Kenya keeps vigil to keep Ebola at bay

As dawn breaks over the bustling Malaba One Stop Border Post between Kenya and Uganda, the movement of people and goods is already in full swing. Long-distance trucks rumble toward the crossing after journeys stretching from the Democratic Republic of Congo, South Sudan and Uganda.

Traders clutch bags of merchandise as they rush toward markets across the border, while motorcycle or boda-boda taxi riders weave through crowds of pedestrians.

Before anyone crosses, however, they must stop. Police officers direct the travelers toward designated screening points, where health workers and volunteers stand ready with thermal scanners, hand sanitizers and protective gear. Every traveler is required to wash or sanitize their hands before proceeding further.

Truck drivers park their vehicles and join the line alongside traders, businesspeople and passengers, waiting patiently to have their temperature checked.

The work is relentless. At times, the volunteers appear overwhelmed by the sheer number of people passing through one of East Africa’s busiest border crossings. Yet, they continue screening every traveler, determined that no one slips through unnoticed.

High alert

Behind what many travelers see as a routine health check lies Kenya’s first line of defense against Ebola.

Although Uganda has declared the end of its latest Ebola outbreak, health authorities at Malaba remain on high alert because DR Congo continues to report infections. The constant movement of people across the region means the threat has not disappeared.

The heightened vigilance comes as DR Congo battles a rapidly expanding outbreak of the Bundibugyo strain of the Ebola virus. According to a statement published on Wednesday, the country had recorded 3,973 confirmed cases and 1,801 deaths across Ituri, North Kivu, South Kivu, Haut-Uele and Tshopo provinces as of Tuesday, since the outbreak began in mid-May, registering a fatality rate of more than 45 percent.

The outbreak, caused by a strain for which there is no approved vaccine or targeted treatment, has become one of the country’s most challenging Ebola epidemics.

The World Health Organization has warned that insecurity, population displacement and cross-border movement continue to hamper response efforts and increase the risk of further spread, underscoring the importance of border surveillance in neighboring countries such as Kenya.

“Kenyans, we are prepared,” said Evelyn Walela, public health officer in charge of Malaba Port. “We’ve been screening every person coming in. We have officers at the point of entry and at the gates. Anyone whose temperature is above the normal range is isolated immediately as we continue monitoring them.”

Walela said the screening process begins the moment travelers arrive at the border. Officers use overhead thermal scanners and handheld thermal guns to check temperatures, while information, education and communication materials displayed across the crossing help travelers recognize Ebola symptoms and understand how the disease spreads.

Hand-washing stations and sanitizers have been installed throughout the point of entry, while health workers conducting screenings wear gloves, masks and protective aprons and regularly sanitize their hands.

If a traveler records a high temperature, they are escorted to a tent located just a few meters from the screening area, where nurses continue to monitor them.

“After every five minutes, the temperature is taken again,” Walela said. “If it remains high, we notify the subcounty disease surveillance team, which works with the laboratory personnel, to collect samples. If necessary, the patient is transferred by a designated ambulance to the isolation center at the Alupe subcounty hospital in Busia County.”

The operation runs around the clock to keep pace with the constant flow of people at the border crossing. On average, about 1,500 travelers are screened at Malaba border post each day. Since enhanced Ebola surveillance began about two months ago, more than 50,000 travelers have been screened, according to the Port Health Office.

During the day, six health workers are deployed at the screening points, while three officers take over the night shift. The response team also includes two public health officers and a nurse, with three health workers specially trained to identify Ebola symptoms and respond to suspected cases.

So far, Busia County has recorded three suspected Ebola cases since enhanced surveillance began in late May — one in Malaba and two in Busia town — but all tested negative.

“Our biggest success has been training our staff and ensuring we have people working around the clock,” Walela said.

Health workers operate in day and night shifts, supported by additional county personnel because of the heavy traffic through the border.

Beyond screening, authorities regularly conduct awareness sessions with truck drivers and cross-border traders, educating them on Ebola symptoms and ways to reduce the risk of infection.

Still, the work is not without challenges. Some travelers attempt to bypass official crossing points through informal routes to avoid screening, while misinformation continues to fuel skepticism.

“There are people who say Ebola does not exist,” Walela said. “That’s why we continue working with community leaders, the media and organizations like the Kenya Red Cross to provide the correct information.”

Beyond the visible temperature checks, health workers also use All-Disease Outbreak Module or ADaM, a digital surveillance system to register travelers and capture their travel histories, allowing authorities to quickly trace contacts and monitor movements should a suspected Ebola case emerge. The digital platform has become an important tool in strengthening surveillance at the busy border.

For volunteers, preparedness is more than checking temperatures. Bonface Amwayi, a public health volunteer from Kampala, Uganda, spends his day screening travelers, recording travel histories and educating communities about Ebola prevention.

“This is our normal routine,” he said. “We work 12-hour shifts. Every day we screen travelers so that we make sure Ebola is not imported into our country.”

