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Community mistrust worsening DR Congo Ebola outbreak: study

One out of four people interviewed in eastern Congo last year believed Ebola wasn’t real, according to a new study, underscoring the enormous challenges health care workers are now facing. Health workers said public mistrust is now the biggest obstacle to stopping the epidemic, with many refusing vaccines, resisting treatment and concealing symptoms, as the…

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Community mistrust worsening DR Congo Ebola outbreak: study

One out of four people interviewed in eastern Congo last year believed Ebola wasn’t real, according to a new study, underscoring the enormous challenges health care workers are now facing.

Health workers said public mistrust is now the biggest obstacle to stopping the epidemic, with many refusing vaccines, resisting treatment and concealing symptoms, as the world’s second-biggest Ebola outbreak spreads.

The survey found that mistrust resulted in people being 15 times less likely to seek medical treatment at an Ebola health center, according to the study published in the The Lancet Infectious Diseases journal.

The study released on Wednesday was based on interviews conducted last September, about a month after the outbreak began. It comes as the number of probable and confirmed cases has exceeded 1,000.

At least 639 people have died from Ebola in eastern Congo since August in what is now the second deadliest outbreak in history, according to the World Health Organization.

Attacks on DRC’s Ebola treatment facilities threatens progress 1:53

In recent weeks, there have been on average eight new cases per day said the country’s health ministry.

The outbreak’s response has been hampered by a series of deadly attacks on Ebola health centers since the study was completed. As a result, Doctors Without Borders has stopped staffing two health centers at the outbreak’s epicenter after violent attacks.

Researchers found that trust in public authorities had already fallen in the cities of Beni and Butembo before Ebola hit, due to decades of conflict and poor governance.

‘Paying the consequences’

“It’s been three years now that we saw a declining level of trust in those actors, and the Ebola crisis comes on top of that and accelerates the distrust,” said Patrick Vinck, of Harvard University, who led the research.

“In some ways, we are now paying the consequences of many years of lack of interest and focus on this issue.”

Eva Erlach, the community engagement and accountability delegate for the International Federation of Red Cross and Red Crescent Societies (IFRC), called the findings “absolutely interesting” and said they show how the level of trust correlates with preventative behaviors.

The organisation has had more than 800 trained volunteers working to get out prevention messages amid the region’s security challenges.

“There is still a part of the community who do not believe that Ebolais real and we definitely still need to continue focusing on community engagement,” said Erlach, who was not part of the study. “And this is why this report is so helpful even if it’s from September.”

WHO Director-General Tedros Adhanom Ghebreyesus said earlier this month he was encouraged “to see the communities accepting the response more and more”. 

The study highlights just how pervasive misinformation has been in places in eastern Congo like Beni and Butembo, where in-person interviews were conducted with 961 people.

Some 25.5 percent of those interviewed did not believe Ebola was real. In addition, nearly 45.9 percent of people thought the Ebola outbreak was being fabricated to destabilize the region or for financial gain.

Additionally 18.2 percent believed all three of those statements, the study found.

Volatile security situation

Those who didn’t believe Ebola was real were far less likely to agree to agree to the Ebola vaccine or to go to a treatment center. Ebola is spread through the bodily fluids of the sick, and isolation of those infected is key to stopping transmission.

Attacks on Ebola treatment centers in eastern Congo also hamper the health response. [John Wessels/AFP]

This outbreak has been uniquely challenging because of the volatile security situation in the region. Eastern Congo is home to numerous armed groups and the Ebola epidemic has deepened the political and economic grievances of many in the area. The fact that people in Ebola affected areas were excluded from the December presidential election has only heightened conspiracy theories.

Tariq Riebl, of the International Rescue Committee, who is currently working in eastern Congo, said the findings released Wednesday mirror what he and his colleagues are seeing on the ground. Concern remains about how Ebola prevention efforts are going because new cases are still emerging.

“Once you reach a wider outbreak zone, especially urban zones, the community engagement and prevention side of things is almost more important than the treatment side,” Riebl said.

“If you can’t have those messages out successfully, it doesn’t matter if you have all the treatment options available because no one is ever arriving to take advantage of that,” he said.

The world’s worst epidemic of Ebola, a hemorrhagic fever, killed more than 11,300 people in West Africa from 2013 to 2016.

