Belfast doctor tells of battling deadly Ebola in war zone
Outbreak has claimed lives of nearly 700 in DR Congo
A Northern Ireland doctor involved in tackling a major Ebola outbreak in the Democratic Republic of the Congo has told of the challenges of battling the deadly disease in a war zone.
Dr Stacey Mearns spent four months in the central African country, working as part of an aid team.
The number of confirmed cases has passed 1,000 with the death toll standing at 679.
Dr Mearns (35), who is from Belfast, said dealing with the virus in an area where no one feels safe brought many challenges.
Ebola is spread via small amounts of bodily fluid and infection is often fatal. Early symptoms are flu-like, followed by vomiting, diarrhoea, a rash and internal and external bleeding.
The current outbreak is the 10th that DR Congo - the largest country in Sub-Saharan Africa - has suffered and the worst since its first epidemic in 1976.
Dr Mearns is senior health coordinator for aid organisation International Rescue Committee (IRC). Previously she was an NHS doctor for six years and joined IRC four years ago after helping with the West Africa Ebola epidemic in Sierra Leone -the largest ever outbreak, which killed more than 11,000 people between 2013 and 2016.
Dr Mearns was also in DR Congo for four months and returned on February 19.
She helped with the response to the outbreak in Beni, Butembo and Katwa in the country's war-torn North Kivu province, where 120 militia groups operate.
Humanitarian group Medecins Sans Frontieres (MSF) has pulled out of Butembo because of the security situation. In the past month, four Ebola clinics have been attacked. A male nurse was strangled in front of his wife.
Dr Mearns said dealing with a contagious and deadly virus in one of the world's most dangerous conflict zones was challenging.
"The attacks are fuelled by mistrust," she said. "Some people believe Ebola was deliberately introduced in this area as a political tool to enrich those in power. The populations in opposition strongholds like Beni and Butembo were not allowed to vote in the December election because of Ebola.
"Another problem is a lack of understanding. A lot of rumours have circulated that if you go for the vaccine, you are actually injecting people with Ebola. There are all manner of suspicions that mean there are still communities who refuse to take the vaccine."
Dr Mearns described the security situation as "hazardous".
She added: "I was not attacked personally, but I certainly had my movement affected. You have fierce fighting between rival factions and aid organisations being targeted directly.
"Security concerns mean that all the response workers, your safe burial teams, your surveillance teams, your vaccination teams, teams working in Ebola treatment centres and health workers cannot get to where they rapidly need to be to control the outbreak.
"We've seen at numerous points during this outbreak where there has been two or three days where every single response activity has been on pause because no one is safe to move. It is so difficult."
Dr Mearns was born in Belfast but left Northern Ireland at the age of seven to move to the Isle of Man. Now based in London, she previously worked at a hospital in England.
However, she was shocked by what she encountered between 2014 and 2016 when in Sierra Leone, dealing with the previous Ebola outbreak.
She added: "Working in the NHS as a doctor, I'd seen people die, but nothing could have prepared me for the volume and pace of death we faced working at in Sierra Leone.
"I worked in a 20-bed Ebola unit and we were constantly full, and we constantly had more patients than we had beds for. It was very, very difficult.
"Once people have the advanced stages of Ebola there's very little you can do to bring them back. There was a period where dead bodies were just being dumped all over the hospital.
"I think on the worst day, I saw 25 people in body bags. That was a combination of bodies dumped around the hospital and people dying inside the unit. It felt like everyone was just dying and that was a very tough environment to work in.
"You just see immeasurable amounts of suffering and all of that takes its toll on you.
"When I think back to West Africa, there were times of just feeling hopeless. You were seeing the outbreak worsening, feeling exhausted and tired from the work you were doing."
Dr Mearns added: "I think the hardest moments are those moments of just wondering if this is ever going to end."
Dr Mearns has used her West Africa experience to provide training for front line health workers as the IRC's programme director in DR Congo, in an Ebola response project supported by UK aid through the Department for International Development.
She believes the number of cases in DR Congo would be far greater had a new vaccine - developed with support from UK aid - not been administered through the World Health Organisation to more than 85,000 people.
"This time has been different because we have learned a lot about the disease from the West Africa outbreak and have tools like the vaccine at our disposal," she added.
"You can't really compare the DR Congo outbreak to the West Africa one, although we have still hit 1,000 cases, and that's with the vaccine.
"But without the vaccine we'd be looking at double or treble the number of cases."
The dangers faced by health workers were illustrated during the West Africa outbreak when British nurses William Pooley and Pauline Cafferkey nearly died after returning to the UK in 2014 with Ebola.
Dr Mearns admitted the threat of contracting the virus has given her sleepless nights.
She said: "When you come back from an Ebola outbreak you do get paranoid. Every time you get a headache or something, you fear the worst.
"It wasn't too bad this time, but I remember in West Africa, when I was working directly with patients, any time you felt remotely unwell, or a pain here or there, the first thing that comes to mind is 'Do I have Ebola?' Sometimes that would keep you awake at night.
"Ebola is the last disease in the world you'd want to catch."
International Development Secretary Penny Mordaunt said: "From helping to put specialists like Dr Mearns on the ground, to developing a vaccine - the UK is playing a crucial role in the fight against Ebola.
"Disease does not respect borders, so UK aid playing a significant role in saving lives and stopping the spread of this devastating and deadly virus is firmly in our national interest."