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A
Swissinfo podcasts. This is Inside Geneva. I'm your host, Imogen folks, and this is a production from swissinfo, the international public media company of Switzerland.
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B
In today's program, my grandma was a humanitarian. She had worked in Malawi, and I remember when I was about 10 years old, she said to me, when you grow up and you become a humanitarian, you should work for Medecent Sans Frontiere because they really have strong values and ethics that you will appreciate.
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C
The World Health Organization says the rate Ebola is infecting people means there is community transmission. And the WHO warns without more public health measures, the virus could spread to new areas.
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B
It's not just an Ebola outbreak. It's an Ebola outbreak in a context with massive, massive humanitarian needs that has high insecurity. There's ongoing conflict. We see the outbreak is starting to go into areas with high, high insecurity where we hear about community deaths, but you don't have access to them to be actually sampling to see if it's Ebola or not, or to have or to have a proper Ebola response.
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D
A place to be buried quickly.
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More bodies keep arriving.
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The number of Ebola cases growing as
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health authorities struggle to contain the outbreak.
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B
A mother had her child. The child was sick, and then the mother died of Ebola. The grandmother took the baby, came to where our project is. The grandmother died. The baby is now sick with Ebola. None of the family wants to come to the child because everyone that touches the child dies. It just breaks your heart.
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The virus spreading through the Democratic Republic of the Congo, outrunning teams trying to contain it.
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It's now the third largest Ebola outbreak on record. And in the past months, it has expanded faster than any previous outbre.
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B
And people here, they're people, and we're all humans. And so I have a hard time understanding why we can't connect that way.
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A
Hello and welcome again to Inside Geneva. I'm Imogen, folks, and it's that time of year again. We're starting our regular series of summer profiles, and today we've got a really topical one for you. But what's it like working to tackle an Ebola outbreak? What makes someone volunteer for such a dangerous mission? Right now in the Democratic Republic of Congo, the current Ebola outbreak is, the World Health Organization says, the fastest spreading on record. It's happening in a region which has suffered conflict and insecurity for decades. Hundreds of thousands of people are displaced. They lack life's basics. Shelter, medicines, clean water, sanitation. How do you combat a deadly disease in such conditions, especially when this strain of Ebola known as Bundi Bujo, has so far no vaccine and no treatment. We're going to discuss all of that today with a nurse who works for Medecin Sans Frontiere or Doctors Without Borders, who joined us from Bunya in DRC at the heart of the Ebola outbreak.
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B
My name is Trish Newport. I'm Canadian. I'm from the Yukon, which is right next to Alaska. But currently I live in Geneva because I am the responsible for emergency response for MSF Switzerland. So I'm based in Geneva, but I travel all over the world to organize and coordinate large scale emergency response.
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D
Right now you're actually in Democratic Republic of Congo working on Ebola.
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A
Did you always plan on a job
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that would take you to such places? I mean, how did you get into it?
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B
I did, but I never planned to the scale that it would be. I always wanted to work for msf. My grandma was a humanitarian. She had worked in Malawi. And I remember when I was about 10 years old, she said to me, when you grow up and you become a humanitarian, you should work for Medicine Sans Frontiere because they really have strong values and ethics that you will appreciate. And so I just took this without any thought. It was just became my truth. I, I will work for msf. And so I did many other things because I didn't feel responsible or mature enough to, to have an adult's job. And then when I finally decided to become a nurse, I actually called MSF and I said, I got accepted into nursing school. What do I need to do to be able to work for you? And they gave me a list which included working for two years and covering all these things, and two years to the day of graduating, I applied to work for them.
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D
You phoned up msf, they told you what you want to do, then you got accepted. So, I mean, nursing for Medecin Sans Frontieres is not your average western hospital nursing or a clinic.
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A
Where has this job taken you? What have you been confronted with?
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This job has taken me everywhere. I'm so lucky to have had the experiences that I worked. My first experience with MSF was in Djibouti. I was offered a position in Djibouti in Canada. We never learn about Djibouti. I actually had to look up Djibouti to see that it was a country. And I went to Djibouti. Djibouti, which is the capital of Djibouti. And then from there I worked all throughout the Sahel. I worked a lot in acute Malnutrition response for a number of years. So that must be quite hard to see. It's hard to see, but you can really do well, you can really do something in the sense a little malnourished child comes. If they get plumpy nut and proper care for six weeks, they become fat little cute kid and they go home. What's challenging is that MSF saves lives for today, for the changes that will come tomorrow. And so we're not changing the context that these children are living in. And so they became malnourished for a reason. And so often we would see children recovered from malnutrition, and then two months later, they come back malnourished all over again. And this was a hard thing to accept, that we can't do everything. We need to have other organizations and governments doing things, but at least we can be saving lives for today.