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UN-brokered talks on Libya elections resume in Cairo

DUBAI: After more than a decade of civil war, regime-held Syria is in a state of economic ruin. Conflict, endemic corruption, drought and the mass migration of skilled workers have exacted a devastating toll, leaving the country ripe for exploitation. According to the World Bank, Syria’s gross domestic product shrank by at least 50 percent…

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DUBAI: After more than a decade of civil war, regime-held Syria is in a state of economic ruin. Conflict, endemic corruption, drought and the mass migration of skilled workers have exacted a devastating toll, leaving the country ripe for exploitation. According to the World Bank, Syria’s gross domestic product shrank by at least 50 percent between 2010 and 2019, leaving more than 90 percent of the population below the poverty line and more than 50 percent facing extreme poverty. In this vulnerable state, Syria’s domestic markets have been flooded with cheap imports. Iran, capitalizing on its military and political backing for the regime of Syrian President Bashar Assad, has expanded its exports to Syria, exploiting and exacerbating the disintegration of the country’s manufacturing base by monopolizing entire markets. The collapse of domestic industry since the war began in 2011 has provided businessmen close to the Assad regime with lucrative opportunities to import cheaply made goods from Iran, to the detriment of Syrian producers. While few of the grandiose reconstruction agreements between Tehran and Damascus have broken ground as yet, Iran has succeeded in breaking into Syria’s pharmaceutical and food industries, muscling out the local competition. Prior to the uprising that sparked the civil war, Syria had a thriving pharmaceuticals industry; about 70 factories nationwide met 93 percent of domestic demand and exported to about 60 countries. However, a decade of war has left these factories and the power grid needed to sustain such industries in ruins. Violence and persecution have sent legions of skilled workers into exile, while sanctions have blocked access to raw materials and machine parts. Light bulbs made in Iran have flooded the Syrian market. (Supplied) As a result, by 2020 Syria’s overall pharmaceutical production capacity had fallen by about 75 percent. “The active ingredients for medicines are very difficult to import and are very expensive,” Hamed, a student of pharmaceuticals nearing graduation at a leading Syrian university, told Arab News. “Many factories stopped production lines due to shortages of the active ingredients and energy.” Drugs close to their expiration date often find their way into Syria, where they are taken nonetheless by desperate patients. (AFP file) The crisis facing Syria’s pharmaceuticals industry, along with similar challenges in the domestic agricultural sector, has been aggravated by a sharp devaluation of the currency that began in late 2019. Tied to the banking crisis in neighboring Lebanon, the devaluation caused the import of crucial components — including, seeds, pesticides, fertilizer, diesel and the raw materials needed for the manufacture of medicines — to become exceedingly expensive. Syrian companies and industrialists had long deposited their capital in Lebanese banks to avoid Western sanctions. When the Lebanese currency plunged in value, therefore, so too did Syrian deposits. Meanwhile, the devastating decline of Syria’s power grid amid years of fighting and neglect has caused production to become even more expensive, as factories and cold-storage facilities have been forced to rely on costly private generators. Power cuts in Syria has forced factories and cold-storage facilities to rely on costly private generators. (AFP file photo) All of this is on top of endemic corruption, which has long necessitated the payment of bribes to local officials, along with the loss of essential staff to military conscription and displacement. As the prices of Syrian-made products soared, foreign and domestic demand evaporated and the market for cheap foreign imports exploded. The regime’s protectionist policies are equally disruptive. According to Hamed, “limitations imposed by the Ministry of Health” on the prices and export of Syrian-made medicines have rendered local manufacturing unprofitable and further fueled the growth of the black market. The plunging value of the Syrian pound has made it profitable for Iranian importers to grab all the Syrian exports they could find. (AFP file photo) The destruction of Syria’s productive capacity, combined with the depreciation of Iran’s currency under years of Western sanctions, has been a boon for Iranian exporters, who have been able to flood the Syrian market with cheap products. Iran has been especially successful in exporting pharmaceutical goods to Syria, Lebanon and Iraq. It has organized trade fairs and signed distribution deals slanted in its favor, even though many consumers view Iranian-made medicines as substandard. About 75 percent of the medicines sold on the Iraqi market are brought into the country through illegal border crossings with Iran. These drugs are often close to their expiration date or lack the required active ingredients to help patients. Drugs close to their expiration date often find their way into Syria, where they are taken nonetheless