Cases in the eastern province of South Kivu are spreading over twice as fast in children as in the general population, according to new analysis, [1][2] as health workers race to curb the spread of the virus as the new school term starts this week.
With delivery of vaccines to DRC and neighbouring countries delayed, it is critical that the international community steps up funding so that schools can ensure they have adequate clean water, hygiene and sanitation measures for children in the next few weeks. Many schools have no running water, disinfectant or soap – basic measures to prevent the spread of disease that be contracted from contaminated surfaces and objects, Save the Children said.
Save the Children analysis of Ministry of Health data for South Kivu showed that there were 15 cases of mpox recorded in the first four weeks of the year, compared to 1,192 cases in the four weeks between 22 July and 18 August among children and young people.[3]
The latest mpox variant, clade 1b, was detected in DRC in September 2023 and has recently been found in neighbouring countries and other parts of the world. The World Health Organization (WHO) declared the spread of the virus to be a public health emergency of international concern three weeks ago.
To date about 90% of reported cases of mpox are in the DRC where it has infected at least 18,000 people and led to 615 deaths, according to the WHO. South Kivu is the epicentre, with almost half (46%) of the country's new cases in the past four weeks (up to 18 August) in the province, the highest of any one province in the country. Of this, two thirds of cases have been in children.
Julien Chabo Byake, Social Behavioural Change Communication Officer with Save the Children in South Kivu, is currently training communities to try to stop the spread of mpox through simple measures such as avoiding handshakes and other close contact with others. He is also working with health authorities on tackling misinformation and guiding communities about how to seek proper medical treatment.
Health workers are having to fight socio-cultural stigma around the virus due to a widespread belief that it is spread through sexual contact and people reluctant to seek treatment for fear of isolation from their families and livelihoods. Some people have opted instead for seek help from traditional medicine practitioners or self-medication which could be fatal.
Recalling a boy of 4 or 5 years old with mpox he met at the hospital, Byake said:
"We saw lesions and rashes covering his body. The child was crying frequently and only wanted to be held by his mother. He had a fever and appeared very exhausted. His mother told us he hadn't been eating, despite being offered his favourite foods, and was losing weight. His eyes were slightly red."
"She was deeply worried and initially thought the illness was due to witchcraft or some form of harm from others [...] There is a lot of misinformation in the community: some people believe this illness doesn't exist, others claim it originated in European labs to reduce the African population, while some think it's witchcraft or a god's punishment for sinners."
He added that there is also a part of the community that does recognise mpox as a disease, like Ebola and cholera that have also hugely impacted the country.
Greg Ramm, Save the Children Country Director in DRC, said:
"This country has borne the brunt of health crises before – from Ebola to cholera to measles. Enough is enough – this deadly new mpox strain should be the ultimate call for the world to commit to investing in disease control and prevention so that children and families do not suffer needlessly."
"It's high time children in the DRC stopped being another forgotten crisis. The world must also invest in longterm solutions, such as equitable access to vaccines and increased testing capacities."
Save the Children is calling for a substantial injection of funding to implement clean water, hygiene and sanitation facilities in schools and communities, so that children can play and learn safely. The organisation is also calling for support to increase awareness raising activities in schools and in the wider community. This would also help stave off other diseases rife in DRC, such as measles, which killed nearly 6,000 people last year according to MSF. [4]
In DRC, Save the Children is responding to the mpox outbreak in North Kivu and South Kivu through water, sanitation and health services support, including providing PPE and training leaders in engagement, communication, and community alert systems for identifying and reporting suspected cases. The outbreak is exacerbating an already dire humanitarian crisis, with over 7 million people displaced, primarily due to conflict and a weakened health system.