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D
Well, right now you're in Democratic Republic of Congo. You're there where this new Ebola outbreak is taking place.
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A
What motivated you?
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D
Right, I've heard about this. I'm going there.
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C
So I first did an ebola response in 2018, and I became fascinated by this disease. It is. It's horrible. It's horrible to families, it destroys families. But it's also very methodological. There's six pillars to outbreak response. If you have all pillars in place at the same time, you can stop an outbreak. And you can't just have one thing. You can't just have an isolation. You can't just have case management. You need to have every single pillar. And this I find fascinating. And so I became very involved in Ebola outbreak. In almost every single Ebola outbreak, I will be involved in it. So I'm happy to be here. I have worked in the DRC for many, many years. There are. We have amazing staff here. I feel like I come home and I see the family. I went to Mongolu, which is our big Ebola response. It's one of the epicenters of the Ebola outbreak. And I got there and I just saw the family of Congolese staff who respond to every single Ebola outbreak and this. We rejoice to be together and that we all know our work together. And so while it's a really horrible situation, it's a disaster. We have an amazing team to work together, and I wouldn't want to be anywhere else right now.
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D
A lot of people will find your enthusiasm, it's almost enthusiasm, more than a sense of duty, which we imagine sometimes from aid workers and many other people. You know, hearing the word Ebola would
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run in the opposite direction. Direction.
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D
But you not. I mean, I'm even wondering what your family and friends think about you doing this.
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C
So I. I mean, it's very genuine. I wouldn't want to be anywhere else in the world right now. And I feel. And I think a lot of people here feel we have the skills. We have the skills to help this. And so it. It's a duty, but also a desire. If I'm able to help, and I'm able to help save lives and I'm able to help find strategies and ways to stop this outbreak, why wouldn't I want to be involved? My family, they're used to it.
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D
Okay. They don't try and persuade you not to go?
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No.
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C
You know, I lived in a canvas tent in the remote wild of the Yukon for 10 years. They know that there's no hope.
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D
So you like challenging physical environments then?
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B
I love it. Yeah.
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D
You thrive on them. Okay, well, on that point, then, what is a day like for you right now in drc?
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I'm really the manager and the coordinator of MSF Switzerland's response here in Etori. So I work a lot. I talk with all of our different projects, but I also work a lot in collaboration with the Ministry of Health and with other organizations, all about how to collaborate and organize this response. I unfortunately, am in a lot of meetings, but I also, in the end, were responsible for the security management of our teams. And this is. It's not just an Ebola outbreak. It's an Ebola outbreak in a context with massive, massive humanitarian needs, with that has high insecurity, there's ongoing conflict. And so there's also. It's not just about talking about Ebola. It's also about networking with different actors that can share information about the context and the security and to figure out how we can also respond to the humanitarian needs in the area. We can't ignore them. Before the Ebola outbreak started, we had five big humanitarian responses in Etori province. And so those. Most of them have continued on. And so now there's Ebola creeping into these projects into big displacement camps that have horrible sanitation. And so spend a lot of time, one really advocating for other actors to respond not just to Ebola, but also to the humanitarian response. So I do a lot of discussions, a lot of advocacy, but I also visit the projects, which sounds easier than said, because you can take six hours on very bad roads getting to where you need to be, but I can't support the projects or advocate for what is needed if I don't actually see what's going on.
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D
And what are you seeing? I mean, we heard the WHO just a couple of days ago saying that this outbreak is the fastest spreading ever.
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C
We see that. We see in a lot of Ebola outbreaks, you have a little hotspot and you can manage and it stays small, and then you see another hotspot and you can move there. But you have time, right? You follow the epidemiology here. It just started. It was so big already. By the time the outbreak was declared, there were over 300 suspect cases, over 55 deaths. So it was massive. And so we've never, ever caught up to it. When I say we, it's not just msf, it's the entire response. It's the Ministry of health. It's the 17th Ebola outbreak in the Democratic Republic of the Congo. The Ministry of Health knows how to respond. It's just the sheer amplitude of this. Right. Right now, there are areas that have Ebola cases and no one is responding to it. And this is scary because if this is happening, it means that are responding. Local Ministry of Health staff don't have the training. If you respond to Ebola without proper training, without the knowledge and experience, you're really exposed, and there's a high risk people will get infected, and then the outbreak will just continue. We see the outbreak is starting to go into areas with high, high insecurity where we hear about community deaths, but you don't have access to them to be actually sampling to see if it's Ebola or not, or to have. Or to have a proper Ebola response. I just went to visit one of our projects in Fataki. There was a population of about 100,000 people that were forced to flee because of fighting there in 100,000 people in a displacement camp on a hill. It's very crowded, very poor sanitation. There's not enough latrines for everyone. There's not enough water. And Ebola cases have started there. And so we already have activities in the camp. We provide water, we provide health care in the camp. But how to possibly, I mean, respond to Ebola and the humanitarian response? I mean, there weren't enough humanitarian responders there in the first place. It's extremely challenging.
