Keren Habimana, a resident of a camp for internally displaced people in Congo's North Kivu province, was forced from her home by the ongoing conflict in the region.

Tensions flared in March 2022 when rebels from the M23 group, after a decade of relative calm, attacked Congolese army positions near the border between Uganda and Rwanda — causing locals to flee for their safety. 

The conflict has forced millions like her to seek refuge in makeshift camps, highlighting the dire humanitarian situation in eastern Congo.

But now, she has more to worry about beyond the conflict, as all four of her children have contracted mpox.

"When this disease invades your household, no one can escape it because it's highly contagious," Habimana told DW.

How does mpox spread?

A rash, fever, severe headaches, muscle aches and back pain are some of the main symptoms of mpox. 

The World Health Organization on Wednesday declared the spread of mpox a global public health emergency, the second time in two years it has categorized the virus as such.

Mpox is transmitted by direct contact with bodily fluids, skin lesions or respiratory droplets from infected people. It can also be spread by contact with infected animals, such as rodents and primates.

Mpox, which causes flu-like symptoms and pus-filled lesions on the skin, is usually mild. However, it can be fatal in rare cases.

A new version of the virus emerged in Congo this year, and has rapidly spread to neighboring countries including Rwanda, Burundi and the Central African Republic.

Cases are up 160% and deaths are up 19% compared with the same period last year.

The Africa Centres for Disease Control and Prevention (Africa CDC), the health authority of the African Union, was the first to declare the outbreak a public health emergency.

Following the WHO's declaration, efforts to accelerate research, funding and international public health measures are expected to intensify, fostering greater cooperation to contain the spread of mpox. 

"It's clear that a coordinated international response is essential to stop these outbreaks and save lives," WHO Director General Tedros Adhanom Ghebreyesus told a media briefing on Wednesday.

"This is something that should concern us all. The potential for further spread within Africa and beyond is very worrying."

Lack of vaccines for treatment

According to the Africa CDC, only about 200,000 mpox vaccines are available for treatment across the African continent — while over 10 million are needed.

This shortage leaves individuals like Keren Habimana struggling to secure enough doses for her children.

"We are told that medical treatment is free, but once we get to hospital, we are only given a really small dose of medicine to treat the disease," she told DW.

At least two dozen cases of mpox have been recorded at the health center Habimana visits near her camp, which also treats people who fled the war.

'Early intervention important'

There are hundreds of known cases across North Kivu, where the ongoing conflict has exacerbated the situation. Overcrowding in camps for internally displaced people facilitates the spread of mpox.

Additionally, limited access to clean water makes it challenging for residents to adhere to hygiene measures.

"A lot of people fall ill in this camp," said Jean-Pierre Kamala, who lives in a camp in North Kivu.

"Today we bought 20 liters of water for 1,000 Congolese francs, and then we have the choice between washing and preparing food. The second option is more crucial for our survival," he told DW.

Local health authorities are now focused on providing advice on how people can avoid contracting the disease.

"Observe hygiene measures and avoid all contact with anyone displaying any symptoms of mpox," Dr. Thierry Turano, a health officer in North Kivu, told DW.

"Early medical intervention is also really important. Any patient showing symptoms of the disease should seek medical attention as soon as possible to avoid becoming very ill."

Fears amid low public awareness

In Goma, the capital and largest city of North Kivu, tension is mounting as news of the mpox epidemic spreads.

The city now faces a new health threat, adding to the already fragile security situation caused by ongoing armed conflict.

While identified mpox cases are being treated in local health centers, many residents have complained about insufficient information regarding the disease.

A Goma resident expressed their concern over the mpox public health emergency, highlighting a lack of information on barrier measures and access to care — especially for displaced families in the region.

"I am already afraid, especially with the families who are here in Goma, the situation here in the east, there are many displaced people who don't know how to access care, we are not explained the barrier measures, there is no alert," they told DW.  

Other residents are calling for local health authorities to increase efforts in raising awareness and educating the public about mpox. 

"I would ask the authorities to stand up, to speak out, and to tell us what to do," another Goma local said. "A public health emergency really shows that the situation is serious."

Tresor Hamiri Hemedi, a doctor and public health expert in Congo, echoed concerns about the lack of awareness.

"Faced with such emergencies, what we can ask is to remain calm and keep our cool while knowing that the government is there to seek preventive measures," he said.

"There should be good awareness, good communication in the community so that preventive measures are rigorous within the population to avoid any spread."

Mpox isn't just on the rise in North Kivu. Over 1,000 suspected cases were reported in 22 other Congolese provinces within the first eight months of this year.

Edited by: Keith Walker

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