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Porous Border Could Hinder Efforts to Control the Outbreak of Ebola

Eastern Congo has battled the Ebola outbreak since last August

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Ebola, Congo, Uganda
People coming from Congo have their temperature measured to screen for symptoms of Ebola, at the Mpondwe border crossing with Congo, in western Uganda, June 14, 2019. VOA

Several well-trodden paths crisscross this lush area where people walk between Congo and Uganda to visit nearby family and friends and go to the busy markets.

The problem is that the pedestrians may unknowingly be carrying the deadly Ebola virus, and hindering efforts to control the current outbreak in eastern Congo, which has killed more than 1,400 people.

The busy border post is open 12 hours a day from 7 a.m., but after dark people walk along the “panyas,” or “mouse paths,” as the narrow dirt trails are known in the local Kiswahili language.

The footpaths show the close kinship between the two countries, where most people have relatives on both sides of the border. But as Ebola rages they are a source of worry for health workers and local authorities trying to prevent any further cross-border contamination. Eastern Congo has battled the Ebola outbreak since last August and last week the disease spread to Uganda, where two people died of the hemorrhagic fever.

Ebola, Congo, Uganda
The problem is that the pedestrians may unknowingly be carrying the deadly Ebola virus. Pixabay

“This border is very porous,” said James Mwanga, a Ugandan police officer in charge of the Mpondwe border post. “You will not know who has passed if the person went through the unofficial border posts, in most cases. Now there is anxiety and so on. We have heightened our alertness.”

The Ebola deaths in Uganda happened after a family of Congolese-Ugandans traveled to Congo to care for a family elder suffering from the disease.

Authorities believe members of that family, including a 5-year-old boy and his 50-year-old grandmother who have since died of Ebola , took a footpath back into Uganda. In doing so, they may have exposed many Ugandans to the viral disease.

The current outbreak in eastern Congo has become the second worst, after the West Africa epidemic of 2014-2016 in which more than 11,000 people died.

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The virus can spread quickly via close contact with bodily fluids of those infected and can be fatal in up to 90% of cases.

Despite new anti-Ebola vaccines, non-biological factors have made the outbreak difficult to control.

Eastern Congo is one of the world’s most turbulent regions, and rebels have attacked medical centers. Community resistance based in fear and mistrust has also hurt Ebola response work.

Identifying people who might have been exposed is crucial. The World Health Organization says at least 112 Ebola contacts have been identified in Uganda.

Ebola, Congo, Uganda
But as Ebola rages they are a source of worry for health workers and local authorities trying to prevent any further cross-border contamination. Pixabay

The outbreak is an “extraordinary event” of deep concern but does not yet merit being declared a global emergency , a Word Health Organization expert committee said last week.

Declaring an emergency could have “unintended consequences,” such as airlines stopping flights or governments closing borders, Preben Aavitsland, the acting chair of the committee, told reporters.

Congo’s Ministry of Health said the decision shows that its efforts to control the outbreak are effective, and some Congolese health workers are also opposed to declaring an emergency.

“Imagine if neighboring countries closed their borders because of us,” said Gerard Kasereka, a health worker who oversees preventive handwashing in the Congolese town of Butembo. “We would suffer because most of the people in Butembo make their living from commerce and most of our merchandise comes from Uganda, Kenya and Dubai.”

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Despite the obvious risks of further cross-border contamination, Ugandan health officials insist they are prepared to prevent the disease from spreading . They urge vigilance and advise people to avoid hugging and even handshakes. At multiple border crossings travelers must wash their hands in chlorinated water and have their temperature taken before they can proceed.

Uganda has faced several Ebola outbreaks in recent years and has succeeded in bringing them under control, although the area in western Uganda where last week’s deaths occurred has never experienced an outbreak. The country’s first outbreak, in 2000, infected 425 Ugandans and killed more than half of them in the country’s north. Another outbreak in 2007 killed 37 people in Bundibugyo, a remote district close to the Congo border.

“I cannot find a relative in Uganda who is willing to let me stay with them,” said Morian Kabugho, who lives in the Congolese village of Kasindipolo and crosses into Uganda to sell eggs in the busy market.

