The fight against mpox is in full swing at the Munigi Health Center in Nyiragongo territory, North Kivu province of the Democratic Republic of Congo (DRC). The urgency is palpable: Medical staff are working tirelessly inside tents to treat confirmed cases and halt the spread of the disease.

Since mid-June, Munigi Health Center in eastern DRC has received 281 suspected cases. The majority of these cases, 75%, are children under the age of 10. In total,  authorities have reported more than 500 cases of mpox in North Kivu alone.

Nyota Aziza is one of the many patients receiving treatment at Munigi. "I had a fever and a bad headache," she told DW. "My relatives told me it was smallpox. I was taken to the hospital here and the doctors take care of me every step of the way."

Nearly ten new patients each day 

Patients are treated at Nyiragongo General Hospital, where a site has been set up by the Medair organization, whose priority is to protect the most vulnerable. According to Medair nurse Tresor Basubi, the situation is worrying due to the new number of cases . 

"Every day, we receive nine patients with the same mpox symptoms," Basubi said, adding that patients are treated according to the national protocol. "For the moment, there is no specific treatment. The treatment we give is based on the symptoms the patient presents."

DR Congo hit hard

Ngashi Ngongo, chief of staff for the Africa Center for Disease Control and Prevention (Africa CDC) in Kinshasa, told DW, that NGOs and African governments are mobilizing their population to tackle the virus. "All the countries have either developed or updated their outbreak response plans, which is very positive." 

He said meetings between stakeholders and the government have been taking place, including with the minister of finance and the prime minister of the DRC. "That is a big change, a really big boost. This government is really waking up."

The mpox outbreak has hit the DRC the hardest. According to Africa CDC, the Central African nation has recorded at least 17,342 suspected cases and 3,167 laboratory-confirmed cases. The virus has claimed 582 lives.

"The reasons for the high infection of children are, on the one side, the intensity of the contacts. At the same time, the immunogenicity of children is still growing," Ngongo explained.

Nearly 40% of the children in the DRC are chronically malnourished. Ngongo said he was extremely concerned about the opening of schools, which could bring children back into close proximity, possibly increasing the infection rate drastically.

Following hygiene rules

Faced with a severe spread in camps for internally displaced people (IDPs), health agents in the DRC are spreading awareness about symptoms of the disease, where to go when a case is reported, and how to protect oneself.

Their main message is to respect hygiene rules. In eastern DRC, around 750,000 people are living in camps after fleeing conflict, and here, more than 100 children have been infected by mpox.

"We've raised people's awareness of mpox, explaining how to prevent it and why it's a very dangerous disease," Furaha Bineyo, a displaced person, told DW. "It's a disease that's transmitted by bodily contact, so you have to be very careful about hygiene rules, like washing your hands every time." 

According to Pierre Olivier Ngadjole, Medair DRC's health advisor, the response is underway and there is hope for an end to the disease, as the recovery rate, he says, is quite high. For him, "the good news is that with the communication we've already started in the camps, people are coming early and we have an estimated cure rate of over 90%, with no deaths to date."

No health checks at border control

In the last few days, Congo-Brazaville has recorded 21 cases of mpox, the country's health minister told state television on Sunday. Since the beginning of the year, the country has registered 158 suspected cases. Other countries in the region, such as Burundi, have confirmed 171 cases, Kenya two, and neighboring Uganda has reported four cases in total. Gabon has registered its first case of mpox.

Truck drivers continue to cross between the DRC and Rwanda with no health controls on the main roads, increasing the risk of spreading the virus. Doctor Hemedi Tresor fears that the DRC will be unable to contain the spread of the epidemic. "No sanitary facilities at our airports, at our borders. And we all know that it's from our borders that we'll reach cruising speed in contamination," Tresor told DW.

Truck drivers from countries such as Tanzania, Kenya and Uganda have not been informed of the presence of mpox in the DRC. "I assure you that no one has informed me so far, I come from Uganda, and I haven't seen anyone telling me to take precautions. It was just business as usual," Aman Lukondo, a Ugandan driver, told DW.

However, Samuel Roger Kamba, Congolese Minister of Public Health, is not worried. "There's no reason for us to start asking questions about planes or anything else, because last year there was a WHO alert at international level and there was no flight ban. So it's the same thing this year."

Mpox vaccines for Nigeria

The first 10,000 mpox vaccines are due to arrive this week in Africa. Made by Danish biotech company Bavarian Nordic, they were donated by the United States. However, they are not destined for the DRC, but for Nigeria. The delivery is a result of several years of talks between both governments, according to a source involved in the process who was not authorized to speak.

Nigeria has had 786 suspected cases this year, and no deaths. The US Agency for International Development (USAID) said it has also donated 50,000 doses to the DRC, but the arrival date is not yet finalized.

Multiple public health officials and scientists have criticized the slow arrival of the vaccines. The World Health Organization (WHO) took until August to officially start the process needed to give poor countries easy access to large quantities of vaccines via international agencies. This forced African governments and the Africa CDC to instead request vaccine donations from rich countries.

"The DRC has requested for three million doses of vaccines", Ngongo said. "All 12 countries don't have any vaccines. We need international partners to come to the rescue of these countries. One single dose costs European countries €200 ($223). Most African countries will find it challenging to afford the vaccines. The DRC cannot mobilize that money. That's about $300 million for three million people. Now the DRC has negotiated with the European Commission's Health Emergency Preparedness and Response Authority (HERA) to buy the vaccines for about €140 a dose. "

Ngongo is pushing for international solidarity. A lesson learned from the COVID-19 pandemic , however, is that such help from abroad can quickly vanish if donors feel they should keep the vaccine to protect their own.

Ruth Alonga in Goma, Jean Noel Ba-Mweze in Kinshasa and Tomi Oladipo contributed to this article.

Edited by: Chrispin Mwakideu