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Posted by Alma Golden on Friday, September 14, 2018
With the confirmation of the 10th Ebola outbreak in the Democratic Republic of the Congo in the provinces of North Kivu and Ituri, health officials have focused on border screening to identify potentially dangerous travelers for local communities.
Recently, I went to the border between DRC and Uganda with the director of the US Center for Disease Prevention and Control (CDC), Dr. Robert Redfield and the US Department of Health. American ambassador to Uganda, Deborah Malac.
The border between Uganda and the DRC is porous. Several times a week, small traders, mostly women, transport goods and food across the border by bike, cart or head. In addition to traders, local farmers, traders, businessmen and refugees cross the region.
In Busunga, a border post in western Uganda, the shallow Lamia River is a physical barrier between the two countries. People cross the river on foot, while others do laundry, wash their motorcycles and take baths in the river flowing near the Rwenzori mountain range. On market days, Wednesdays in Uganda, nearly 500 people are screened for the Ebola virus.
There are 16 other informal crossing points nearby. At the busiest border crossing point, Mpwonde to the south, more than 12,500 travelers cross each day. And on Tuesdays and Fridays, which are market days in Mpwonde, the number of travelers and customers can be multiplied by five.
The early identification, confirmation and isolation of possible Ebola cases are essential to stop the outbreak as early as possible. Volunteers of the Uganda Red Cross Society screen travelers at all border crossings. Volunteers have been trained in the signs and symptoms of Ebola and are equipped with screening tools.
The health screening procedures include hand washing with chlorinated water and soap and a traveler temperature check with the help of a thermoscan thermometer able to detect a fever in a few seconds. Screeners receive simple, illustrated brochures that provide information on Ebola symptoms and how to prevent the spread of the virus.
People with Ebola may experience symptoms similar to those of malaria and other endemic infectious diseases, including typhoid fever and Rift Valley fever. The Ebola virus spreads from one patient to another when there is direct contact with body fluids.
Travelers suspected of having Ebola symptoms are referred to the Bwera Hospital for further evaluation; ambulances are available to transport people with symptoms to an isolation unit until the tests are completed. Health workers were given protective gloves, gowns, masks and other equipment provided by the WHO to reduce the risk of contact with the Ebola virus.
Border control is only one important element of the complex response to this crisis.
In the United States, in the Democratic Republic of the Congo, the United States Government, through USAID, supports key interventions to control the spread of the Ebola virus: disease surveillance, contact tracing, triage and isolation ; prevention and control of infection; diagnostic laboratory support; community involvement; risk communication; water, sanitation and hygiene interventions; and safe and dignified funeral activities.
In the DRC, through trusted messengers, community leaders and radio, communities learn quickly how to protect themselves by learning the basics of the disease, how it is spread and what they can do to prevent it , heal and transport. bury the dead safely. A targeted vaccination campaign is underway and initially follows a ring vaccination protocol: vaccines are administered to front-line health workers and intervention teams, contacts of confirmed cases and contacts of these contacts.
The US government also provides expertise and supplies. The CDC and USAID have deployed more than a dozen technical experts in the region to support the response. And USAID helped the World Health Organization (WHO) to send 20,000 personal protection kits (full suits, hard gloves and goggles) and 50,000 universal care kits (surgical masks, masks and gloves, and disinfection equipment). response efforts in the DRC provinces affected by the Ebola virus.
Congolese and Ugandans have demonstrated a strong ability to manage epidemics. However, Ebola has never been so striking in a region like this. The region suffers from chronic insecurity due to local militias and is in the midst of a long-term humanitarian crisis, which prevents international and national actors from fully deploying measures to control the disease.
USAID has a long history of engagement in the health sector in the DRC, having worked to improve maternal and child health, immunizations, HIV diagnosis and treatment, as well as prevention and prevention. management of malaria and tuberculosis.
The clinics, health workers, laboratories and health systems supported by USAID funding in Uganda and DRC provide the basis for the response to the current epidemic. The DRC's national laboratory, with the support of USAID and other donors, has rapidly sequenced the virus and provided essential laboratory capacity in the field to diagnose the disease at the site of the disease. ;epidemic. The Ministry of Health provides vital leadership in coordinating provincial and national responses.
My visit to the DRC and Uganda was enlightening. I am impressed by the dedication, determination and competence of our health ministry partners and the countless epidemiologists, clinicians, logisticians, social mobilizers, vaccinators and volunteers who are fighting the epidemic.
ABOUT THE AUTHOR
Alma Golden is Assistant Deputy Director of Global Health at USAID.
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