Besides screening, Amwayi helps counter misinformation circulating among travelers, particularly claims that Ebola is merely political propaganda.

“We do our best to inform people and demystify those myths,” he said. “The community has become more prepared through awareness campaigns, but we need to continue educating people because new residents arrive at the border all the time.”

He believes preparedness cannot stop even when outbreaks appear to subside.

“Ebola is fatal,” he said. “We are living in abnormal times, so we need to take abnormal measures. It is better to be safe than sorry.”

That commitment is echoed by Inviolata Mulwoto, a public health volunteer at the Malaba One Stop Border Post. Her responsibilities range from screening travelers and registering truck drivers to promoting infection prevention measures throughout the border.

“Many people think Ebola is not real,” she said. “Some believe it is just propaganda. But Ebola is a deadly disease that spreads very quickly. We are trying our best to prevent it from entering our country through screening, health education and community sensitization.”

Educating travelers

Kenya Red Cross volunteer Odeke Humphrey spends much of his day engaging directly with communities. Apart from assisting with screening, he educates travelers about Ebola, and good hygiene practices.

“Some people think Ebola is a way for the government to get money,” he said. “We explain that it is a virus, just like other infectious diseases, and encourage people to take prevention seriously.”

He believes stronger community engagement remains essential to overcoming fear and misinformation.

Their work reflects a wider lesson emerging from the outbreak in DR Congo. Speaking during an Africa Centres for Disease Control and Prevention media briefing, Director-General Jean Kaseya said the response would remain difficult unless authorities strengthened engagement with affected communities, where mistrust has undermined efforts to contain the virus.

“We need to rethink the way to work with the community if we really want to stop this outbreak,” Kaseya said. He urged governments to work closely with community leaders to promote safe burials, encourage people exposed to the virus to come forward for monitoring and protect healthcare workers from attacks. “There is no magical solution unless we really work with communities,” he said.

For many people living and working around the border, Ebola preparedness has become part of everyday life.

Raphael Omuse, a clearing agent at the Malaba border, said that fear surrounding Ebola has changed the atmosphere at the crossing, with some businesses losing customers during periods of heightened concern. “People became scared,” he said. “Some shops closed and some people lost their capital.”

Others acknowledge that while the screening process can be time-consuming, it provides reassurance.

Every day, boda-boda rider Geofrey Vincent from Uganda makes the short journey between Uganda and Kenya, a trip that now begins with a stop at the health screening point. Like hundreds of other cross-border commuters, he has embraced the routine.

“I wash my hands all the time and avoid getting too close to anyone I suspect may have Ebola,” he said. “The screening is a good service.”

Small price to pay

For him, the few extra minutes spent at the checkpoint are a small price to pay for protecting himself and his passengers.

For Ashraf Kasauli, a truck driver from Kampala who regularly ferries transit vehicles across the Kenya-Uganda border, the outbreak has changed both his route and his income.

Since Uganda announced Ebola cases, he and other drivers have stopped making the full journey to Kampala, handing over vehicles at the border instead.

“It has affected our business because the amount you earn from reaching Kampala is not the same as what you get when you stop at Malaba,” he said.

Even so, Kasauli said the inconvenience is outweighed by the need to protect public health. Every time he crosses the border, he goes through the screening process before continuing his journey.

Like many truck drivers who spend days on the road crossing multiple borders, Cornelius Aruwa Onyando has learned to factor health screening into every trip. The fuel transporter, who regularly drives from Eldoret in Kenya to South Sudan, says waiting at the screening points can be frustrating, especially when the lines are long.

“Sometimes, there is a traffic jam because everyone has to be checked,” he said.

While his monthly salary remains unchanged, the delays mean he completes fewer journeys. “The more trips you make, the more money you earn,” he said. “So when we delay at the border, it affects my mileage.”

Still, he said the inconvenience is a small price to pay. “I wash my hands and keep a safe distance,” he said. “We all have to protect ourselves.”

For Mary Florence, adapting has become part of survival. The fish trader no longer crosses into Uganda to buy fish as she once did, relying instead on suppliers within Kenya.

“We used to get fish from Uganda in plenty, but now we no longer go there,” she said.

Even so, she believes vigilance is necessary. “Malaba is not very safe because many people cross this side every day. We mix with them in the market, so we still have to be careful,” she said.

Yet despite the disruptions, life goes on at Malaba. Trucks line up, waiting to cross. Traders continue to sell their goods. Travelers keep moving between the two countries.

Amid the constant movement, health workers, volunteers, police officers and community health promoters continue to carry out the same routine — screening one traveler after another, hour after hour.

Their work is largely invisible to those simply passing through the border. But for the men and women on the front line, every temperature check, every hand washed and every conversation correcting misinformation is another step toward preventing one of the world’s deadliest diseases from crossing into Kenya, a major transport hub of East Africa, and other countries.

“We are not off the hook yet,” Walela said. “Ebola is real. As long as cases continue to be reported in the DRC, we cannot put down our tools. We will continue screening to keep our communities safe.”

sharon@chinadailyafrica.com