DRC, life under Ebola

A caregiver walking through the high-risk area of the Mambasa Ebola Treatment Centre. Mambasa Ebola Treatment Centre, Ituri, DRC, 8 November 2019. The Ebola Treatment Centre of Mambasa, managed by the NGO ALIMA, installed within the general hospital of Mambasa, can accommodate about thirty patients. A maze of sheet metal, wood and tarpaulins where all the patients are treated in the so-called high-risk zone, which is forbidden to enter without protective suits. The territory of Mambasa has been affected by the epidemic since July 2019. More than 60% of those infected are women and children. PHOTO © OLIVIER PAPEGNIES

It is obligatory to wash your hands with chlorinated water and to take your temperature every time you enter and leave the Ebola Treatment Centre. Mambasa Ebola Treatment Centre, Ituri, DRC, November 9, 2019. These biosecurity measures are essential to avoid any risk of infection and spread of the Ebola disease. PHOTO © OLIVIER PAPEGNIES

An exhausted caregiver rests at the entrance of the Ebola Treatment Centre in Katwa, North Kivu, DRC, November 13, 2019. PHOTO © OLIVIER PAPEGNIES

Kakule, 69, does not have Ebola and will be transferred to the general hospital in Katwa, North Kivu, DRC, November 13, 2019. After spending 72 hours at the Ebola Treatment Centre in Katwa, the result was clear: Kakule is not infected with the Ebola virus. He can therefore be safely transferred to Katwa General Hospital for further medical care. PHOTO © OLIVIER PAPEGNIES

A uniformed health worker takes shelter from the rain at the Kalunguta Transit Centre, North Kivu, DRC, November 13, 2019. The Kalunguta Transit Centre is being built in a remote, rural area. A territory controlled by several Mai Mai rebel groups. It was inaugurated in November 2019 with the aim of carrying out as quickly and efficiently as possible a first "triage" of patients suspected of being contaminated by Ebola before transferring them to the Ebola Treatment Centres. PHOTO © OLIVIER PAPEGNIES

A caregiver after taking a blood sample from a suspect patient, Kalunguta Transit Centre, North Kivu, DRC, November 13, 2019. The blood sample of 9-year-old Sagesse, who is suspected of being contaminated with the Ebola virus, is being tested. It is the cornerstone of the patient management process. It is this sample that will allow us to determine whether or not Sagesse is suffering from haemorrhagic fever. PHOTO © OLIVIER PAPEGNIES

Two guards look after the youngest patients at the Kalunguta Transit Centre, North Kivu, DRC, November 13, 2019. These two young women have been cured of the disease and are now working as wardens. They mainly take care of the young hospitalized patients and thus play the role of surrogate mothers to enable them not to suffer too much from their isolation. PHOTO © OLIVIER PAPEGNIES

Caregivers take a blood sample from 9-year-old Sagesse, who is suspected of having Ebola virus disease. Kalunguta Transit Centre, North Kivu, DRC, November 13, 2019. This blood sample will then be transferred to the central analysis laboratory to allow the testing of this young patient. PHOTO © OLIVIER PAPEGNIES

Sagesse, 9 years old, is taken care of at the Kalunguta Transit Centre, located about 40 kilometres north of Butembo, North Kivu, DRC, November 13, 2019. The young patient was admitted urgently because he is not vaccinated against the Ebola virus and has fever and pain. These symptoms make him a "suspect case". He will be screened and treated at the Transit Centre. PHOTO © OLIVIER PAPEGNIES

A hygienist is disinfecting with chlorinated water the ambulance that transported Sagesse. This 9-year-old boy is suspected of having Ebola virus disease. Kalunguta Transit Centre, located about 40 kilometres from Butembo, North Kivu, DRC, November 13, 2019. PHOTO © OLIVIER PAPEGNIES

A patient being treated at the Ebola Treatment Centre in Katwa, North Kivu, DRC, November 12, 2019. In the treatment centres, all patients are installed and treated in individual units. Each room has two openings to the outside which helps to reduce the patient's sense of isolation. PHOTO © OLIVIER PAPEGNIES

A child in the Mokoko 1 neighbourhood, Mambasa, DRC, November 10, 2019. In this neighbourhood, the Ebola virus has spread from one neighbouring house to another. Two mothers lost their lives. One was a farmer, the other a shopkeeper. PHOTO © OLIVIER PAPEGNIES