by desperate patients. (AFP file) According to Khedr, a Syrian pharmacist living in the west of the country, the quality of the Iranian medicines is “not great” and they are mostly found in state hospitals rather than private pharmacies, where the customers tend to favor better-quality alternatives. Abdullah, a doctor at a hospital in Damascus, is similarly skeptical about the efficacy of the drugs from Iran. “Iranian medications are found in all Syrian hospitals, and I use them in my practice as well, but they are not of good quality,” he told Arab News. For many people living in Syria’s poverty-stricken communities, however, any medicine is better than no medicine. And with shortages rife, in part because of a black market trade in locally made goods, few have any choice other than to buy the Iranian brands.  For many people poverty-stricken communities in Syriae, any medicine is better than no medicine. (AFP file photo) “Compared to locally made medicines, people try to avoid the Iranian ones,” said Hamid. “But, in recent months, some Syrian-made medicines have entirely disappeared from the market as they are being smuggled into Lebanon. So people are relying on Iranian medicine to a greater extent.” Iranian-made opioids are also finding their way onto the black market. Such pain medications can be highly addictive, or deadly if taken in high doses. According to Abdullah, such medications “require special types of prescriptions or can only be found in institutions belonging to the Ministry of Health, because they contain morphine and other opiates for painkillers.” He added: “If one is caught with these types of medications (without a proper prescription), one can be arrested for drug dealing. But they’re flooding the market and it’s all Iranian-made.” In May, the Iran-Syria Joint Chamber of Commerce hosted a forum in Tehran, during which representatives from the private sectors in the two countries exchanged ideas on how to expand trade ties. “Our plan is to increase the level of mutual trade to $1 billion in the first phase, and realizing this goal requires the strong presence of the Iranian private sector in Syrian markets,” Gholam-Hossein Shafeie, the head of the chamber, told delegates, according to the Tehran Times. In part, the Syrian regime has been driven into the arms of Tehran, to get help rebuilding infrastructure and restarting the economy, by virtue of their shared pariah status. Both governments have been squeezed by Western sanctions and global isolation. “We are ready to cooperate with the Iranian private sector to find solutions for removing barriers and neutralizing the impacts of the US sanctions,” Shafiq Dayoub, the Syrian ambassador to Iran, told the joint chamber.  Syrian Prime Minister Imad Khamis, right, and Iranian Vice President Eshaq Jahangiri shake hands after the signing of an agreement in the Damascus on Jan. 28, 2019. (AFP file photo) However, an overriding problem this developing partnership faces is the massive trade imbalance between the two economies, which means Syria is the junior partner and allows Iran to set the terms. “There is not enough foreign currency in Syria to pay for Iranian exports and also Syria does not have much to export to Iran in return,” Abbas Akbari, secretary of the Iran-Syria Economic Relations Development Headquarters, told the forum. Iranian candy products have replaced locally made sweets in many parts of Syria. (Supplied) It is Syrian farmers and manufacturers who pay the price for this trade imbalance. Just like the situation in the pharmaceutical industry, a flood of cheap Iranian imports, combined with the Syrian regime’s strict controls on exports, has devastated the livelihoods of local food producers. Where once Syria was a regional breadbasket, replete with fertile land and food-production facilities of its own, supplemented by imports from neighboring Turkey, it is now almost entirely reliant on imports of fresh and non-perishable goods from Iran.  A street vendor waits for customers in the main market of the rebel-held city of al-Bab in Syria’s northern Aleppo province on the border with Turkey. (AFP file photo) Once again, the quality of these products is widely considered to be lesser than the alternatives, but the lower prices mean they are nonetheless an attractive option for impoverished Syrian consumers. “Today I cooked macaroni made in a factory named after Ayatollah Ruhollah Khomeini,” Bassam, a farmer living in Hama, told Arab News. Abu Omar, a farmer from western Daraa, told Arab News that farmers in southern Syria are banned from exporting their produce until the needs of the local market are satisfied. Yet at the same time, Iranian goods are allowed to flood the Syrian market during the harvest season, harming the ability of local farmers to turn a profit. In this file photo, Syrians work on a small field in a camp for internally displaced. (Photo courtesy of FAO) “The farmer comes out losing money at the end of the harvest, having bought pesticides and diesel in dollars, paid the agricultural engineer (providing the seeds) in dollars, and his workers,” said Omar. Farmers in southern Syria have appealed to the government for additional help but few dare to suggest that a halt to Iranian imports is needed to reset the balance. “This is a state policy. A person can’t change it,” said Omar. “And if you offer your opinion, you can walk yourself right into prison.”

