A. Situation analysis
Description of the disaster
In January 2016, a yellow fever outbreak was detected and confirmed in Angola, Southern Africa. Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes.
There are an estimated 130,000 cases of yellow fever reported yearly, causing 44,000 deaths worldwide each year, with 90 percent occurring in Africa.1 Following cross-border population movement from Angola into neighbouring countries, exported cases were later reported in the Democratic Republic of Congo (DRC). On 23 March 2016, the DRC Ministry of Health (MoH) declared an official yellow fever outbreak, with a total of 39 imported cases from Angola reported in Kongo Central and Kinshasa provinces. According to the World Health Organization (WHO), some autochthonous transmission cases have been also reported in Ndjili, Kinshasa and in Matadi, Kongo Central province. As of 11 May 2016, a total of 44 yellow fever cases were confirmed with 551 suspected cases reported including 167 in Kongo Central and 133 in Kinshasa.
Given the risk of spread to other areas of the DRC as well as to other neighbouring African countries, the MoH of DRC with the support of the international community decided to undertake an emergency vaccination campaign targeting 1.9m people in the most at-risk regions. Vaccination is the most important preventive measure against yellow fever.
Since 20 May 2016, the IFRC allocated a total of CHF 177,927 from its Disaster Relief Emergency Fund (DREF) to contribute to the response to the yellow fever epidemic in the DRC. This DREF allocation was to support the DRC RC and the Ministry of health conduct social mobilization during the vaccination campaign against yellow fever, from 26 May to 4 June in two (2) health zones in the province of Kinshasa and nine (9) health zones of the province of Kongo Central.
Major donors and partners of the current DREF include the Belgian Red Cross / Govt., Canadian Red Cross / Govt., and Netherlands Red Cross/Silent Emergencies Fund and other corporate and private donors. This DREF has been replenished by the Netherlands RC/SEF, the Belgian RC/Government and the Canadian RC/ Government DFATD. The IFRC on behalf on the RDC Red Cross society would like to express its gratitude to all for their generous contributions.
Summary of the current response
Overview of Host National Society
The Red Cross of the Democratic Republic of Congo (DRC RC) is a neutral humanitarian organization, auxiliary to the public authorities. At the national HQ, there is an operational management structure including six technical departments and professionals trained as part of the National Disaster Response Team (NDRT). The DRC RC has provincial disaster response intervention teams (PDRT) with 110 members, a national disaster response intervention teams (NDRT) with 30 members, and 10 staff members that are regional disaster response team (RDRT) trained. Moreover, the DRC RC has a pool of approx. 120,000 registered volunteers (one of the largest voluntary networks in the world), of which 60,000 are active.
Activities of the current DREF include community surveillance and vector control by hygiene and sanitation. As such, some 550 volunteers, 55 supervisors, 11 heads of health zones have been deployed in the field with the necessary equipment. This team was supported by the NS through its director for health, finance and communication officers, as well as the IFRC's Yaoundé CCST health coordinator and finance team. The vaccination campaign was carried out successfully with a vaccination coverage of 107 per cent, compared to a target of 95 percent. This high vaccination rate is justified by the fact that the vaccination campaign was not carried out in all affected health districts, and as such, populations of neighbouring health districts came to the areas where the campaigns were being held to benefit from vaccination.
As of this operation update, volunteers have visited 404,723 households in which 1,039,510 people including 601,545 men and 437,965 women, were reached with messages on yellow fever. Some 877,137 children from 9 months to 14 years were also reached. Some 1,916,647 people were directly reached by the DRC RC volunteers during the vaccination campaign against yellow fever which took place from 26 May to 4 June 2016 in 11 health zones of the Kinshasa and Kongo Central provinces, representing a coverage rate of 96.91% for social mobilization.
In addition, 1,455 cases of refusal were noted, amongst whom 1,379 were managed while 684 cases of AEFI were identified and taken in charge by Médecins Sans Frontières (MSF). Some 59 cases of vaccine preventable diseases were also identified. DRC RC volunteers participated in 97 coordination meetings and conducted 94 evaluation missions with other actors.
Please, note that despite the activities carried out through the DREF operation, the epidemic is continuing to spread rapidly within other provinces. This is the consequence of the high mobility of the people, refusal to be vaccinated and the persistence of bad behavioural habits. Also on 22 June 2016, at the Coordination meeting with the others actors, the results presented revealed one new province where cases of yellow fever have been detected. It is the province of Kwango (Kahemba: 7 confirmed cases including 2 indigenous; Kajiji: 1 confirmed case and Kisandji: 1 confirmed case). In total, 9 new cases detected June 22, 2016 after vaccination organized by the Government and partners in the 11 localities.
Overview of Red Cross Red Crescent Movement in country
The IFRC Cluster Country Support team (CCST) Yaoundé has supported the DRC RC with the coordination of all activities within the DREF operation, including the approval of all planning, implementation, monitoring and reporting, as well as participating in monitoring/evaluation missions in the localities.
Partner National Societies (PNS) include the Belgian Red Cross, Canadian Red Cross, Spanish Red Cross and Swedish Red Cross societies. In addition, the International Committee of the Red Cross (ICRC) also has extensive presence in DRC.
Coordination and Partnerships
A yellow fever coordination and support cell [CCPEC] made up of the Ministry of Health, WHO, UNICEF, MSF France, MSF Belgium, IFRC, and the DRC RC was setup and meets on Mondays, Wednesdays and Fridays at 10:00 under the lead of epidemiologists from the Ministry of Health.
MSF Belgium participates in the management of patients in the Sino-Congolese hospital of Kinshasa and also in the fumigation of sites around contaminated or deceased patients. MSF has made an ambulance available to the MoH for the transfer of cases that fit the case definition. MSF France, on its part provides health care to patients and carries out fumigation in sites around contaminated or deceased patients that match the case definition in Kwango.
Needs analysis, beneficiary selection, risk assessment and scenario planning
Please refer to the original EPoA, which provides an overview of the needs analysis, beneficiary selection, risk assessment and scenario planning for this DREF operation.