GOMA, DR Congo — An ever-growing number of patients have been flocking to a Goma hospital in eastern Democratic Republic of Congo, where a rapidly-spreading epidemic of mpox has erupted in recent months.

Five to 20 people are walking each day into Nyiragongo General Referral Hospital in North Kivu to consult overburdened medical teams at an outdoor isolation center, fearing they are ill with the virus.

The disease can spread from animals to humans, but also human-to-human through sexual or close physical contact.

Doctor Tresor Basubi inspected the breathing and heartbeat of a calm little girl whose body was covered in skin lesions caused by the disease, which has killed 548 people in the DRC so far this year.

Health workers and patients are seen at the Mpox treatment center at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. AFP PHOTO

Cases have now surfaced in all provinces of the DRC, a country of 100 million people.

"This is just the start, the child is not asthenic, she does not show severe symptoms, she can walk on her own," said Basubi as he examined the girl.

In benign cases, which make up the great majority of infections, treatments can help relieve the symptoms — including paracetamol to reduce fevers and a zinc oxide cream to soothe the lesions.

"Patients get itchy but the scars go away with time," the doctor added.

While mpox cases have emerged previously, a new more deadly and more transmissible strain of the virus — clade 1b — causes death in around 3.6 percent of cases, with infants and children being more at risk, according to the World Health Organization (WHO).

The displaced at risk

The DRC, which has recorded around 16,000 cases so far this year, is the epicenter of an epidemic that led the WHO to trigger Wednesday its highest level of international alert.

The neighboring province of South Kivu alone has been detecting some 350 new cases per week, said Justin Bengehya, an epidemiologist at the provincial health division of South Kivu.

Health workers walk between wards at the Mpox treatment center at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. AFP PHOTO

Goma, the capital of North Kivu, almost surrounded by an armed rebellion and where hundreds of thousands of displaced people are crammed into makeshift camps, fears a large-scale spread due to promiscuity.

There are at least 7.3 million displaced persons in the DRC, according to the UN Office for the Coordination of Humanitarian Affairs.

At the treatment center, parents held their contagious children in their arms despite risks of skin-to-skin transmission, and as staff has been raising awareness about prevention measures.

"My son was hospitalized here for mpox, and my daughter was looking after him. After they got out on a Sunday, my daughter began showing the same symptoms by Wednesday," said Deogracias Mahombi Sekabanza, a health worker who brought his daughter Confiance.

Sekabanza said his son was infected after playing with friends.

"We are scared"

Furaha Makambo has been living in a nearby tent with her three children, Ornella, Rachelle and Baraka — all contracted mpox on the camp where they have been displaced.

"My children sleep on the same bed and they are constantly contaminated at the same time, and I didn't have an extra bed to separate them," said Makambo.

After her husband passed away, she fled from her home in Masisi territory in eastern DRC, where violent armed groups are operating, and sought refuge in Goma.

Health workers walk at the Mpox treatment center at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. AFP PHOTO

Dozens of militias from both the DRC and neighboring countries have been fighting in the country's east for 30 years.

"We are scared, this disease needs to be eradicated so that it stops reaching the displaced because it can exterminate us," she told AFP.

While preventative measures and experience from previous epidemics are helping staff respond to suspected cases swiftly, children in particular struggle with social distancing.

"This disease is very contagious. If you touch the sweat, urine or even clothes of a sick person, you are directly exposed," said doctor Basubi.

"Washing hands with soap or ashes can help protect you but there is no guarantee," he added.

In a tent she shares with three children from other families, Nyota Mukobelwa, a doughnut vendor who was displaced by fighting, sat on her bed, chuckling elegantly in front of cameras.

"The vaccine needs to be available, otherwise the epidemic will continue to spread, many people will die and we will contaminate our children at home," she said.

The WHO has urged manufacturers to ramp up production of mpox vaccines to rein in the spread of clade 1b cases, asking countries to donate stockpiles to countries with outbreaks.

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