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Largest Palestinian displacement in decades looms after Israeli court ruling

DUBAI: After more than a decade of civil war, regime-held Syria is in a state of economic ruin. Conflict, endemic corruption, drought and the mass migration of skilled workers have exacted a devastating toll, leaving the country ripe for exploitation. According to the World Bank, Syria’s gross domestic product shrank by at least 50 percent…

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DUBAI: After more than a decade of civil war, regime-held Syria is in a state of economic ruin. Conflict, endemic corruption, drought and the mass migration of skilled workers have exacted a devastating toll, leaving the country ripe for exploitation. According to the World Bank, Syria’s gross domestic product shrank by at least 50 percent between 2010 and 2019, leaving more than 90 percent of the population below the poverty line and more than 50 percent facing extreme poverty. In this vulnerable state, Syria’s domestic markets have been flooded with cheap imports. Iran, capitalizing on its military and political backing for the regime of Syrian President Bashar Assad, has expanded its exports to Syria, exploiting and exacerbating the disintegration of the country’s manufacturing base by monopolizing entire markets. The collapse of domestic industry since the war began in 2011 has provided businessmen close to the Assad regime with lucrative opportunities to import cheaply made goods from Iran, to the detriment of Syrian producers. While few of the grandiose reconstruction agreements between Tehran and Damascus have broken ground as yet, Iran has succeeded in breaking into Syria’s pharmaceutical and food industries, muscling out the local competition. Prior to the uprising that sparked the civil war, Syria had a thriving pharmaceuticals industry; about 70 factories nationwide met 93 percent of domestic demand and exported to about 60 countries. However, a decade of war has left these factories and the power grid needed to sustain such industries in ruins. Violence and persecution have sent legions of skilled workers into exile, while sanctions have blocked access to raw materials and machine parts. Light bulbs made in Iran have flooded the Syrian market. (Supplied) As a result, by 2020 Syria’s overall pharmaceutical production capacity had fallen by about 75 percent. “The active ingredients for medicines are very difficult to import and are very expensive,” Hamed, a student of pharmaceuticals nearing graduation at a leading Syrian university, told Arab News. “Many factories stopped production lines due to shortages of the active ingredients and energy.” Drugs close to their expiration date often find their way into Syria, where they are taken nonetheless by desperate patients. (AFP file) The crisis facing Syria’s pharmaceuticals industry, along with similar challenges in the domestic agricultural sector, has been aggravated by a sharp devaluation of the currency that began in late 2019. Tied to the banking crisis in neighboring Lebanon, the devaluation caused the import of crucial components — including, seeds, pesticides, fertilizer, diesel and the raw materials needed for the manufacture of medicines — to become exceedingly expensive. Syrian companies and industrialists had long deposited their capital in Lebanese banks to avoid Western sanctions. When the Lebanese currency plunged in value, therefore, so too did Syrian deposits. Meanwhile, the devastating decline of Syria’s power grid amid years of fighting and neglect has caused production to become even more expensive, as factories and cold-storage facilities have been forced to rely on costly private generators. Power cuts in Syria has forced factories and cold-storage facilities to rely on costly private generators. (AFP file photo) All of this is on top of endemic corruption, which has long necessitated the payment of bribes to local officials, along with the loss of essential staff to military conscription and displacement. As the prices of Syrian-made products soared, foreign and domestic demand evaporated and the market for cheap foreign imports exploded. The regime’s protectionist policies are equally disruptive. According to Hamed, “limitations imposed by the Ministry of Health” on the prices and export of Syrian-made medicines have rendered local manufacturing unprofitable and further fueled the growth of the black market. The plunging value of the Syrian pound has made it profitable for Iranian importers to grab all the Syrian exports they could find. (AFP file photo) The destruction of Syria’s productive capacity, combined with the depreciation of Iran’s currency under years of Western sanctions, has been a boon for Iranian exporters, who have been able to flood the Syrian market with cheap products. Iran has been especially successful in exporting pharmaceutical goods to Syria, Lebanon and Iraq. It has organized trade fairs and signed distribution deals slanted in its favor, even though many consumers view Iranian-made medicines as substandard. About 75 percent of the medicines sold on the Iraqi market are brought into the country through illegal border crossings with Iran. These drugs are often close to their expiration date or lack the required active ingredients to help patients. Drugs close to their expiration date often find their way into Syria, where they are taken nonetheless by desperate patients. (AFP file) According to Khedr, a Syrian pharmacist living in the west of the country, the quality of the Iranian medicines is “not great” and they are mostly found in state hospitals rather than private pharmacies, where the customers tend to favor better-quality alternatives. Abdullah, a doctor at a hospital in Damascus, is similarly skeptical about the efficacy of the drugs from Iran. “Iranian medications are found in all Syrian hospitals, and I use them in my practice as well, but they are not of good quality,” he told Arab News. For many people living in Syria’s poverty-stricken communities, however, any medicine is better than no medicine. And with shortages rife, in part because of a black market trade in locally made goods, few have any choice other than to buy the Iranian brands.  