Congo’s humanitarian crisis helped mpox spiral again into a global health emergency

Patients listen to a doctor outside the consultation room of the Mpox treatment centre at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. (AFP)
Patients listen to a doctor outside the consultation room of the Mpox treatment centre at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. (AFP)
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Updated 18 August 2024
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Congo’s humanitarian crisis helped mpox spiral again into a global health emergency

Congo’s humanitarian crisis helped mpox spiral again into a global health emergency
  • Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis

GOMA, Congo: Sarah Bagheni had a headache, fever, and itchy and unusual skin lesions for days, but she had no inkling that her symptoms might have been caused by mpox and that she might be another case in a growing global health emergency.
She also has no idea where to go to get medical help.
She and her husband live in the Bulengo displacement camp in eastern Congo, a region that is effectively ground zero for a series of mpox outbreaks in Africa.
This year’s alarming rise in cases, including a new form of the virus identified by scientists in eastern Congo, led the World Health Organization to declare it a global health emergency on Wednesday. It said the new variant could spread beyond the five African countries where it had already been detected — a timely warning that came a day before Sweden reported its first case of the new strain.
In the vast central African nation of Congo, which has had more than 96 percent of the world’s roughly 17,000 recorded cases of mpox this year — and some 500 deaths from the disease — many of the most vulnerable seem unaware of its existence or the threat that it poses.
“We know nothing about this,” Bagheni’s husband, Habumuremyiza Hire, said Thursday about mpox. “I watch her condition helplessly because I don’t know what to do. We continue to share the same room.”
Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis. Hundreds of thousands of people like Bagheni and her husband have been forced into overcrowded refugee camps around Goma, while more have taken refuge in the city.
Conditions in the camps are dire and medical facilities are almost nonexistent.
Mahoro Faustin, who runs the Bulengo camp, said that about three months ago, administrators first started noticing people in the camp exhibiting fever, body aches and chills — symptoms that could signal malaria, measles or mpox.
There is no way of knowing how many mpox cases there might be in Bulengo because of a lack of testing, he said. There haven’t been any recent health campaigns to educate the tens of thousands of people in the camp about mpox, and Faustin said he’s worried about how many people might be undiagnosed.
“Just look at the overcrowding here,” he said, pointing to a sea of ramshackle tents. “If nothing is done, we will all be infected here, or maybe we are already all infected.”
Around 70 percent of the new mpox cases in the Goma area in the last two months that were registered at a treatment center run by Medair were from displacement camps, said Dr. Pierre Olivier Ngadjole, the international aid group’s health adviser in Congo. The youngest of those cases was a month-old baby and the oldest a 90-year-old, he said.
In severe cases of mpox, people can develop lesions on the face, hands, arms, chest and genitals. While the disease originated in animals, the virus has in recent years been spreading between people via close physical contact, including sex.
Bagheni’s best hope of getting a diagnosis for her lesions is a government hospital that’s a two-hour drive away. That’s likely out of the question, given that she already struggles with mobility having previously had both her legs amputated.
Seven million people are internally displaced in Congo, with more than 5.5 million of them in the country’s east, according the UN refugee agency. Congo has the largest displacement camp population in Africa, and one of the largest in the world.
The humanitarian crisis in eastern Congo has almost every possible complication when it comes to stopping an mpox outbreak, said Dr. Chris Beyrer, director of Duke University’s Global Health Institute.
That includes war, illicit mining industries that attract sex workers, transient populations near border regions, and entrenched poverty. He also said the global community missed multiple warning signs.
“We’re paying attention to it now, but mpox has been spreading since 2017 in Congo and Nigeria,” Beyrer said, adding that experts have long been calling for vaccines to be shared with Africa, but to little effect. He said the WHO’s emergency declaration was “late in coming,” with more than a dozen countries already affected.
Beyrer said that unlike COVID-19 or HIV, there’s a good vaccine and good treatments and diagnostics for mpox, but “the access issues are worse than ever” in places like eastern Congo.
In 2022, there were outbreaks in more than 70 countries around the world, including the United States, which led the WHO to also declare an emergency that lasted until mid-2023. It was largely shut down in wealthy countries within months through the use of vaccines and treatments, but few doses have been made available in Africa.
The new and possibly more infectious strain of mpox was first detected this year in a mining town in eastern Congo, about 450 kilometers (280 miles) south of Goma. It’s unclear how much the new strain is to blame, but Congo is now enduring its worst outbreak yet and at least 13 African countries have recorded cases, four of them for the first time.
The outbreaks in those four countries — Burundi, Kenya, Rwanda and Uganda — have been linked to Congo’s, and Doctors Without Borders said Friday that Congo’s surge “threatens a major spread of the disease” to other countries.
Salim Abdool Karim, an infectious disease expert who chairs the Africa Centers for Disease Control and Prevention’s emergency committee, said the Congo outbreak has a particularly concerning change, in that it’s disproportionately affecting young people. Children under 15 account for 70 percent of cases and 85 percent of all deaths in the country, the Africa CDC reported.
Unlike the 2022 global outbreak, which predominantly affected gay and bisexual men, mpox now appears to be spreading in heterosexual populations.
All of Congo’s 26 provinces have recorded mpox cases, according to the state-run news agency. But Health Minister Samuel-Roger Kamba said Thursday that the country doesn’t have a single vaccine dose yet and he pleaded for “vigilance in all directions from all Congolese.”
Dr. Rachel Maguru, who heads the multi-epidemic center at Goma’s North Kivu provincial hospital, said they also don’t have drugs or any established treatments for mpox and are relying on other experts such as dermatologists to help where they can. A larger outbreak around the city and its numerous displacement camps already overburdened with an influx of people would be “terrible,” she said.
She also noted a pivotal problem: poor and displaced people have other priorities, like earning enough money to eat and survive. Aid agencies and stretched local authorities are already wrestling with providing food, shelter and basic health care to the millions displaced, while also dealing with outbreaks of other diseases like cholera.
 