She complained of the health officials in Congo. “I am not happy with my government. The nurses are lazy. When you go to the nearest health center, they will tell you to go far away in Beni,” Kabugho said.

She said if she ever had a fever and feared she had contracted Ebola, she would cross into Uganda in hopes of getting better care there.

Local authorities acknowledge it is difficult to police the border but hope more people will heed safety messages.

“The challenge we have here is low levels of adoption of the messages we send to the people. A woman comes from Congo, avoids the border crossing and goes through a panya,” said Moses Mugisa, a town clerk who oversees the border area.

As many as 800 Congolese walk into Uganda daily at the Mpondwe border post, according to official figures, but there is no count of how many cross using the footpaths. The numbers swell on market days, when traders arrive with everything from vegetables to sacks of grain.

“The numbers are overwhelming,” said Primrose Natukunda, a branch manager with the Uganda Red Cross who supervises health teams screening travelers. “So, it’s not easy. It’s constant. Every minute you have to be on alert.”

When the border post is closed, the footpaths come alive after dusk, she said: “At night that’s where people pass. There is no one to stop them.” (VOA)

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WHO: Rise of Ebola Epidemic in DRC’s Goma Could be a ‘Game Changer’

Participants at the meeting agree on the urgent need to stop the Ebola virus now

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ebola epidemic
A man receives a vaccine against Ebola from a nurse outside the Afia Himbi Health Center on July 15, 2019 in Goma. VOA

The head of the World Health Organization warns the spread of Ebola to a large city in the eastern Democratic Republic of Congo could have dire consequences. The WHO chief spoke Monday at a high-level meeting that examined current efforts to contain the growing Ebola epidemic in Congo.

The Ebola outbreak in Congo’s conflict-ridden North Kivu and Ituri provinces is the second largest after the historic 2014 epidemic that killed 11,300 people in West Africa. As the first anniversary of the DRC epidemic draws near, the WHO reports nearly 2,500 people have been infected with the virus and 1,665 people have died.

WHO Director-General Tedros Adhanom Ghebreyesus says the effort to stop the spread of the disease has received another blow with the news that the first case of Ebola had been detected in the eastern Congolese city of Goma.

He says WHO was informed Sunday that a pastor who had traveled from Butembo was infected with the deadly virus.

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World Health Organization (WHO) director-general Tedros Adhanom Ghebreyesus (R) listens to a delegate at the end of a meeting organised the United Nations on the Ebola disease in DRC, on July 15, 2019, in Geneva. VOA

“The identification of the case in Goma could potentially be a game changer in this epidemic,” he said. “Goma is a city of two million people, near the border with Rwanda, and is a gateway to the region and the world.  We are confident in the measures we have put in place and hope that we will see no further transmission of Ebola in Goma.”

But Tedros agrees he cannot be sure of that.  And, so, he says he will reconvene a WHO Emergency Committee as soon as possible to determine whether Ebola in the DRC poses a global health threat.

The co-chair of this high-level conference, U.N. Emergency Relief Coordinator Mark Lowcock, considers a lack of funding and eastern Congo’s dangerous security environment to be the two biggest threats to the anti-Ebola campaign.

Recently, two Ebola responders were murdered in their home in the Congolese city of Beni. On the financial front, he notes less than half of the money needed to run the Ebola containment operation has been received, leaving a funding gap of $50 million.

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FILE – Mwamini Kahindo, an Ebola survivor working as a caregiver to babies who are confirmed Ebola cases, holds an infant outside the red zone at the Ebola treatment center in Butembo, DRC, March 25, 2019. VOA

Lowcock warns it will not be possible to get to zero cases unless there’s a big upturn in the response.

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“If we do not get an increase in the funding available, treatment centers are going to close,” he said. “There will be fewer teams to conduct training or to give life-saving vaccinations.  There will be fewer mobile teams available to immediately investigate, isolate, treat and trace each new case no matter where the disease pops up.”

Participants at the meeting agree on the urgent need to stop the Ebola virus now. They say Goma is a warning that will test the health community’s response, preparedness and ultimate ability to prevent further cases of Ebola in that big urban center. (VOA)