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D
How is msf? Do you feel you have trust from the local communities? Because we know that in previous outbreaks, this has been a real problem.
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Suspicion and mistrust.
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C
Yes. So it's not an easy answer. MSF has been present in Itre Province since 2005. We have covered almost every area. Right. For emergency response. So the population in general knows us in Mongwalu. We had never, ever been to Mongwolu. Humanitarian actors hadn't been to Mongwolu in general. It's a real mining area. It's a town of about 150,000. And so it was a big work for our teams to really engage with the community. It was in the news the first day our teams arrived. They put up a tent. It was empty. They went to bed. It got burned down. It was maybe one of the best things that could have happened because it said, okay, we need to pause. We need to look at all the lessons Learned from the 2018, 2020 outbreak, where there was a lot of violence towards the Ebola response. And we need to take a moment, engage with the community, see how they're feeling, and ask them what their priorities are. Because in the 2018-2020 outbreak that was in Etori and North Kivu, there was a lot of violence. And at one point, I asked one of our staff why there was so much violence towards the Ebola response. And he said to me, ebola is your priority. It's not our priority. We don't have access to running water. We don't have access to clean water. I've had children die of malaria because they don't have access to treatment. And then you guys come in with all of your money because you care about ebola, but you don't care about us having water or access to basic medication. And this changed the way that I see Ebola response. And in that outbreak, we started, we stopped responding to Ebola. And we would go into communities and we would say, what is your priority? So in Mongolu, after the tent was burned, I'm so proud of our teams. They went to the community and they said, what is your priority? And they said, we need this outbreak to stop. We have so many people dying in this community. We. We need safe and dignified burials. We need isolation. And our team said, great. How do we do this together? Right? Because even if they want it, there's still going to be problems. And so they actually made a group of the leaders in the community who commit to responding to the problems. So if there are any. If we have any, like, harassment, our team calls this group of community leaders who will come and deal with the problem. And so this is something you have to continue to renew. You have to continue to engage. It's not like you can say, check community engagement. Now we get to move on. But it's A huge amount of work.
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D
So it's a constant. Working together and establishing and re establishing
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trust totally and having them engaged in the response. We can't just say this is how it needs to be done, but to say how can we do this in your community? Like these are the principles of Ebola response. How do you see this working in community and how can we make this happen together? It can't be the same way that we do it in every single community. Every community is different.
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D
Do you think aid agencies have in the past. I mean, I know this is a bit of an old chestnut and it gets talked about a lot, but do you think you are maybe still suffering from this maybe 10, 20, 30 years ago? Aid agencies go and say this is how we do it and don't look at the community or the local culture at all.
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C
I feel like this still happens all of the time. I mean, there are organizations that definitely focus on community engagement, but there are so many that don't. Right. And it's also about donor structures and the way that donors give money because they say we will give money for exactly this. And then an organization needs to come and do exactly this. And so if the community says no, no, we want it this way, or this is our priority, a lot of organizations don't have the donor structure to be able to do that.
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D
Let's actually, since you've mentioned it, let's talk about finances because this is. And you know, because you, you when you're not in the field, you're in Geneva, you know, the absolute shock of all of this, the cuts in funding. MSF is maybe a little bit shielded. You're. You don't get money from states. Mostly you get, it's private. But are you seeing the funding cuts in this outbreak?
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C
So that's a hard one to answer. I'll answer it in two different ways. The first way is that in the last year and a half we've seen a lot of actors leave Etori. We have seen funding cuts and so regular humanitarian activities were cut and organizations left, which left.
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D
I mean, that would also hinder just the general sense of well being of communities and also surveillance, I would guess all of this.
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C
Right. And so it impacts surveillance, it impacts well being of the population and their sentiment about the objectives and motivations of humanitarian organizations. Because then it leaves a bigger humanitarian situation to respond to, which makes it harder to respond to Ebola. And now all these organizations are coming back with money just for Ebola. And it reminds me of the situation we faced in 2018. 2020. And so this first, I think is a real challenge. And then the second part is it's hard to say if the funding cuts have impacted this, but the response is not big enough. This we see. I mean, it is a massive Ebola outbreak in Bunya, which is where I am right now. There's a big response for Ebola. It's still not big enough. There's not enough beds for patients. And not every single pillar is functioning and working today. You step outside of Bunyan, there's very little. Right. We're in Mongwalu and usually in an Ebola outbreak we might be doing case management and some part of outreach because there's other actors doing things. Now we're doing in collaboration with the Ministry of Health. We're doing almost every single pillar. And this just is. There's not enough actors. There's not enough actors anywhere. There's not enough funding, there's not enough international support. Is it related to funding cuts? This I can't say. That's out of my, like, knowledge and scope. But I can see on the ground, we see that it's not big enough.