 


Joint sea drills with Russia signal start of Indonesian foreign policy shift

Joint sea drills with Russia signal start of Indonesian foreign policy shift
Updated 11 sec ago
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Joint sea drills with Russia signal start of Indonesian foreign policy shift

Joint sea drills with Russia signal start of Indonesian foreign policy shift
  • Indonesia's new president, Prabowo Subianto, has called for stronger ties with Moscow despite Western pressure on Jakarta
  • Prabowo has visited more than a dozen countries including China and Australia, where he struck a key security deal
  • Jakarta has also kickstarted a process to join the BRICS group of emerging economies

JAKARTA: Indonesia’s first joint military drills with Russia this week signal that new President Prabowo Subianto will seek a bigger role for Jakarta on the world stage as part of a significant foreign policy shift, analysts say.
Indonesia has long maintained a neutral foreign policy and refuses to take sides in the Russia-Ukraine conflict or US-China rivalry, but Prabowo has called for stronger ties with Moscow despite Western pressure on Jakarta.
“It is part of a broader agenda to elevate ties with whomever it may be, regardless of their geopolitical bloc, as long as there is a benefit for Indonesia,” said Pieter Pandie, researcher at the Center for Strategic and International Studies.
The southeast Asian ASEAN bloc, which Indonesia is a member of, held joint drills with Russia in 2021, but individual member nations have never held joint exercises with Moscow.
Jakarta has billion-dollar trade ties with Moscow, but major arms imports have stalled in recent years, according to weapons watchdog SIPRI, following Western sanctions on Russia after it seized Crimea in 2014 and invaded Ukraine in 2022.
Still, Prabowo has kept alive a $1.1 billion Russian fighter jet deal he agreed in 2018 as defense minister, despite the reported threat of US sanctions.
Jakarta also refused to budge when Western nations lobbied Indonesia to disinvite Russia from the G20 summit it hosted in 2022.
Prabowo met Russian President Vladimir Putin at the Kremlin in July, later announcing joint naval drills that experts say indicate how Moscow will grow in significance as part of a broader foreign policy.
The five-day drills begin Monday in eastern Java where Moscow will send three corvette-class warships, a medium tanker ship, a military helicopter, and a tug boat.
“They reaffirm that we will not alienate one or two countries in the geopolitical arena,” said Anton Aliabbas, professor at the Paramadina Graduate School of Diplomacy.

Diversifying partners

During his Kremlin visit, Prabowo — a 73-year-old ex-general — said he wanted to deepen the relationship with Russia.
“We consider Russia as a great friend and I would like to continue to maintain and enhance this relationship,” Prabowo told Putin.
Before his inauguration last month, Prabowo said he wanted to build a “web of strong friendships.”
To that end he visited more than a dozen countries including China and Australia, where he struck a key security deal, and Jakarta has since kickstarted a process to join the BRICS group of emerging economies.
The new leader has already been tested at sea, with a Chinese coast guard vessel being driven away three times from Indonesian-claimed waters by Jakarta’s ships last month.
For Indonesia, the chance to host one of the world’s most advanced navies is clear.
It will allow “capacity building to be obtained” and for Jakarta to “exchange ideas” on maintaining Russian equipment it already owns, said Curie Maharani Savitri.
Indonesia has Russian-made amphibious tanks, helicopters, missiles and fighter jets in its arsenal.

