MPONDWE, Uganda – On Tuesday and Friday, an estimated 19,000 people descend from the North Kivu Province in Congo to cross the border to this small town, many of which were on their way to a vast open-air market.
In recent weeks crossing the border has become more difficult because the Ugandan health authorities have taken measures to prevent the spread of the Ebola virus. An outbreak centered in North Kivu accounts for 105 confirmed or suspected cases, including 67 deaths, according to Robert Redfield, director of the US Centers for Disease Control and Prevention, who has just returned from the area.
Uganda is determined to prevent the deadly haemorrhagic fever from spreading to its side of the border. Before travelers are allowed through, they have to walk in small tubs with chlorinated water to disinfect their shoes, and their temperatures are taken with non-touch thermometer guns aimed at their sleep.
Uganda moved quickly and made the precautionary measures a week after the last outbreak was declared on August 1st. Six suspected cases were found at this junction, but laboratory tests have all solved them.
"So far we have not received a single case of Ebola," said Ithungu Honorata, a nurse who oversees the screening, said Friday. "But we do not want it to come to Uganda."
The last Ebola outbreak, the tenth of Congo, was declared only a week after a smaller outbreak in another part of the country was suppressed. It comes four years after the ebola epidemic in Liberia, Sierra Leone and Guinea killed more than 11,000 people, made more than 28,000 nausea and caused panic about travel in other parts of the world, including the United States.
The Topical the outbreak is still escalating, according to Redfield and employees of non-governmental organizations who have worked to treat victims and interrupt the spread of the disease
"Really, in two weeks time we went from 24 cases to 105 cases", said Redfield, mainly because many health workers in a hospital in the city Mangina, where the outbreak began, became infected when they were treated early patients without recognizing that they had Ebola and therefore did not take adequate precautions. The disease spreads through contact with the body fluids of victims, putting health professionals and family members of patients at the greatest risk.
"In the coming weeks we will have more clarity" about the scale of the problem, Redfield said.
"The scary thing is that we already have more than 100 cases," says Michelle Gayer, emergency aid director for the International Rescue Committee, a non-profit organization that helps in the region. But she said it would take another week for the health authorities to begin to fully assess how bad the outbreak can be.
"Everyone is rightly convinced that cases are still coming," said Karin Huster, Emergency Response Coordinator for Médecins Sans Frontières, who is in Beni, a city in the affected area of Congo.
Several factors make this outbreak a challenge. Years of conflict between militias and the government have caused large numbers of people to move and weaken the health infrastructure in the region. The instability also makes it difficult to travel to remote areas where cases have been discovered, such as Oicha, without military protection.
But unlike four years ago, when Ebola tore through part of West Africa, the authorities now have a vaccine and several experimental treatments developed in the interval. Redfield said that nearly 3,000 people have been vaccinated, with 400 to 600 more who receive the vaccine every day. Approximately a dozen confirmed cases have been treated with two experimental therapies, including one that has been developed at the US National Institutes of Health. All treated patients are still alive, he said.
The most successful way to stop an outbreak of this species is to detect all contacts of everyone infected with the virus and to test them for exposure. These people are isolated and treated if they are infected and vaccinated if they are not. The contacts of those contacts must be found and also assessed in a process known as "ring vaccination & # 39 ;.
Four years ago, the World Health Organization and the United States were accused of being too slow intervene in the West African epidemic . This time they both quickly moved into the area. And Doctors Without Borders opened a treatment center with 70 beds in Mangina on August 14, while the Alliance for International Medical Action has a center with 40 beds in nearby Beni. A third is being built, Redfield said.
Until now, according to Redfield, it is not necessary to test travelers at US ports of entry, partly because there are no direct flights to the United States from the affected region and screening of departing passengers is being carried out. Four years ago, the debate raged about whether or not to conclude all journeys from West Africa to the United States. President Trump, then a private citizen, was an outspoken supporter of that position and tweeted that the United States could not allow two infected American missionaries into the country for treatment.
Kent Brantly and Nancy Writebol were admitted to US hospitals and survived after receiving intensive care.
At the border of Congo-Uganda, Alphosine Kahindo (47) was on her way to the market, a journey of 12 hours on foot from her home in Kisima, to buy fish and soap and to sell a milky white liquor made from fermented corn. She said that her uncle is ill and that her brother died in the current outbreak. She did not attend his funeral, she said, because of the fear of infection.
"I longed to go, but I could not," she said.
On the market, sellers are also aware of the outbreak. Malik Meredith (45) sold piles of plump aubergines for babies. "No one is ill here," she said. "But we are afraid of it."
Bernstein reported from Washington.