Esther, cured of Ebola and immune, works as a warden at the Ebola Treatment Centre in Mambasa, Ituri, DRC, November 11, 2019. From 7:30 am to 5:30 pm every day, she looks after patients - both infants and adults - in the high-risk area of the Treatment Centre. "If the doctor gives me medicine, I give them medicine, I give them food, I give them food," she explains. Many people who have been cured of the disease and immunized have become wardens at the treatment centres. For Esther, it's a way to help in turn, after being supported in her fight against the virus. PHOTO © OLIVIER PAPEGNIES

Dr. Junior, a doctor at the Ebola Treatment Center with a patient. Ebola Treatment Centre, Mambasa, Ituri, DRC, November 10, 2019. Before coming into contact with patients suspected of being infected with the Ebola virus, the doctor has previously donned a high security suit and will only be able to spend a limited amount of time with the patients, as the temperature can rise up to 45° inside his suit. Dr. Junior assures him: "We really need to know about the Ebola virus disease and control its management in order to save lives". PHOTO © OLIVIER PAPEGNIES

Dr Junior, doctor at the Ebola Treatment Centre in the so-called "high-risk area". Ebola Treatment Centre, Mambasa, Iturin DRC, November 10, 2019. All patients are treated in the so-called "high risk" zone. It is forbidden to enter this zone without protective clothing. The territory of Mambasa has been affected by the epidemic since July 2019. PHOTO © OLIVIER PAPEGNIES

Dr. Junior, a doctor at the Ebola Treatment Centre leaves the so-called "high-risk" area. Everything must be disinfected before leaving the area. Ebola Treatment Centre, Mambasa, Ituri, DRC, November 10, 2019. All patients are treated in the so-called "high risk" zone. It is forbidden to enter this zone without protective clothing. The territory of Mambasa has been affected by the epidemic since July 2019. PHOTO © OLIVIER PAPEGNIES

A hygienist dries protective clothing in the laundry room of the Ebola Treatment Centre in Mambasa, Ituri, DRC, November 11, 2019. In the Ebola treatment centres, hygienists are responsible for the biosecurity of the site to avoid any contamination of the health facilities. All the clothes are thoroughly washed and disinfected in the laundry of the treatment centre. Gloves are essential accessories for anyone working in the Ebola treatment centres. They protect the hygienists from any risk of infection. "Our goal is to protect the teams from the Ebola virus, we sacrifice ourselves, we fight to put an end to this epidemic," says Jerome, a 34-year-old hygienist at the Mambasa ETC.PHOTO © OLIVIER PAPEGNIES

A hygienist dries protective gloves in front of the laundry room at the Ebola Treatment Centre in Mambasa, Ituri, DRC, November 11, 2019. In the Ebola treatment centres, hygienists are responsible for the biosecurity of the site to avoid any contamination of these health facilities. All the clothes are thoroughly washed and disinfected in the laundry room of the treatment centre. Gloves are essential accessories for anyone working in the Ebola treatment centres. They protect the hygienists from any risk of infection. "Our goal is to protect the teams from the Ebola virus, we sacrifice ourselves, we fight to put an end to this epidemic," says Jérôme, a 34-year-old hygienist at the Mambasa ETC. PHOTO © OLIVIER PAPEGNIES

Students at the Mapendo Institute in Kasabinyole, Beni town, a neighbourhood regularly targeted by the ADF, one of the deadliest armed groups in eastern DRC. Half of the schoolchildren are no longer attending school because their families fled the violence and left the neighbourhood. On that day, they participate in an awareness raising session to dispel doubts and fears about the disease. Kasabinyole neighbourhood, Beni, North Kivu, DRC, November 12, 2019. PHOTO © OLIVIER PAPEGNIES

Alfred, a driver for the NGO Alima, plays basketball in his town, Beni, North Kivu, DRC, November 11, 2019. Alfred is in charge of safely transporting the staff and equipment of the NGO ALIMA. Originally from Beni, he had to deal with the outbreak of the haemorrhagic fever epidemic in this region on 1 August 2018. This city located in the East of the Democratic Republic of Congo is a "martyr city", caught between the Ebola epidemic and the massacres perpetrated by the ADF rebel militias. "Beni, as I knew it, was a city that welcomed everyone, but since the presence of the ADF everything has changed, the city has changed," Alfred laments. A very unstable security context has made it even more difficult to maintain the continuity of Ebola activities in this region. PHOTO © OLIVIER PAPEGNIES