Different goals

Jakarta and Moscow have different maritime goals, with Indonesia facing threats of smuggling and piracy while Russia is looking for willing allies.
Pieter said he expects the exercises to not be as advanced as annual Super Garuda Shield drills Indonesia hosts with the US and other allies.
“I think it’s an introductory phase to the military relationship between the two, especially on the naval side,” he said.
But the drills may still raise eyebrows in Washington, which has been trying to diplomatically isolate Russia.
The US embassy in Jakarta declined to comment on the drills.
For Prabowo they allow him to send a message about his new policy in the early days of his presidency, said Pieter.
“Historically, the US has been the partner of choice for military exercises. But... Indonesia has been trying to diversify its partners,” he said.
“And I think there’s an overall bigger trend of that.”


Ukraine ‘holding back’ powerful Russian offensive, Kyiv top commander says

Ukraine ‘holding back’ powerful Russian offensive, Kyiv top commander says
Updated 31 min 54 sec ago
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Ukraine ‘holding back’ powerful Russian offensive, Kyiv top commander says

Ukraine ‘holding back’ powerful Russian offensive, Kyiv top commander says
  • The war is entering what Russian analysts say is its most dangerous phase as Moscow’s forces advance

KYIV: Ukrainian forces are restraining one of Russia’s most powerful offensives since the start of Moscow’s full-scale invasion on its smaller neighbor, the top commander of Kyiv’s forces said on Saturday.
Russian troops advanced in September at their fastest rate since March 2022, the month after President Vladimir Putin ordered the invasion, according to open-source data. Ukraine in August took part of Russia’s Kursk region.
“The Armed Forces of Ukraine are holding back one of the most powerful Russian offensives from launching a full-scale invasion,” General Oleksandr Syrskyi wrote on the Telegram messaging app.
After failing to capture the capital Kyiv early in the war and win a decisive victory, Putin scaled back his war ambitions to taking the Donbas industrial heartland in Ukraine’s east, which covers the Luhansk and Donetsk regions.
Donbas has since become the war’s main theater, where some of biggest battles in Europe for generations have taken place and where thousands of troops on each side have died.
On Saturday, Moscow said it has taken two more settlements along the Donbas frontline. In the week of Oct. 20-27 alone, Russia captured nearly 200 square km (80 square miles) of Ukrainian territory, according to the Russian media group Agentstvo, which analyzed Ukrainian open-source maps.
The war is entering what Russian analysts say is its most dangerous phase as Moscow’s forces advance, North Korea sends troops to Russia and the West ponders how the conflict will end.
Ukraine’s President Volodymyr Zelensky has been traveling the world lobbying NATO countries to allow Kyiv the use of the long-range missiles they have provided to strike targets deep inside Russia.
Ukraine is bracing for what could be the toughest winter of the war after long-range Russian airstrikes destroyed what officials say is about half of its power generating capacity.
 


UK FM Lammy vows ‘new approach’ ahead of Africa trip

UK FM Lammy vows ‘new approach’ ahead of Africa trip
Updated 03 November 2024
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UK FM Lammy vows ‘new approach’ ahead of Africa trip

UK FM Lammy vows ‘new approach’ ahead of Africa trip
  • Lammy said that economic growth would “underpin our relationships in Nigeria, South Africa and beyond”

LONDON: UK Foreign Secretary David Lammy on Sunday vowed a “new approach” with Africa that will “listen rather than tell” as he began a visit to Nigeria and South Africa.
“Our new approach will deliver respectful partnerships that listen rather than tell, deliver long-term growth rather than short-term solutions and build a freer, safer, more prosperous continent,” he said, according to a press release from his ministry.
“I want to hear what our African partners need and foster relationships so that the UK and our friends and partners in Africa can grow together,” he added, as he set off for his first trip to the continent as foreign minister.
Lammy said that economic growth would “underpin our relationships in Nigeria, South Africa and beyond.”
In Nigeria, he will sign a “Strategic Partnership” that will cover growth, national security and climate change.
Lammy will then travel to South Africa, where he will “agree to develop a new UK-South Africa Growth Plan,” according to the Foreign Office.
He will also attend the Earthshot+ conference in Cape Town, where he will speak with innovators to find out how Britain can help channel finance to environmental solutions.
Founded by Prince William, The Earthshot Prize is a global environmental award and platform designed to develop solutions to ecological problems.


