you report that
05:56the hospital has no food or water to give to ailing patients.
06:00This is consistently an issue with health care in places like this.
06:04I know when you're giving HIV medication, when you're giving tuberculosis medication, when you're giving supportive care, that supportive care
06:10can't work if your patient is malnourished or you don't have clean water.
06:14And it's often the part of the response that it seems to get lost in the shuffle.
06:18Are there any efforts being made to address that piece of this?
06:22What is needed?
06:23And where do you think it should be coming from?
06:27Look, very.
06:28I mean, certainly the World Food Programme have mobilized in this area.
06:31They're mounting feeding programs and so on.
06:33But, you know, there are two issues with that.
06:36Firstly, as you say, you know, in a hospital like this, they just don't generally, for normal treatment, provide food
06:44or water to patients.
06:44The families are generally responsible for bringing food to their patients, right?
06:48The families are responsible.
06:48They come in.
06:49They provide the food.
06:50Now, that is providing a biosecurity hazard in this environment because family members come in unprotected to provide food to
06:57people and run a high risk of being contaminated themselves.
07:00The other issue is in terms of people's ability to fight this virus because this virus is a rare virus
07:08that as yet has no vaccine and no cure.
07:11The only way to treat it really is to bolster the defenses of a person who is sick in order
07:17that their own body can fight that virus.
07:20And obviously food, water, IV drips, all of these very basic, you know, not even medical treatments, but certainly basic
07:31things to bolster their immune system are key.
07:34And that's why if the medical authorities are going to successfully start to push back this wave of infections, they're
07:42going to have to get those pieces in places as well.
07:45Declan, let me ask you lastly just about what you heard from that Congolese doctor with whom you spent the
07:49most time.
07:49And I think in circumstances like this past outbreaks, the frustration and exhaustion are palpable among the medical staff who
07:55are in facilities like this one.
07:58How would you assess his level of optimism that this is going to get under control and indeed, what does
08:03he need or what does he say that he needs going forward?
08:07I think firstly, he just wanted protective equipment for the staff.
08:11Secondly, he wanted to be able to secure that hospital so that they could work in a safe environment.
08:17You know, when I met that man in the ward, the young doctor, you know, he was just not just
08:22exhausted.
08:23He'd just come off a night shift where someone had died during the night.
08:27A lady fell into a coma and died.
08:30But, you know, he really felt like he was at the end of his tether.
08:33He said, we were almost two weeks into this crisis and this is all we have.
08:38How is it possible that both my own government, but also this international system that has, you know, deployed to
08:44so many of these Ebola emergencies?
08:46He was basically saying, why is that not here?
08:49And that kind of frustration is palpable among many of the health professionals, health care professionals you meet in some
08:56of these frontline areas.
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