Crisis Severity The severity score from 1 to 5 is based on 31 indicators aggregated into 3 pillars (impact, conditions, and complexity)4.20 Very lowVery high 5
Impact This measures the impact of the crisis itself, in terms of the scope of its geographical, and human effects.4.60 Very lowVery high 5
Humanitarian Conditions This measures the conditions and status of the people affected, including info about the distribution of severity.4.00 Very lowVery high 5
Complexity This measures the complexity of the crisis, in terms of factors that affect its mitigation or resolution.4.30 Very lowVery high 5
Access Constraints This measures the level of humanitarian constraints.4.0No constraintsExtreme constraints
DRC: Displacement in Ituri
DRC: Displacement in Sud Kivu
A complex emergency has persisted in DRC for more than 20 years. Over 99% of displacement, which is frequent and repeated, is due to armed clashes and intercommunal violence between foreign, self-defence, and other armed groups. 4.49 million IDPs are registered and 800,000 refugees are hosted in neighbouring countries. DRC also hosts approximately 533,000 refugees.?
An Ebola virus outbreak began in Ituri and Nord-Kivu provinces on 1 August 2018, transmission rates have been increasing since late March. Conflict in Nord-Kivu make the response to extremely challenging, and activities are regularly suspended.?
By mid-December 2018, almost 670,000 Congolese nationals returned from Angola to Kasai and areas close to the border after the Angolan government forced all those without documentation to leave. Most returnees are staying with host communities while some are sleeping out in the open or in churches. They are in need of healthcare, food, drinkable water, WASH, and also face protection concerns as the security situation in Kasai is volatile.?
The Commission électorale nationale indépendante announced the provisional results, with Félix Tshisekedi declared the new president, after elections took place on 30 December in a tense climate with reports of widespread irregularities, voter suppression, and violence. ?
INFORM measures DRC's risk of humanitarian crisis and disaster to be very high, at 7.6/10. Lack of coping capacity is of particular concern, at 8/10 as well as vulnerability at 7.6/10. ?
19/08: The Ebola outbreak has reached Sud Kivu province as at least three Ebola cases, including two deaths, have been reported from Mwenga health zone, southwest of the province’s capital Bukavu. The first two cases, a mother and her child had travelled from Nord Kivu province, where they were likely exposed to the disease and considered a high-risk contact. As of 18 August, 2,888 cases (2,794 confirmed and 94 probable cases) including 1,934 deaths (CFR 67%) have been reported from 28 health zones in the three provinces currently affected.?
02/08: The third Ebola case was confirmed in the major border city of Goma on 1 August. The new case is the daughter of the Ebola patient who died in Goma on 31 July, after having travelled from Bunia, in Ituri province and had spent several days with his family while exhibiting the symptoms. It is the first transmission inside Goma, and the hard task of tracing and monitoring people who were in contact with the victim have begun. The spread in this densily populated location, could make it even harder to contain the disease. On the same day, Rwanda temporarily closed the border which was later reopened. ?
18/07: On 14 July, the first Ebola case was detected in Goma, the economic hub of Nord Kivu and home to close to 2 million people located on the shores of Lake Kivu at the Rwandan border. After cross-border transmissions to Uganda on 11 June, the spread to this high-risk location was regarded as a major threshold, making it harder to contain the disease. On 17 July, WHO declared the current outbreak a “Public Health Emergency of International Concern” (PHEIC). Although not currently planned, the declaration could lead to restrictions on trade and travel, which could further fuel backlash against the response and have notable effects for the population on both sides of the borders. Trade, labour and family ties see tens of thousands of people crossing the borders between DRC, Uganda and Rwanda every day. As of 17 July, 2,522 confirmed and suspected cases and 1,698 related deaths (CFR 67%) have been recorded.?
