無國界醫生組織：剛果伊波拉疫情爆發六個月後仍未控制

奧莉維亞・勒普瓦德萬與珍妮佛・里格比報導By Olivia Le Poidevin and Jennifer Rigby

日內瓦11月12日（路透社）——無國界醫生組織（Médecins Sans Frontières，MSF）週四表示，剛果伊波拉疫情爆發6個月後，可能仍有許多病例未被掌握，一些地區醫院內傳播猖獗，病毒仍在失控擴散。GENEVA, Nov 12 (Reuters) - Six months into Congo's Ebola outbreak, many cases are likely being missed, transmission in hospitals in some areas is rife and the virus is still spreading out of control, Médecins Sans Frontières said on Thursday.

目前確診病例數已超過1萬1000例，這波疫情在5月中宣布爆發，由罕見的 Bundibugyo 病毒種引起，目前沒有獲准使用的治療方法或疫苗，是有紀錄以來第二嚴重的伊波拉疫情。With the number of confirmed cases now surpassing ‌11,000, the outbreak — declared in mid-May and caused by the rare Bundibugyo species of the virus, for which there are no approved treatments or vaccines — is the second-worst on record.

不過，這個醫療慈善組織表示，援助並未送達最需要的人手中，並指出問題包括人員未受訓且未領薪、救護車沒有燃料，以及缺乏監測團隊與物資，無法安全處理疑似病例。Help, however, is not reaching those who need it most, the medical charity said, pointing to untrained and unpaid staff, ambulances without fuel and a lack of surveillance teams and supplies to safely manage suspected cases.

MSF國際主席賈維德・阿卜杜勒穆奈姆（Javid Abdelmoneim）醫師週四表示：「儘管已有龐大資金投入應對，許多第一線醫護人員卻只能在既缺物資、也缺經費的情況下，試圖控制疫情。」"Despite the vast amounts of money provided for the response, many frontline responders are left trying to contain the outbreak with empty hands and empty pockets," Dr. Javid Abdelmoneim, MSF's international president, said on Thursday.

他說：「我們的團隊經常對他們在許多地區目睹的運作失靈感到無言以對。應對行動已進行6個月，這種情況根本無法接受。」"Our teams are often left speechless by the dysfunctions they witness in many areas. Six months into the response, this situation is simply unacceptable," he said.

MSF呼籲剛果政府及包括世界衛生組織（WHO）在內的聯合國各機構，確保已動員的資源能轉化為現場支援。MSF called on the Congolese government and UN agencies, which include the World Health Organization, to ensure the resources that have been mobilised translate into support on the ground.

剛果政府未立即回應路透社的採訪詢問。The Congolese government did not immediately respond to Reuters requests for comment.

流行病學家：可能只有半數病例被偵測到ONLY HALF OF CASES LIKELY DETECTED, EPIDEMIOLOGIST SAYS

在週三另一場簡報會上，英國流行病學家尼爾・佛格森（Neil Ferguson）表示，病例偵測仍是一大挑戰。他一直在為這波疫情進行即時模型分析。At a separate briefing on Wednesday, British epidemiologist Neil Ferguson, who has been working to model the outbreak in real time, said case detection remained a major challenge.

他說，因此一年後疫情很可能仍在持續傳播，這波疫情也可能超過2014至2016年西非疫情。該疫情是史上最大規模，共有逾2萬8600例病例，並造成超過1萬1000人死亡。For that reason, he said it was likely transmission would still be ongoing a year from now and the outbreak could outstrip the 2014-2016 West African outbreak — the biggest ever — which saw more than 28,600 cases and killed more than 11,000 people.

倫敦帝國學院流行病學家兼公共衛生主任佛格森表示：「在整場疫情中，我們認為實際發生的病例大概只有一半被偵測到。」"Throughout the outbreak, we think we're probably only detecting about half of cases which are occurring," said Ferguson, an epidemiologist and director of public health at Imperial College London.

他的團隊估計，剛果目前有2000至3000名伊波拉患者。His team estimated there are currently between 2,000 and 3,000 Ebola patients in Congo.

挑戰：從物資短缺到致命攻擊CHALLENGES: FROM LACK OF SUPPLIES TO DEADLY ATTACKS

MSF表示，剛果不同地區面臨不同挑戰，其中一些地區是衝突地帶。MSF said different regions of Congo, some of which are conflict zones, faced varying challenges.

例如在伊圖里省，MSF治療的伊波拉患者中，只有9%是已知病例的接觸者。For example, in Ituri province, only 9% of Ebola patients treated by MSF were known contacts of existing cases.

MSF補充說，過去1個月，通報的伊波拉相關死亡病例中，近三分之二發生在社區，而不是治療中心。Over the last month, close to two-thirds of reported Ebola-related deaths have occurred in communities rather than in treatment centres, MSF added.

MSF表示，醫療環境中從用水到氯等物資不足也是風險，並舉北基伍省貝尼衛生區為例；據信當地近四分之三的伊波拉患者是在這類場所感染。A lack of supplies from water to chlorine in healthcare settings was also a risk, MSF said, citing the Beni health zone in North Kivu, where almost three-quarters of Ebola patients are believed to have contracted the disease in such locations.

路透社詢問MSF的批評時，WHO提到其秘書長譚德塞（Tedros Adhanom Ghebreyesus）週二的談話；他在談話中承認，存在醫護人員薪資延宕等問題。Asked by Reuters about MSF's criticisms, the WHO pointed to remarks made by its Director-General Tedros Adhanom Ghebreyesus on Tuesday in which he acknowledged issues like health worker payment delays.

他說，WHO正與剛果當局、非洲疾病管制暨預防中心（Africa CDC）和其他夥伴合作，以強化應對行動，但他警告，安全局勢不穩，尤其是醫療設施遭攻擊，已成為遏制疫情的最大障礙之一。He said the WHO was working with Congolese authorities, the Africa CDC and other partners to strengthen the response, but warned that insecurity, notably attacks on health facilities, had become one of the biggest obstacles to containing the outbreak.

他說，上週北基伍省坎廷-阿洛亞鎮發生一起攻擊，造成66名平民死亡，其中包括3名醫護人員，是地方當局最初通報死亡人數的兩倍。這起事件也導致超過1000名接觸者失聯、無法追蹤，另有3名伊波拉確診患者未能掌握行蹤。An attack in the town of Cantine-Aloya in North Kivu last week killed 66 civilians, including 3 health workers, he said, double the initial death toll reported by local authorities. It also led to more than 1,000 contacts being lost to follow-up and 3 confirmed Ebola patients left unaccounted for.

（達卡克萊芒・博內羅補充報導；喬・巴維爾編輯）(Additional reporting by Clément Bonnerot in Dakar; Editing by Joe Bavier)