For many people poverty-stricken communities in Syriae, any medicine is better than no medicine. (AFP file photo) “Compared to locally made medicines, people try to avoid the Iranian ones,” said Hamid. “But, in recent months, some Syrian-made medicines have entirely disappeared from the market as they are being smuggled into Lebanon. So people are relying on Iranian medicine to a greater extent.” Iranian-made opioids are also finding their way onto the black market. Such pain medications can be highly addictive, or deadly if taken in high doses. According to Abdullah, such medications “require special types of prescriptions or can only be found in institutions belonging to the Ministry of Health, because they contain morphine and other opiates for painkillers.” He added: “If one is caught with these types of medications (without a proper prescription), one can be arrested for drug dealing. But they’re flooding the market and it’s all Iranian-made.” In May, the Iran-Syria Joint Chamber of Commerce hosted a forum in Tehran, during which representatives from the private sectors in the two countries exchanged ideas on how to expand trade ties. “Our plan is to increase the level of mutual trade to $1 billion in the first phase, and realizing this goal requires the strong presence of the Iranian private sector in Syrian markets,” Gholam-Hossein Shafeie, the head of the chamber, told delegates, according to the Tehran Times. In part, the Syrian regime has been driven into the arms of Tehran, to get help rebuilding infrastructure and restarting the economy, by virtue of their shared pariah status. Both governments have been squeezed by Western sanctions and global isolation. “We are ready to cooperate with the Iranian private sector to find solutions for removing barriers and neutralizing the impacts of the US sanctions,” Shafiq Dayoub, the Syrian ambassador to Iran, told the joint chamber.  Syrian Prime Minister Imad Khamis, right, and Iranian Vice President Eshaq Jahangiri shake hands after the signing of an agreement in the Damascus on Jan. 28, 2019. (AFP file photo) However, an overriding problem this developing partnership faces is the massive trade imbalance between the two economies, which means Syria is the junior partner and allows Iran to set the terms. “There is not enough foreign currency in Syria to pay for Iranian exports and also Syria does not have much to export to Iran in return,” Abbas Akbari, secretary of the Iran-Syria Economic Relations Development Headquarters, told the forum. Iranian candy products have replaced locally made sweets in many parts of Syria. (Supplied) It is Syrian farmers and manufacturers who pay the price for this trade imbalance. Just like the situation in the pharmaceutical industry, a flood of cheap Iranian imports, combined with the Syrian regime’s strict controls on exports, has devastated the livelihoods of local food producers. Where once Syria was a regional breadbasket, replete with fertile land and food-production facilities of its own, supplemented by imports from neighboring Turkey, it is now almost entirely reliant on imports of fresh and non-perishable goods from Iran.  A street vendor waits for customers in the main market of the rebel-held city of al-Bab in Syria’s northern Aleppo province on the border with Turkey. (AFP file photo) Once again, the quality of these products is widely considered to be lesser than the alternatives, but the lower prices mean they are nonetheless an attractive option for impoverished Syrian consumers. “Today I cooked macaroni made in a factory named after Ayatollah Ruhollah Khomeini,” Bassam, a farmer living in Hama, told Arab News. Abu Omar, a farmer from western Daraa, told Arab News that farmers in southern Syria are banned from exporting their produce until the needs of the local market are satisfied. Yet at the same time, Iranian goods are allowed to flood the Syrian market during the harvest season, harming the ability of local farmers to turn a profit. In this file photo, Syrians work on a small field in a camp for internally displaced. (Photo courtesy of FAO) “The farmer comes out losing money at the end of the harvest, having bought pesticides and diesel in dollars, paid the agricultural engineer (providing the seeds) in dollars, and his workers,” said Omar. Farmers in southern Syria have appealed to the government for additional help but few dare to suggest that a halt to Iranian imports is needed to reset the balance. “This is a state policy. A person can’t change it,” said Omar. “And if you offer your opinion, you can walk yourself right into prison.”

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At least 22 wounded in Russian strike in western Ukraine

Kyiv: At least 22 people were wounded when Russia struck the Ukrainian town of Chortkiv, the regional governor said Sunday, marking a rare attack in the west of the country. “Yesterday at 19:46 (1645 GMT) Chortkiv was hit by four missiles, all fired from the Black Sea,” Volodymyr Trush said in a Facebook post, adding…

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Kyiv: At least 22 people were wounded when Russia struck the Ukrainian town of Chortkiv, the regional governor said Sunday, marking a rare attack in the west of the country. “Yesterday at 19:46 (1645 GMT) Chortkiv was hit by four missiles, all fired from the Black Sea,” Volodymyr Trush said in a Facebook post, adding that all of those wounded were hospitalised.

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