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D
So where do you think this outbreak is, is going? I mean, is it out of control at the moment?
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C
It is a very, very concerning situation. And as long as there's not adequate surveillance, it will move. I mean, the good thing about Ebola is that it doesn't have pandemic potential. That's because you can't be infectious unless you're symptomatic and it's not respiratory transmission. And because of these two things, it doesn't have pandemic potential. But does it, does it have potential to move? Oh, yes. If you don't have proper surveillance in place, usually in an Ebola outbreak, for every new case, you identify everyone that was in close contact with that new confirmed case. And then you follow all of those people for 21 days. Following means they need to take their temperature twice a day. And as soon as they have fever or any sign of illness, they need to be isolated so that they're not going to infect anyone else and get tested. But today that contact tracing, the follow up, it's not being done everywhere. And so we don't know who's at risk of having Ebola. And so we really have no global overview of the situation today. And that is frightening.
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D
And what do you say to people in countries, well, like Canada or maybe here in Europe? Ebola is not really our problem. We need our money for us here at home.
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C
This is, I mean, I can see where people come from in the sense that everyone lives their own reality. Right. But there is a real global risk if we're not putting resources into responding to neglected illnesses or illnesses that don't come about very well very often. Bunjibugio virus, which is causing this outbreak, it's the third time there's been a known bunjibugio outbreak in history. And there has been discussion before. There needs to be more research and development about these Ebola viruses. It hasn't happened. Right. Money goes to other places. We think of COVID I mean, viruses appear, and the more research and development that is done, we learn lessons. There's transversal knowledge that happens. And so I think being able to have answers like treatments, increased diagnostic capacity for any illness helps the entire world. And people here, they're people, they're humans. You know, it's. It breaks my heart. There are families that have had 15 people die in their family. There was this horrible story in Fataki this week where a mother had her child, the child was sick, and then the mother died of Ebola. The. The grandmother took the baby, came to where our project is. The grandmother died, the baby is now sick with Ebola. None of the family wants to come to the child because everyone that touches the child dies. It just breaks your heart. I mean, and there are these stories over and over again of people who have dealt with so much trauma, and we're all humans. And so I have a hard time understanding why we can't connect that way.
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D
I know it's hard to look ahead in a situation like this, but there is a lot of attention on this outbreak. Now, where do you think you're going to be in a couple of months? Where do you think this outbreak is going to be in a couple of months?
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C
I hope we'll see what I. What I see and what I hope. I hope that there will be more actors here and it will start to be better managed and that we can start to take a grasp of it, catch up to it, and actually start to control it. But this doesn't happen if we don't have resources in place, if there's not more international support to be able to respond to this outbreak. One of our staff, we were sitting around the other night, and I said, what is going to happen here? And one of our Congolese staff said to me, trish, everything has an end. It's going to end at some point. It's just a question about how long it takes and how many resources are put into place to actually stop it.
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D
And how many people die?
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And how many people die and how many families are really destroyed by the virus?
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A
And that brings us to the end of this edition of Inside Geneva. Huge thanks to Trish Newport and MSF Switzerland for making the time for this interview in the midst of such demanding work and difficult conditions. We wish Trish and all her colleagues all the very best. Next time, we'll be profiling an aid worker currently tasked with keeping the Geneva conventions relevant in 21st century warfare. And in a way, also profiling one of the most recognizable iconic symbols in the world, the Red Cross emblem itself.
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The emblem, it's. It's a symbol of hope. It's a symbol of, okay, there is a human. In the midst of war, of awful situation. There are people who are looking at this emblem because they know maybe their family will be found or maybe they will get medical treatment.
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A
Does the emblem need to go digital to protect vital infrastructure from cyber attacks?
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The fact that cyber attacks are more and more done by machine. We are talking about a machine talking to another machine. The computers themselves. We know that this is a sign. And maybe one day these attacks will be avoided because the system, the standard, will be saying, this is a protected server. This is a protected data.
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A
That episode's out on August 4th. And later in our summer profiles, we'll be talking to UN women about the consequences of cuts in aid funding on women and girls. And we'll hear from a pair of human rights defenders how to keep support for human rights alive when some of the most powerful nations on earth are pushing back. All that and more this summer on Inside Geneva. I'm Imogen, folks, thanks for listening. A reminder, you've been listening to Inside Geneva, a Swiss info production. You can email us on Inside GenevaissInfo Ch and subscribe to us and review us wherever you get your podcasts. Check out our previous episodes. How the International Red Cross Unites Prisoners of War with Their Families or why Survivors of Human Rights Violations Turn to the UN in Geneva for Justice. I'm Imogen, folks. Thanks again for listening.