Ebola: No taking chances with anybody crossing the border

Screening intensified for prevention

By Joachim Buwembo
ebola preparedness and response
UGDA/2019/Adriko
18 February 2019

While people from Kampala capital city get used to security checks using metal detectors on accessing public buildings and premises, those in the Ebola high risk districts of Kanungu and Kisoro now live with health and hygiene procedures at public venues instead. At the international border with Congo it gets more sophisticated as pistol-like infra-red thermometers are aimed at the heads of all persons entering Uganda.

The queue at Bunagana border post is long. About two thousand people cross into Uganda from the Democratic Republic of Congo every day. And though the ones from local communities are not subject to the immigration procedures, they have to go through the health screening for any possibilities of Ebola, hence the long queue.

Health workers from the government, Red Cross staff and volunteers and Village Health Team (VHTs) are manning the different screening tasks. Everybody crossing into the country, without exception, must step into the chlorinated water basin to disinfect their feet/shoes, wash their hands, listen to the briefing and have their temperature accurately measured with an infra-red thermometer. Then and only then are their particulars recorded from their Identity Card and they get cleared to enter into Uganda. A few cases have been noted since Ebola broke out in Congo in August 2018. These were mainly people whose temperature was slightly above normal, and most of them did not even know that they had a slight fever, notably malaria. These are put aside, observed for a period as further tests are carried out and then treated or advised on what to do.

The volunteers at the border live a hectic life as they try to defend the country from an invasion deadlier than an army equipped with ballistic weapons - Ebola. This invisible enemy keeps the volunteers on their toes, and they arrive at the border points of entry by sunrise, and only leave at sunset.

UNICEF Uganda

Pamela Chomugisha is a mother of three who arrives at the Bunagana border by seven in the morning and leaves after six. She is in a team of eleven, comprising eight men and two other young ladies. They do not earn for their work, but as a committed VHT, she has been sacrificing like this since September 2018. She however says that the task of checking arrivals for Ebola signs is less intolerable these days since more police personnel joined hands with the health workers to keep the Congolese people orderly. Otherwise it was simply terrible earlier when their stubbornness would get out of control.

But for the people who have always been free to ignore the border because they have family and daily economic activities on either side of the border, being subjected to such examinations is not accepted willingly. A Ugandan man who spent a night with his family in Congo and rushing to work in Uganda in the morning, a Congolese woman coming to do her work in Uganda before returning home in the evening, such are the daily circumstances that cannot be stopped, only made safer. So interconnected are the communities on both sides that there is even a Uganda police officer who lives in Congo and crosses the border to come to work in his country. His boss, the Officer –in – Charge of Bunagana Police Station ASP Douglas Bawe just ensures the man never goes home with his uniform, or any work equipment for that matter.

Besides the people who cross to engage in their daily activities, there are at least 120 refugees who cross into Uganda through Bunagana every day. The number often goes up to 150 in a day. The official travellers who go through Immigration for visas are also subjected to the health checks. And there is strictly no exception.

The Vice Chairperson of Kisoro District ,Ms Rose Manirakiza illustrates the enormity of the responsibility of screening at the border by giving a transport statistic. Every day, she says, thirteen passenger buses leave Kisoro for Kampala.  Public transporters therefore need to be sensitized on the need, and how to, observe their passengers. This is already standard practice for boda boda operators in Kisoro and Kanungu districts. Bus operators in the rest of the country, especially on routes from the West, should be sensitized to do the same.

In each of those buses are some people from DR Congo proceeding to Kampala on business or other personal matters, many of them involving bodily contact. If the screening in Kisoro is not thorough, then Ebola from Congo can easily end up in Kampala capital city, the most densely populated urban centre of Uganda, from where it would spread to all parts of the country.  
  
All over Kanungu and Kisoro districts, hand washing facilities have been installed by UNICEF with funding from UKaid. Chlorine generators are operated by tireless Red Cross volunteers to supply chlorine water to the wash tanks in schools, at offices and other busy places. 

Kanungu Chief Administrative officer (CAO) Eriab Begumya is happy with widespread use of chlorine water for sanitizing hands which, after all, so far has no other use unlike soap which can be diverted or hoarded.

Having worked in Bundibugyo where there was an Ebola attack several years back, he keeps reminding staff and task force members that Ebola can only be compared to a bush fire. By the time you are fighting it where you are, be sure the next three villages in all directions are not safe. The CAO is confident that the message has not only reached everybody in the district, but it is constantly repeated by the local council leaders who have been committed to reminding the population at all social gatherings, be it weddings of funerals, to remain vigilant.

The public has accepted to put off cherished cultural practices like hugging and handshaking.

An indication that the messages have been taken seriously was when recently a Ugandan who had been working in Congo died under mysterious circumstances and as the body was being brought for onward transportation, the locals immediately informed the authorities and the process was halted, for the specialized burial teams to take charge. It was a real drill on how to respond in case of an Ebola related death.

All in all, the people in Kanungu and Kisoro can recognize the signs of Ebola and know what to do. But the health workers have to keep repeating some reminders that even they are not sure how readily the people would abide in case the dreaded eventuality happened, like a child falling sick with the Ebola symptoms. The mother will instinctively cuddle it and the last thing on her mind would be to find gloves for touching her baby and for the mother having to surrender the baby to the health workers without being allowed even to see him/her during treatment is not easy to fathom.

Because of Ebola’s deadliness, the messages have to be repeated all the time because the situation is still of high alert. The disparity between the alertness in the border districts and the rest of the country is extremely wide.

For a while the border areas tightly man the Points of Entry, the rest of the country doesn’t observe these at the home or office level. People come and go without hygiene protocols (except when visiting a home with a new born baby, or when entering somebody’s poultry farm!) In border areas for example, people pose questions about the origin of any food stuff before buying it. And this is not just about cheap meat that becomes suspect for it could be from the bush. Even fruits are suspect, for a bat could have sucked juice from it and left its infested saliva therein. For much of the country, safety is still dependent a lot on luck.