As the world grapples with COVID-19, the International Organization for Migration (IOM) joins the Democratic Republic of the Congo (DRC) and its neighbouring countries to celebrate the end of the battle against another deadly virus, Ebola, in the conflict-ridden east.  

Lessons drawn from the response are helping IOM to tackle both the current coronavirus pandemic and a new Ebola outbreak in DRC’s north-western Équateur province, with a focus on the link between human mobility and public health.  

After 694 days – 23 months – battling the Ebola virus disease (EVD), DRC officially declared on Thursday the end of an epidemic that infected 3,317 and killed 2,280 people in North-Kivu and its surrounding areas. The second largest Ebola epidemic in history and the tenth the country has faced, was declared on 1 August 2018; the last case reported was on 27 April 2020.  

In collaboration with Ministry of Health, the World Health Organization (WHO) and other key partners, IOM supported the following key five areas of intervention to help end the deadly outbreak in the region. 

Population mobility mapping 

In our increasingly mobile world, understanding how people move within and across borders is critical to understand how diseases are transmitted. In DRC, South Sudan, Burundi and Uganda, IOM - with the support and participation of communities - mapped and analyzed people’s mobility trends and dynamics. Population mobility mapping (PMM) allows responders to identify hotspots, strengthen prevention measures and inform decision-making processes, in particular regarding public health measures.

Since the beginning of the outbreak, IOM carried out 28 PMM exercises to support decision-making.

Data was collected in collaboration with IOM’s Displacement Tracking Matrix through the monitoring of movements in and out of certain key areas (known as “flow monitoring”) as well as information provided by the communities themselves (known as “participatory mapping exercises”). Over the past two years, 28 PMM exercises were carried out across the four countries.

Health screenings at key transit locations 

During the outbreak, systematic health screenings at borders and other strategic locations - combined with handwashing and the provision of reliable information - helped reduce transmission to neighbouring countries and among highly mobile populations, while continuing to enable the movement of people and goods, and minimizing disruption to the economy.

A health screening point in Beni, the epicentre of DRC's ninth Ebola outbreak. Photo: Muse Mohammed / IOM

IOM directly led this aspect of the response by carrying out health screenings at land border crossings and in airports (known as “points of entry” or PoEs), and other strategic transit spots. The Organization deployed over 1,500 workers who conducted over 190 million screenings 169 locations in DRC, South Sudan, Burundi and Uganda. To facilitate operations past sunset, solar panels were installed by IOM in many of the health screening locations.

Through these health screenings at PoEs and elsewhere, IOM raised close to 17,000 alerts, dozens of which were laboratory-confirmed as positive EVD cases.

For sustained disease surveillance and given the current COVID-19 pandemic, health screening activities at PoEs and other transit and congregation locations continue in all four countries, and will be launched shortly in Rwanda. In addition, in Tanzania, IOM was asked to carry out an assessment on PoEs and help advise on the implementation of public health measures.

Provision of water, sanitation and hygiene services

To help prevent and control infections, IOM installed or upgraded water, sanitation and hygiene (WASH) services at PoEs and other key transit and congregation locations throughout DRC, South Sudan, Burundi and Uganda. All 169 health screening points were equipped with several handwashing stations, including clean water with chlorine.

Handwashing station at one of the border crossings between DRC’s populous city of Goma and Rwanda, La Grande Barrière. Photo: Muse Mohammed / IOM

In addition, in South Sudan, 13 boreholes were repaired, and nine health facilities’ WASH services were upgraded. As proper hygiene practices remain a major component in the fight against many infectious diseases including COVID-19, IOM remains committed to ensure the most vulnerable have access to clean water to wash their hands, especially in areas of high mobility.
Data was collected in collaboration with IOM’s Displacement Tracking Matrix through the monitoring of movements in and out of certain key areas (known as “flow monitoring”) as well as information provided by the communities themselves (known as “participatory mapping exercises”). Over the past two years, 28 PMM exercises were carried out across the four countries.

Trainings and simulations for local responders 

To build the capacity of government workers and other local responders, IOM delivered a series of trainings in DRC and in neighbouring countries. For example, a mobile medical unit from the Congolese military deployed to strengthen surveillance at PoEs along the DRC-Uganda border received specialized training on health screenings.

Government staff trained to carry out health screenings at one of the border crossings between DRC’s populous city of Goma and Rwanda, La Petite Barrière.  Photo: Muse Mohammed / IOM

Others were trained on contact tracing and information management using tablets and a mobile application co-developed by IOM to enhance data collection and analysis, supply management and improve evidence-based decision-making. Overall, thousands of local responders and government workers, including hundreds of women, were trained by IOM in DRC, South Sudan, Burundi, Uganda and Rwanda.

Informing communities of the risks and engaging them in the response 

In a battle that could only be led and won by the Congolese people themselves and their neighbours, IOM helped ensure that women, men and children on the move were informed of the health risks and how to protect themselves and their loved ones. Information campaigns were carried out across the region through focus group discussions, posters, door-to-door engagement, radio programmes and more.

Travellers attend an IOM information session on how to avoid EVD transmission, at a point of entry in Yei, South Sudan. Photo:  Olivia Headon/IOM

The messaging included handwashing recommendations, information on how to reduce transmissions and health services, and the importance of respecting public health measures. In particular, a series of risk awareness dialogues were held with traders so they could carry on making a living, armed with the necessary knowledge on how to keep themselves and their loved ones safe.

Dialogues were also held with youth and community leaders in various locations, including some of the most vulnerable areas in North Kivu. Overall, hygiene promotion messages reached some five million people in DRC, South Sudan and Burundi.

In addition to these five key areas of work, IOM also supported governments by facilitating cross-border coordination, deploying health workers to support medical facilities and constructing incinerators. Critical supplies were also donated for the response, to ensure that frontline workers, community volunteers and health professionals, especially those working at PoEs and other transit/congregation locations, were adequately protected. As the country now faces COVID-19 and yet another -- the eleventh -- EVD outbreak in the north-west, IOM stands ready to support as needed.