Russia, Ukraine accuse each other of obstructing prisoner of war swaps

Russia, Ukraine accuse each other of obstructing prisoner of war swaps
Updated 03 November 2024
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Russia, Ukraine accuse each other of obstructing prisoner of war swaps

Russia, Ukraine accuse each other of obstructing prisoner of war swaps
  • Kyiv and Moscow have frequently exchanged prisoners since Russia’s full-scale invasion of its smaller neighbor in 2022

MOSCOW: Kyiv called on Moscow on Sunday to provide a list of Ukrainian prisoners of war ready for a swap after Russia accused Ukraine of sabotaging the exchange process.
In requesting the list of Ukrainians from his Russian counterpart, Ukrainian human rights commissioner Dmytro Lubinets wrote on his Telegram messaging channel: “We are always ready to exchange prisoners of war!“
Kyiv and Moscow have frequently exchanged prisoners since Russia’s full-scale invasion of its smaller neighbor in 2022. The last swap took place in mid-October with each side bringing home 95 prisoners.
On Saturday, Russian Foreign Ministry spokeswoman Maria Zakharova said that Ukraine was essentially sabotaging the process and has refused to take back its own citizens.
Zakharova said Russia’s defense ministry had offered to hand over 935 Ukrainian prisoners of war but that Ukraine had taken only 279.
Lubinets, in turn, said that Ukraine was always ready to accept its citizens and accused Russia of slowing down the exchange process.
Russia’s Commissioner for Human Rights Tatyana Moskalkova said on Saturday that Ukraine has “politicized” the issue.
“We consider it necessary to return to a constructive dialogue and speed up the exchange of prisoners,” Moskalkova wrote on Telegram.


Harris, Trump nearly cross paths in North Carolina in final days of US election campaign

Harris, Trump nearly cross paths in North Carolina in final days of US election campaign
Updated 03 November 2024
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Harris, Trump nearly cross paths in North Carolina in final days of US election campaign

Harris, Trump nearly cross paths in North Carolina in final days of US election campaign
  • The close encounter was a dramatic illustration how the two candidates are focusing on a handful of states where Tuesday’s US presidential election will be won or lost

CHARLOTTE, North Carolina: Democrat Kamala Harris was greeted by an unusual sight as she arrived in North Carolina on Saturday: the red-white-and-blue airplane of Donald Trump, her Republican rival for the presidency.
As Harris descended from the vice presidential airplane Air Force Two at the Charlotte airport, Trump’s private Boeing 757 was parked on the tarmac nearby.
The close encounter was a dramatic illustration how the two candidates are focusing on a handful of states where Tuesday’s US presidential election will be won or lost.
It was the fourth day in a row that the candidates were campaigning in the same state. Only seven states, North Carolina among them, are seen as truly competitive.
Harris was arriving for a rally in Charlotte, the state’s biggest city, while Trump had campaigned in suburban Gastonia a few hours earlier.
It was not clear whether Trump was on board his plane when Harris arrived.
With the election just three days away, Trump and Harris stuck to familiar themes at their appearances.
Trump said he would deport millions of immigrants if elected and warned that if Harris were to win, “every town in America would be turned into a squalid, dangerous refugee camp.”
Campaigning in Atlanta, Harris said Trump would abuse his power if he returns to the White House.
“This is someone who is increasingly unstable, obsessed with revenge, consumed with grievance, and the man is out for unchecked power,” she said.
More than 72 million Americans have already cast ballots, according to the Election Lab at the University of Florida, short of 2020’s record early-voting pace during COVID-19, but still indicating a high level of voter enthusiasm.
Some 4 million votes have already been cast in North Carolina, and the western counties that have been devastated by Hurricane Helene appeared to be voting at roughly the same rate as the rest of the state, according to Catawba College political science professor Michael Bitzer.
Trump criticized the federal government’s response to the disaster and repeated his false claim that aid had been diverted from the state to help immigrants entering the country.
He also said that residents of US suburbs, traditionally seen as a refuge from crime and other dangers, are under threat.
“The suburbs are under attack right now. When you’re home in your house alone, and you’ve got this monster that got out of prison, you know, six charges of murdering six different people,” he said. Violent crimes dropped in the US last year. However, Trump and his allies have emphasized crime on the campaign trail and falsely suggested immigrants are responsible.
North Carolina backed Trump in 2020 by a narrow margin of less than 1.5 percentage points and elected a Democratic governor on the same day, giving hope to both parties.
Trump was due to rally in Salem, Virginia, though the state is not likely to back him for president, before returning to North Carolina for an evening rally in Greensboro.
POLICY DIFFERENCES 
Harris and Trump have very different policies on major issues including support for Ukraine and NATO, abortion rights, immigration, taxes, democratic principles and tariffs, which reflect that schisms between the Democratic and Republican parties. Republican House Speaker Mike Johnson said Friday that if Trump wins and Republicans control Congress, his party would “probably” repeal the CHIPS Act, passed under Joe Biden’s administration, which gave over $50 billion in subsidies to companies for semiconductor chip manufacturing and research in the United States. Democrats have seized on the remarks. “It is further evidence of everything I’ve actually been talking about for months now, about Trump’s intention to implement Project 2025,” Harris said Saturday, referring to a conservative blueprint to remake US government and policies that was written with the help of many of Trump’s closest advisers.
Johnson revised his remarks later on Friday, saying the act would be streamlined to eliminate regulations.