Race to keep Ebola at the border

MPONDWE, Uganda – On Tuesdays and Fridays 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 outdoor 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.

A health worker from the World Health Organization gives an ebola vaccination to a primary care provider in Mangina, Democratic Republic of Congo. Associated Press / Al-hadji Kudra Maliro

Uganda moved quickly and made the precautionary measures a week after the last outbreak was declared on August 1st. It has found six suspected cases 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 10th Congo, was declared just 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 current outbreak is still escalating, according to Redfield and workers from non-governmental organizations who have worked to treat victims and to interrupt the spread of the disease.

"Really, in two weeks time we went from 24 cases to 105 cases", said Redfield, especially because many health workers in a hospital in Mangina, where the outbreak began, became infected when they 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, making health workers and family members of patients at 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.



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