Students at the Mapendo Institute in Kasabinyole, in the town of Beni, a neighbourhood regularly targeted by the ADF, one of the deadliest armed groups in eastern DRC. Half of the students are no longer attending school because their families have fled the violence and left the area. On that day, they participate in an awareness raising session to dispel doubts and fears about the disease. Beni, North Kivu, DRC, November 12, 2019. PHOTO © OLIVIER PAPEGNIES

A young patient in a single room, suspected of being infected with the Ebola virus, treated at the Ebola Treatment Centre in Mambasa, Ituri, DRC, November 10, 2019. More than 60% of those infected with the Ebola virus are women and children. PHOTO © OLIVIER PAPEGNIES

A grieving family: Mupila - 32 years old - and her 7 children lost their wife and mother brutally. Her name was Fatuma, she was a farmer. Mokoko 1 neighbourhood, Mambasa, Ituri, DRC, November 10, 2019. "Ebola brought me a lot of misfortune, Ebola took my wife away from me, it separated me from her," says Mupila, desperate. PHOTO © OLIVIER PAPEGNIES

Coffins are stored in an unoccupied room at the Mambasa General Reference Hospital. Mambasa, Ituri, DRC, November 11, 2019. Faced with the very rapid spread of the Ebola epidemic, Congolese health authorities have put in place special procedures to bury bodies when deaths occur outside medical facilities. These burials, described as "dignified and secure", aim to avoid any contact between the living and the body fluids of the deceased, potentially contaminated by the virus. PHOTO © OLIVIER PAPEGNIES

Kikopo in front of the grave of his wife Everine, who died of the Ebola virus. Mobombi Cemetery, Beni, North Kivu, DRC, November 12, 2019. Kikopo also contracted the virus, but survived. He comes as soon as he can with his five children to visit the grave of his beloved, which is hidden in the heart of the jungle. Most of the people buried in this cemetery are Ebola victims. It was built away from the city because at the beginning of the epidemic, "many inhabitants believed that the dead were still contagious," explains the neighbourhood chief. Moreover, Kikopo still didn't dare tell her children that their mother died because of Ebola. "It's too difficult, there are still a lot of people for whom Ebola is a taboo," he says. PHOTO © OLIVIER PAPEGNIES

The Mobombi cemetery, located on the outskirts of the city, is home to nearly 1,000 people who have lost their lives to the Ebola virus. DRC, North Kivu, Mobombi, November 12, 2019. PHOTO © OLIVIER PAPEGNIES

A man carrying an empty coffin to a community funeral. Mambasa General Referral Hospital, Ituri, DRC, November 10, 2019. Faced with the very rapid spread of the Ebola epidemic, the Congolese health authorities have put in place special procedures to bury the bodies of those who die outside medical facilities. Ancestral practices for burying bodies have had to be adapted to reduce the risk of contamination, despite resistance from part of the population. These burials, described as "dignified and safe", aim to avoid any contact between the living and the body fluids of the deceased, potentially contaminated by the virus. PHOTO © OLIVIER PAPEGNIES

A member of the Primitive Church, 150 faithful, Mambasa, Ituri, DRC, November 10, 2019. This faithful wants to know what are the symptoms of the Ebola virus. "Is it headaches, stomach aches, pains in the body" she mimed in front of Pastor André. Faced with these first signs that are not very "specific", the latter advises her to go to the hospital as soon as one of her relatives is ill, as a precaution. "It's only when they get there that the doctors will be able to make a diagnosis," he reassures her. PHOTO © OLIVIER PAPEGNIES

Pastor André sensitizes (in French and Swahili) his faithful to the fight against the Ebola epidemic during Sunday mass. Mambasa, Ituri, DRC, November 10, 2019. "Say Allelujah". The pews of the Primitive Church are full. In a country with nearly 12,000 evangelical churches, governmental and non-governmental actors in charge of fighting the Ebola epidemic can rely on pastors - true opinion leaders - to get their prevention messages across. PHOTO © OLIVIER PAPEGNIES

Pastor André clearing the land of his future small business in the Hewa Bora district, Mambasa, Ituri, DRC, November 9, 2019. Pastor André is one of the first inhabitants of the Hewa Bora district, located in the heart of the equatorial forest. "Before there was absolutely nothing here, just swamps, nobody could live here," he explains. As a community leader, Pastor André is raising awareness among his 150 followers about the fight against the Ebola epidemic. PHOTO © OLIVIER PAPEGNIES

