SCOTT SIMON, HOST:
The number of mpox cases in the Democratic Republic of Congo continues to rise. According to the World Health Organization, Congo has over 26,000 suspected cases - over 80% of the world's total. The heart of this outbreak is in South Kivu, in the east of Congo, where children seem to be bearing the worst of the disease. Emmet Livingstone reports from the border town of Uvira.
EMMET LIVINGSTONE: A group of small children sit on the steps of an mpox isolation center in Uvira Hospital, eating from a shared bowl of rice. Their hands and faces are covered in pustules, the distinctive mark of mpox infection. Most of the patients here are children, many under the age of 5.
SHANGULA SALOMON: (Speaking French).
LIVINGSTONE: Dr. Shangula Salomon, who runs the isolation center, says that children's weaker immune systems may explain their susceptibility to mpox. The majority of the infections are from a fast-spreading strain of the disease known as mpox clade 1b, a mutation that remains poorly understood. Scientists only identified it for the first time in September. It causes skin rashes and mouth sores, and, at its most severe, brain inflammation and even death. Chito Mweze, a 24-year-old man, has just been committed to the isolation center.
CHITO MWEZE: (Speaking French).
LIVINGSTONE: "It starts with a fever," he says. "Your head hurts, and you scratch yourself all night." Mweze, whose hands are covered in blisters, says he's already feeling better. And, as a young adult, his prospects of making a full recovery are strong.
PANZU NIMI: (Speaking French).
LIVINGSTONE: Dr. Panzu Nimi, the head of Uvira Hospital, says his team has identified 800 suspected cases of mpox here, but the true number isn't clear. Nearly 1,000 people have died from mpox in the Congo in this latest outbreak, with many finding it impossible to get treatment. In South Kivu, those infected with mpox can travel hundreds of kilometers across nearly impassable mud roads to reach Uvira Hospital. Here in Uvira, the testing laboratory in the nearest city has only managed to send back three results since May, a consequence of shortages of chemicals needed to conduct the test and the region's abysmal roads.
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UNIDENTIFIED HEALTH OFFICIAL: (Speaking French).
LIVINGSTONE: As people cross the border from nearby Rwanda, health officials warn travelers to be careful of the dangers of mpox. The region is deeply impoverished, and in Uvira, sanitation is poor. Cholera is endemic.
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LIVINGSTONE: It's from Uvira's lively and densely populated neighborhoods that many of the mpox cases are cropping up.
TABO MWAVITA: (Speaking Kinyarwanda).
LIVINGSTONE: Tabo Mwavita sells charcoal in a market near a trash-strewn river. She says she's seen photos of the pustules and is frightened of infection. It's still not clear how mpox clade 1b is transmitted. But skin-to-skin contact is thought to spread the disease, as is sex work, which is ubiquitous here.
MARIE MITHILA PONGA: (Speaking French).
LIVINGSTONE: The head of the office for women and gender at the town hall, Marie Mithila Ponga, keeps in contact with sex workers. Ponga says a single sex worker might see upwards of 10 clients a day, and many of them have fallen ill. It's because of poverty, she says. But the women are aware of the risks. She's reached out to a small proportion of the sex workers, and they say they're interested in taking an mpox vaccine. And, after months of waiting, the immunization campaign can finally begin. But it's just a start. Tackling other underlying issues such as malnutrition and poor water supply is critical. For now, doctors and aid organizations say that everything is in short supply, and the challenges to stopping the disease in its tracks steep.
For NPR News, I'm Emmet Livingstone in Uvira.
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