Mpox: This gold mining town in Congo is the epicenter of the latest outbreak

KAMITUGA, Congo (AP) — Divine Wisoba lay slumped on a mound of earth, pulling weeds from her daughter's grave. The month-old baby died by mpox In Eastern Congo in August, but 21-year-old Wisoba was too traumatized to attend the funeral.

On her first visit to the cemetery, she cried into her shirt for the child she had lost and worried about the rest of her family. “When she was born, it was as if God had answered our prayers – we wanted a girl,” Wisoba said of little Maombi Katengey. “But our greatest joy turned to despair.”

Her daughter is one of more than 6,000 people authorities suspect have contracted the disease in South Kivu province, the epicenter of the recent global epidemic. MPOX outbreakwhat the World Health Organization calls a global health emergencyA new variant of the virus spreads primarily through skin-to-skin contact, including sex. A lack of money, vaccines and information is making it difficult to contain the spread, worried epidemiologists say.

Mpox – which mostly causes mild symptoms such as fever and body aches, but can also trigger severe cases with noticeable blisters on the face, hands, chest and genitals – had spread largely undetected in Africa for years until an outbreak reached more than 70 countries in 2022. Globally, gay and bisexual men made up the vast majority of cases in that outbreak. But officials point out that Mpox has long disproportionately affected children in Africa, and they say cases are now rising sharply among children, pregnant women and other vulnerable groups, with many types of close contact responsible for the spread.

Health authorities have focused on Kamituga, a remote but bustling gold mining town of about 300,000 people that attracts miners, sex workers and traffickers who are constantly on the move. Cases from other parts of eastern Congo can be traced here, officials say, with the first coming from the nightclub scene.

Since the outbreak began a year ago, nearly 1,000 people have been infected in Kamituga. Eight have died, half of them children.

Challenges on site

Last month, The World Health Organization said With government leadership and cooperation, MPOX outbreaks could be stopped in the next six months.

But in Kamituga, people say, the reality is completely different.

The general hospital, which regularly reaches its capacity limits, is seeing an average of five new cases per day. Overall, the number of new suspected cases per week in South Kivu has risen from around 12 in January to 600 in August, according to the province's health authorities.

But even that figure is probably an underestimate, they say, because of a lack of connectivity to rural areas, many residents have no access to medical care, and because Kamituga's situation is only temporary.

Locals say they simply don’t have enough information about Mpox.

Before her daughter became ill, Wisoba said, she was infected herself but did not know it.

Painful sores formed on her genitals, making it difficult for her to walk. She thought she had a common sexually transmitted infection and went to a pharmacy to look for medicine. Days later, she went to the hospital with her newborn and was diagnosed with Mpox. She recovered, but her daughter developed sores on her foot.

Almost a week later, Maombi died in the same hospital where her mother had been treated.

Wisoba said she didn't know about Mpox until she got it. She wants the government to invest more in educating the public about protective measures.

Local authorities cannot reach areas more than a few kilometers outside Kamituga to trace suspected cases or inform residents. They broadcast radio messages but say these do not reach far enough.

Kasindi Mwenyelwata goes door to door explaining how to detect Mpox – by looking for fever, pain or lesions. But the 42-year-old community leader says that due to a lack of funds, he lacks the right materials, such as posters with pictures of patients, which he says are more informative than words.

ALIMA, one of the few aid organizations working against Mpox in Kamituga, does not have the resources to set up programs or clinics that would reach around 150,000 people, according to program coordinator Dr. Dally Muamba, and its budget will be exhausted by the end of the year.

If support continues to wane and Mpox spreads, he said, “it will have an impact on the economy. People will stop coming to the area as the epidemic takes its toll. … And as the disease spreads, will resources be sufficient?”

The vaccine vacuum

Health experts agree: What is most urgently needed are vaccines – even though in Congo they are only available to adults and are subject to emergency approval.

None have yet arrived in Kamituga, a priority town in South Kivu, officials say. It is unclear when or how they will get there. The main road into town is unpaved and barely passable by car during the ongoing rainy season.

If they have made it this far, it is unclear whether supply can meet the demand of those most at risk and first in line: medical staff, sex workers, miners and motorcycle taxi drivers.

Congo's government has earmarked more than $190 million for its initial vaccination campaign, including the purchase of three million doses, according to a draft national vaccination plan circulated among health experts and aid groups this month and obtained by The Associated Press. But so far only 250,000 doses have arrived in Congo and the government has allocated just $10 million, the Finance Ministry said.

Most people with mild cases recover in less than two weeks. But lesions can become infected, and children or immunocompromised people are more susceptible to severe cases.

Doctors can ensure the cleaning of the lesions and administer painkillers or antibiotics in case of secondary infections such as sepsis.

But even those who recover can still become infected with the virus again.

A new variant, a lack of understanding

Experts say a lack of resources and knowledge about the new variant makes it difficult to give people advice on how to protect themselves. An internal report circulating among aid groups and organizations seen by the AP described confidence in available information about MPOX in eastern Congo and neighboring countries as low.

Although the variant is known to be more easily transmitted through sex, it is unclear how long the virus stays in the body. Doctors advise recovered patients to abstain from sex for three months, but admit that this number is largely arbitrary.

“Studies have not clarified whether you are still contagious or not… whether you can have sex with your wife or not,” said Dr. Steven Bilembo of Kamitugas General Hospital.

Doctors say they are seeing cases they simply don't understand, such as pregnant women losing their babies. Of 32 pregnant women who have contracted the virus since January, nearly half have lost their babies through miscarriage or stillbirth, hospital statistics show.

Alice Neema was among them. From the hospital's isolation ward, she told AP that she had noticed wounds on her genitals and fever – but did not have enough money to ride the 50 kilometers by motorbike to get help in time. After her diagnosis, she suffered a miscarriage.

While information is slowly coming in, locals report that fear is spreading with the new variant.

Diego Nyago said he took his two-year-old son Emile for circumcision when he developed fever and skin lesions.

It was Mpox – and today Nyago is grateful that the medical staff noticed his symptoms.

“I didn't believe children could get this disease,” he said as doctors carefully poured water on the boy to bring his temperature down. “Some children die quickly because their families are not informed.”

“The ones who die are the ones who stay at home.”

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AP reporters Jean-Yves Kamale in Kinshasa, Congo, and Maria Cheng in London contributed.

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The Associated Press Health and Science Department receives support from the Science and Educational Media Group of the Howard Hughes Medical Institute. All content is the responsibility of the AP.