VERY HIGH CONSTRAINTS
Humanitarian access has continued to be restricted, and subject to local conflict dynamics. Most security incidents were reported from Nord and Sud Kivu, Ituri, Tanganyika and Haut-Uele provinces. Besides armed conflict and insecurity, remoteness and poor infrastructure are major obstacles for humanitarians. Whereas access to Maniema and Kasai provinces has improved due to surrender of armed groups since the elections in December, violence and violent clashes between FARDC and armed militia in Fizi and Shabunda territory, Sud Kivu, and Beni and Masisi territory, Nord Kivu, diminished access to affected populations. Attacks on humanitarian staff and facilities, including kidnapping and looting, continue in various provinces and force humanitarian actors to suspend activities. Attacks against Ebola treatment centres have increased since December as community mistrust against aid workers persists.
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On 2 June 2019, the Ebola outbreak in northeast DRC surpassed 2,000 cases including nearly 1,400 deaths.? The rapid increase in case numbers since late March has been linked to widespread insecurity resulting from some 120 active armed groups in the area and violence against response workers by armed groups and villagers, that lead to temporary suspension of response activities. Community distrust due to misinformation, scepticism against the government, and a reluctance to seek treatment and adhere to preventative measures is widening gaps in Ebola treatment and tracking; it is estimated that only 75% of cases are detected.? High population mobility and frequent internal and cross-border conflict displacement aggravate the situation and increase the risk of Ebola spreading to neighbouring provinces and countries, including Rwanda, South Sudan and Tanzania. ? On 11 June, an Ebola outbreak was declared in Uganda as several people infected with the virus returned from DRC to Uganda via informal crossings to avoid health checkpoints. ? The spread to more densely populated, economic centres is particularly concerning and will make it harder to contain the outbreak. Nord Kivu’s capital Goma is a high-risk location, given its proximity to the border with Rwanda, frequent movement of goods and people, and limited preparedness. Despite response adjustments including communication campaigns that target community mistrust, an extension of the vaccination campaign, and the activation of the “Humanitarian System-wide Scale-Up” in late May, the risk of Ebola spreading remains high, with a high probability of the disease reaching Goma and then becoming even more challenging to contain. ?
This geographical spread will make it harder to gain control of the outbreak and increase the loss of human life. The case fatality rate has risen in recent months, from 61% in early January to 67% in mid-June. ? The first EVD cases in Uganda and the threat of Ebola reaching Goma near the Rwandan border mean that the declaration of a “Public Health Emergency of International Concern (PHEIC)” is likely. This would place restrictions on trade and travel.
Trade, employment and family ties see several tens of thousands of people cross the DRC-Rwanda-Uganda borders every day. Restrictions on movement will likely impact livelihoods, food security, and nutrition. Disruptions are likely to increase reluctance towards response efforts and increase informal crossings where no screening is in place, thus further impeding humanitarian operations.? Although preparedness and response capacity was previously estimated to be good in some neighbouring countries, several factors could aggravate the situation: including other disease outbreaks that display similar symptoms such as cholera; the ongoing rainy season hindering access in Uganda and South Sudan; and the volatile security situation in South Sudan. As in the ACAPS’ Global risk analysis published in December 2018, IDP and refugee populations are anticipated to be at a higher risk due to congested displacement sites and limited access to adequate WASH facilities.
This risk was identified in the June Quarterly Risk Report.
Food security: 13.1 million people are in IPC Phase 3 (Crisis) and IPC Phase 4 (Emergency), mainly in the conflict-affected eastern part of the county and Greater Kasai region, where a severe cholera outbreak and recent influx of returnees from Angola further aggravate the situation.? Conflict and insecurity, which limit access to livelihoods and disrupt farming activities, are key drivers of food insecurity, especially in the east and in the Greater Kasai region.?
Protection: Sexual gender-based violence (SGBV) by armed groups and government forces is often reported in conflict-affected areas: in 2017 over 13,000 cases of SGBV were reported across the country.?
WASH 13.1 million people are in need of WASH support.? 50% of households in DRC do not have access to drinking water, and poor sanitation and hygiene services are among disease predisposing factors. Damage to WASH infrastructure in conflict as well as long-term displacement and a high concentration of IDPs has placed pressure on water resources.?