San Francisco Frontiers - In Belgium, health expert readies to fly to DR Congo Ebola zone

Working with the Institute of Tropical Medicine in Antwerp, the specialist is assembling equipment, including testing kits, and plans to conduct a clinical study on site to trial new treatments.

"We prepare first of all mentally," Liesenborghs told AFP as he readied to leave at the weekend for Kinshasa and then Bunia, in Ituri province in northeastern DRC, where the outbreak is spreading.

"It's not scary, but you need to know what you're doing," said Liesenborghs, who travels regularly to the country and describes two types of "insecurity" in the present situation.

You need to "know where it's safe to go and where it's not safe to go", he said, given the unrest in eastern DRC, where armed groups regularly carry out massacres.

And then "obviously, the virus itself poses a lot of danger or risk", with the DRC in this case facing a relatively uncommon strain of Ebola known as Bundibugyo.

"Vaccines are not yet approved, drugs are not yet approved, and also the diagnostic tests are much more difficult," Liesenborghs said.

"So we need to reinvent the wheel here a little bit for this atypical variant," he said. "And that, on top of the geographical insecurity, makes this response very, very, very challenging."

The infectious disease specialist believes the outbreak could worsen in the DRC, though in line with the World Health Organization, he does not currently see a risk of a global pandemic.

- 'Conspiracy theories and distrust' -

On the ground, Liesenborghs will, like his colleagues, wear a full protective suit, two pairs of gloves, a hood, protective goggles and a mask.

"There's a very specific procedure how to dress, but especially undress," he explained. "And during every step, you're sprayed with chlorine to kill every potential virus that is still left on the personal protective equipment."

Under tropical temperatures, "five minutes within the suit and you're soaking wet," he said.

"You can imagine staying in this suit for an hour, you're completely drained and dehydrated -- so that's very challenging."

"In these conditions, you then need to work with patients who are very ill, who are very afraid," he said.

One of the major challenges is building a relationship of trust with local communities where the team is working.

"Epidemics can really thrive where you have conflict and instability," Liesenborghs said.

"Because people often think, or they don't know, is this response, is this Ebola treatment unit, is it associated with the government? Is it associated with rebels? So they inherently don't trust this.

"In addition to this, an Ebola treatment centre is a very scary place," he said. "People approach you in these spacesuits. It looks really creepy. And then you see people that come in, more than half of them don't come out alive.

"Add this to conflict, and of course you will have conspiracy theories and distrust."

R.Baker--SFF