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Are you prepared for an Ebola strike?

Thursday October 24 2019

A health worker outside Unicef tents at an Ebola treatment centre run by Medecins Sans Frontieres (Doctors without Borders) in Monrovia, on October 27, 2014. PHOTO | ZOOM DOSSO

A health worker outside Unicef tents at an Ebola treatment centre run by Medecins Sans Frontieres (Doctors without Borders) in Monrovia, on October 27, 2014. PHOTO | ZOOM DOSSO | AFP

RICHARD ODINDO
By RICHARD ODINDO
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The East African Community (EAC) Secretariat has called upon the partner states to increase risk and crisis communication by involving all leaders such as in the community and religious institutions as well as the media in raising public awareness on Ebola. At the same time, the Secretariat calls upon traders and travellers crossing border of Ebola-affected countries to take extra precaution, emphasizing that the Ebola Virus Disease (EVD) threat is real.

The unanticipated cases of the disease in regions previously considered non-endemic, coupled with inadequate infrastructure and susceptible, yet highly mobile populations, might have contributed to the outbreak, infecting over 60 times more individuals than any previous outbreak.

Communities need to be well prepared to prevent disease, detect it early, care for patients and take the right precautions

The Eastern Africa region has a population of 436,921,589, according to the United Nations. Within this region is the EAC, a regional partnership of six States with 150 million people and a combined gross domestic product of Sh7.4 trillion ($74.5 billion).

HUGE BORDER

The outer border of this region is probably longer than that of the entire Western Europe, with each country having seven different countries with whom to deal with in matters of cross-border migration.

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The concern is, does EAC have the capacity to monitor and control such a huge border? The movement across the porous border has a negative implication on the intensified screening to forestall the spread of Ebola, with increased cross-border infection risks. And hindering trade or travel could spur Ebola’s spread by driving the heavy traffic of merchants through illegal crossings where there are no infection screening measures.

Ebola virus was first described in 1976 near the Ebola River in what is now the Democratic Republic of Congo. Since then, the virus has emerged periodically and infected people in several African countries. The current outbreak in the DRC has infected 3,204 people and killed 2,142, as of October 5, 2019.

Transmission of Ebola between humans can occur through the following ways:

  • Direct contact through broken skin and mucous membranes with the blood, secretions, organs, or other body fluids of infected people.
  • Indirect contact with environments contaminated with such fluids.
  • Exposure to contaminated objects, such as needles.

Those at the highest risk include people who have cared for an infected person as well as laboratory personnel working with bodily fluids of an Ebola patient.

Predicting when and where pathogens will emerge is difficult, yet, as shown by the recent Ebola and Zika epidemics, effective and timely responses are key. As pathogens continue to emerge and spread into populations at risk, a move from purely responsive activities to also include proactive management of emerging infectious diseases is urgently needed. It is therefore crucial to transition from reactive to proactive responses to these pathogens.

REGIONAL APPROACH

Ebola impacts the economy in several different ways. Less trade and transportation; an Ebola outbreak may lead to restrictions on trade and transportation to prevent transmission of the virus. This may mean the limit of goods moved within a country. According to the Africa Economic Brief, informal cross-border trade is a source of income for about 43 percent of Africa's population.

However, most countries in the region lack incentives and resources to invest in cross-border interventions and border areas tend to be inhabited largely by vulnerable human populations, including migrant and rural populations. The challenge is compounded by inadequate mechanisms for a regional approach to prevention and control of communicable diseases. Consequently, East Africa is experiencing a general lack of preparedness to deal with public health emergencies occurring across international boundaries.

Meanwhile, interventions have been fragmented, leading representatives from the ministries of health and academic institutions in Kenya, Tanzania, and Uganda to form the East African Integrated Disease Surveillance Network (EAIDSNet) to address these challenges.

With adequate preparation, introduction of the virus can be contained before a large outbreak develops. The WHO urges and supports preparedness activities aimed to ensuring all countries are ready to effectively and safely detect, investigate and report potential EVD cases, and to mount an effective response.

When the systems for recognising and responding to disease outbreaks, in this case EVD, act too slowly, the result is unnecessary delay, greater Ebola disease spread, additional people affected, and more lives lost. In the case of Liberia in 2014, the huge scale of the epidemic was driven, in a large part, by the long delay in mounting an effective response.

An intervention strategy needs to include, as a permanent agenda, village meetings to inform people or notify village leadership whenever they receive visitors or patients referred from the regions that are affected by Ebola.

Simulation exercises reflecting real-life challenges of managing an Ebola outbreak are also important, during which the exercise management team note the strengths and weaknesses of the response system.

The author is a social and behaviour change communication consultant. [email protected]

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