Young residents washing their clothes in the basins of the Hewa Bora neighbourhood in Mambasa, Ituri, DRC, November 9, 2019. A neighbourhood that has come out of the ground in the heart of the equatorial forest that constitutes the territory of Mambasa. In this district, no inhabitant has been affected by the Ebola virus. Since the beginning of the epidemic in August 2018, 2239 people have died out of the 3416 cases of contamination recorded in the east of the Democratic Republic of Congo. PHOTO © OLIVIER PAPEGNIES

The United Nations Mi8 helicopter crosses the territory of North Kivu to supply the population with humanitarian aid/medicines. During the stopovers, the health authorities are present to disinfect the hands and take the temperature of each person. DRC, between Beni and Mambasa, November 8, 2019 . The territory of Mambasa is located in the middle of the equatorial jungle in the north-east of Congo and is the second largest tropical forest in the world. Difficult to access, the helicopter, when weather conditions permit, remains the preferred means of transport. PHOTO © OLIVIER PAPEGNIES

At the ETC (Ebola Treatment Centre) in Béni, families are waiting for the results of blood tests. Each one hopes that the result will be negative. DRC, North Kivu, Béni, November 7, 2019. ALIMA was in charge of the Ebola treatment centre for 13 months before handing over to MSF. During this period, the ALIMA teams were committed and invested in treating and curing as many patients as possible, but also in promoting its activities in the communities of Beni, which have been particularly affected in recent years by numerous acts of violence. PHOTO © OLIVIER PAPEGNIES

A newborn baby, 4 days old, is being cared for in a serious condition at the Ebola Treatment Centre in Beni. He has a fever and is considered a "suspect case" by the medical teams. He will die the next day from suspected sepsis // Beni Ebola Treatment Centre, North Kivu, DRC, November 7, 2019. More than 300 patients out of the 600 confirmed cases have been cured in this treatment centre since the beginning of the epidemic. "In the ETCs there are moments of tears and moments of joy, when some patients get cured," explains Josée, head of nursing care for the ALIMA association. PHOTO © OLIVIER PAPEGNIES

A woman talks to her husband, suspected of having contracted the Ebola virus, through a window at the Ebola Treatment Centre in Mambasa. Mambasa Ebola Treatment Centre, Ituri, DRC, November 8, 2019. The Mambasa Ebola Treatment Centre, managed by the NGO ALIMA, located within the Mambasa General Hospital, can accommodate about 30 patients. A maze of sheet metal, wood and tarpaulins where all the patients are treated in the so-called high-risk zone, which is forbidden to access without a protective suit. The territory of Mambasa has been affected by the epidemic since July 2019. More than 60% of those infected are women and children. PHOTO © OLIVIER PAPEGNIES

Each outfit is cleaned in the laundry room located inside the Ebola Treatment Centre. It is often young people or family members who are victims of the disease who work there. "When you enter the high-risk area, you are not really afraid, you protect yourself well. It's our friends who are inside. For us, it's a question of sacrificing ourselves to put an end to this epidemic, without sacrifice we won't be able to put an end to it"? Jérome, a 34-year-old hygienist. Mambasa Ebola Treatment Centre, Ituri, DRC, November 8, 2019. The Ebola Treatment Centre of Mambasa, managed by the NGO ALIMA, installed within the general hospital of Mambasa, can receive about thirty patients. A maze of sheet metal, wood and tarpaulins where all the patients are treated in the so-called high-risk zone, which is forbidden to access without a protective suit. The territory of Mambasa has been affected by the epidemic since July 2019. More than 60% of those infected are women and children. PHOTO © OLIVIER PAPEGNIES

Waste incineration area, the "incinerator operator" of the Mambasa Ebola Treatment Centre is preparing to incinerate all the waste contained in the so-called "high risk" area. Food, bottles, blankets... When an Ebola patient dies, it is mandatory to burn everything in his hospital room to avoid any risk of spreading the disease. DRC, Ituri, Mambasa, November 8,2019. The Ebola Treatment Centre of Mambasa, managed by the NGO ALIMA, installed within the general hospital of Mambasa can accommodate about thirty patients. A maze of sheet metal, wood and tarpaulins where all the patients are treated in the so-called high-risk area, which is forbidden to enter without a protective suit. The territory of Mambasa has been affected by the epidemic since July 2019. More than 60% of those infected are women and children.PHOTO © OLIVIER PAPEGNIES

