The current outbreak of the Ebola Virus Disease (EVD) in the Democratic Republic of the Congo (DRC) poses a high risk of introduction into neighboring countries including Rwanda. An Ebola outbreak in eastern Democratic Republic of Congo is likely spread over tens of kilometers.
Countries with land borders adjoining the DRC like Rwanda have been advised by the World Health Organization (WHO) to urgently strengthen their surveillance and alert systems for early detection of potential cases, and overall preparedness for timely and effective response.
As part of prevention, Rwanda has increased awareness and community engagement throughout the country using different communication channels like; television, Radio, billboards in public places such as main Roads, borders and Airports. Also interpersonal communication in Health Facilities, hotels, and in public gatherings is ongoing.
The Head of Division Epidemiology and surveillance Response Dr José Nyamusore says Ebola case management trainings for medical staff at health facilities, security organs, the Red-Cross volunteers, Community Health Workers are in place. Meanwhile Ebola screening is ongoing at all border posts to Rwanda including the high risk zones.
The Rwandan National EVD Preparedness and Response Plan, consolidated by the Government, the Ministry of Health, the national experts namely the Epidemic Surveillance and Response Division, National Referral Laboratory, Rwanda Health Communication Centre (Risk communication and Community Engagement), University Teaching Hospitals (Clinicians and IPC), Gisenyi District Hospital, the Directorate General of Immigration and Emigration) and various key Partners such as CDC Country Office and the Rwanda Red Cross. From WHO side, the WHO Regional Office for Africa (AFRO), the departments of Country Health Emergency Preparedness (CPI), Emergency Management (EMO) and the WHO Country Office for Rwanda are in acting in synchronized collaboration to scale up the efficiency of joint interventions.
A number of activities and field interventions are being undertaken including continual monitoring and assessment of high risks zones, namely Rusizi, Burera, Gicumbi Nyagatare Districts, the Rwandan capital Kigali (Gatsata District) and Rubavu (Rugerero District) where a functional Ebola Treatment Center has rapidly been implemented.
The support included capacity building and training via the deployment of a Rapid Response Team (RTT) Training. It was provided by AFRO's Health Emergency Programs (WHE), EVD experts from Sierra Leone, Kenya, Gambia and WHO Lyon. The training was attended by the Ministry of Health, Rwanda Health partners and WHO Country Office Risk Communication and Community Engagement Team. It's objectives was to evaluate knowledge, assess gaps and provide the needed capacity for National Risks Response. An operational RRT team was later deployed in the high risk zone of Rubavu for review and finalization of specific laboratory Standard Operation Procedures (SOPs). They provided technical support on the adaptation of SOPs in collaboration with the Ministry of Health.
In terms of Surveillance, laboratory and epidemiology, the inventory of essential laboratory materials for sample collection, transport and testing has been reviewed with the National Reference laboratory. Local suppliers were also contacted to assess the local availability of the material. Regarding Case Management and IPC, WHO current PPEs stored in Rugerero/Rubavu were declared adequate to be used for national preparedness and response. Finally support and strengthening surveillance activities at points of care, POEs, community levels and Laboratories have been undertaken and joint activities have been put in place by WCO and the MOH to scale up preparedness and response at community level.
The Emergency Operation Center (EOC) and the WCO Multi Sectoral Risk Communication and Community Engagement Task Team are operating from Kigali, in tight collaboration with an Incident Manager deployed from WHO Head Quarters, the EVD preparedness specialist and logistician who helped define EVD Preparedness Key Performance Indicators, notably in the sectors of multi sectoral partnerships, RRTs, surveillance for early detection, laboratory diagnostic capacity, case management including safe and dignified burial, risk communication, social mobilization and community engagement and an IPC specialist who conducted an assessment of RUBAVU Health Center, the Risizi and District and the Refugees center (Nyarushishi transit center). This assessment's output was tailored technical advice on Zoning (Red & Green Zones ) of patients and ambulance entry and exit, hand hygiene and foot baths points, human resources, medical and equipment supplies requirements.
For now the Rwandan two border districts with the DRC currently at risk are, namely Rubavu and Gisenyi as well as the urban district of Kicukiro where an international airport is located at. However, the country has the following existing safety locks: a robust coordination mechanism for disasters and other public health emergencies; a multi-hazard public health preparedness and response plan and an updated and budgeted national EVD preparedness and response plan.