Fighting on the frontline to prevent the spread of the epidemic

Egide Irambona, 40, sat shirtless in a hospital bed near a window in a treatment room he shared with two other men.

The evening sun shone over Bujumbura, the main city of Burundi, and his face, bathed in soft light, was covered in blisters. His chest too, and his arms.

“The lymph nodes in my throat were swollen. It was so painful that I couldn’t sleep. Then the pain there subsided and moved to my leg,” he told the BBC.

Mr. Ilambona suffers from MPOX.

He is one of more than 170 confirmed cases recorded in Burundi since last month. It is one of the world’s poorest countries and borders the Democratic Republic of Congo, the epicenter of several recent MPO outbreaks that have killed at least 450 people and 14,000 suspected cases so far this year.

In Burundi, where no deaths have been recorded, it is unclear how deadly the current outbreak of a new strain called Clade 1b is because there is insufficient capacity in affected areas to conduct testing.

However, it has been declared a global health emergency due to concerns that it could spread rapidly to previously unaffected countries and regions.

This is Mr. Ilambona’s ninth day of treatment at King Khalid University Hospital. One way the virus spreads is through close contact with an infected person, who appears to have passed it on to his wife.

She is also being cared for at the same institution.

“I had a friend who got blisters. I think I got them from him. I didn’t know it was MPOX. Thankfully, none of our seven children showed any signs of infection,” said Ilan Bona said the gentleman, his voice trailing off.

This hospital in Bujumbura is home to one of three MPOX treatment centers in the city.

Fifty-nine of the 61 available beds are occupied by infected patients, a third of whom are under the age of 15, and according to the World Health Organization, children are the most affected age group here.

Odette Nsavyimana, the hospital’s chief physician, said the number of patients was increasing.

“We are setting up tents outside now.” So far, there are three – one for triage, one for holding suspected cases, and one for receiving confirmed cases before transferring them to wards.

“It’s hard, especially when the babies are born. They can’t be left alone, so I have to leave their mothers here too. Even though they don’t have any symptoms… it’s a really tough situation,” Nsawima Dr. Na said, her voice deepened by the sound.

Burundi is currently experiencing a surge in MPO cases.

“I’m concerned about these numbers. If they continue to increase, we won’t have the capacity to deal with this.”

We make a lot of efforts to isolate infected people from the rest of the hospital. There is red tape everywhere, and visitors are required to wear protective gear and maintain physical distance from infected people.

Medical officials worry about limited resources. The country has only one laboratory that can test blood samples for the virus, a shortage of test kits and no vaccine.

Maintaining sanitary conditions throughout Bujumbura is also difficult due to limited basic resources such as water in the city. Running water was scarce and people queued at public taps.

Dr. Lilian Nkengulutes, national director of the Public Health Emergency Operations Center, said she is really worried about the coming days.

“This is a real challenge. The fact that diagnosis is only done in one place delays the detection of new cases.

“The health center called the laboratory to say they had a suspected case, but it took time for the laboratory team to deploy to where the suspected case was to collect samples.

“And it takes more time to release test results. We need about $14 million (£10.7 million) to at least take our response to the next level,” she said.

While there are rumors that vaccines could arrive in the Democratic Republic of Congo as early as next week, there have been no reports of similar action in Burundi.

The public’s awareness of MPOX is limited.

Just 20 minutes from the border with the Democratic Republic of Congo, Bujumbura is a hub for cross-border travel and trade. But they were unaware of the possible risks of the epidemic.

The city is bursting with activity. People are still buying and selling goods as usual. Handshakes, hugs and very close contact are the norm. Long queues formed in front of bus stops as people rushed to board already packed public service vehicles.

“Many people don’t understand the seriousness of the problem. Even where there are cases, people are still just socializing,” Dr. Nkenguluz said.

The BBC spoke to several people in Bujumbura and most had no idea what MPOX was. And those who do so don’t realize it’s spreading in their country.

“I’ve heard about this disease but never seen anyone with it. I’ve only seen it on social media,” one person said.

“I know it affects babies and young people. I’m scared, but that doesn’t mean I’m going to stay home. I have to work. My family has to eat,” said another.

Health workers know that persuading people to be more careful can be difficult for a skeptical population facing a host of financial challenges.

But they will continue to treat patients, ensure they recover, and try to trace those who have come into contact with them to curb the spread of the virus.