Esther is waiting for the test results of her son Joseph, 5 months old, on the forecourt of the analysis laboratory of the general reference hospital of Mambasa. Mambasa, Ituri, DRC, November 9, 2019. "Don't let him get Ebola," whispers the young mother. She herself is cured of the disease and does not want to take any risks. That's why, at the first symptoms, she hurried to take her baby to the hospital to be tested. PHOTO © OLIVIER PAPEGNIES

Esther, cured of the Ebola virus, at the entrance to her house, Mambasa, Ituri, DRC, November 9, 2019. "I am an Ebola winner," Esther proudly says. This young mother was cured at the Ebola Treatment Centre in Mambasa. Esther was infected with the virus through her mother, who died. As soon as she came back from hospital, Esther wanted to testify and reassure her neighbours: "Before, people thought that Ebola was a disease that had been invented, but today, I testify, Ebola is a disease that kills and kills quickly, Ebola exists! Since the beginning of the epidemic on August 1, 2018, this distrust of part of the population has hindered the work of volunteers in charge of the fight against Ebola. PHOTO © OLIVIER PAPEGNIES

Choir rehearsal, Hewa Bora neighbourhood (which means "where the air is good" in Swahili), Mambasa, Ituri, DRC, November 9, 2019. On the earthy floor of the Hewa Bora church, to the rhythm of a metal drum, a group of young people rehearse for the choir for Sunday mass. In this neighbourhood, none of the inhabitants have been contaminated by haemorrhagic fever. PHOTO © OLIVIER PAPEGNIES

The Hewa Bora district is a district of Mambasa, spared by the haemorrhagic fever epidemic. Mambasa, Ituri, DRC, November 9, 2019. PHOTO © OLIVIER PAPEGNIES

View from the sky, UN helicopter flight over the equatorial forest to reach the city of Mambasa, Ituri, DRC, November 11, 2019. The territory of Mambasa is covered by dense forest that is part of the second largest tropical forest in the world. When weather conditions permit, the helicopter remains the preferred means of transport for Ebola response teams operating in these hard-to-reach areas. PHOTO © OLIVIER PAPEGNIES

The wedding guests of Irene, medical student and Alex, business man on the dance floor of the New Fantom Bar. Versailles Hotel, Butembo, North Kivu, DRC, November 13, 2019. While health checks are daily and preventive measures against the spread of the disease are recurrent, life in its most intimate aspects is taking over. PHOTO © OLIVIER PAPEGNIES

A group of women burn meat on the heights of the Biassa market, a few kilometers from the town of Butembo, the economic lung of eastern DRC. Butembo, North Kivu, DRC. November 13, 2019. On the road linking Beni to Butembo, which is heavily used for trade between the two cities, several checkpoints have been set up to avoid any risk of spreading Ebola. At each checkpoint, travellers must wash their hands with chlorinated water and their temperature is taken. Loudspeakers play a looping message: "Let's fight together against the Ebola virus disease". PHOTO © OLIVIER PAPEGNIES

In an attempt to limit the spread of the virus between Butembo and Beni, checkpoints have been installed. Each person must stop to have their temperature controlled. At these checkpoints, hand washing with a 0.05% chlorine solution is also mandatory. DRC, North Kivu, between Kalunguta and Butembo, November 13, 2019. PHOTO © OLIVIER PAPEGNIES

Pineapple and fruit stall on the road leading from Beni to Butembo, two towns in eastern DRC, epicenters of the Ebola epidemic. North Kivu, DRC, November 13, 2019. In this region, the majority of the population survives on agriculture, particularly through the production of bananas and pineapples sold locally in Butembo or Beni. Located 50 kilometers south of Beni, there are many exchanges and population movements between the two towns despite the poor state of the roads, which also encourages the circulation of the virus. PHOTO © OLIVIER PAPEGNIES

Aerial view of the road from Butembo to Béni, North Kivu, DRC, November 12, 2019. PHOTO © OLIVIER PAPEGNIES

A nurse brings a baby to the crèche set up near the Ebola Treatment Centre in Katwa, North Kivu, DRC, November 12, 2019. All children with no symptoms of the disease at the time of admission to the ETC but whose mothers are ill are temporarily separated from them and placed under surveillance at this crèche located near the ETC to reduce the risk of spreading the disease within the community. PHOTO © OLIVIER PAPEGNIES