Ebola fears peak in Somalia and Kenya as officials offer reassurance

Kenyan health officials take passengers' temperatures as they arrive at Jomo Kenyatta International Airport (JKIA) on August 14, 2014, in Nairobi. [Simon Maina/AFP]

By Abdi Moalim in Mogadishu and Bosire Boniface in Garissa
Saturday, August 16, 2014

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With more than 1,000 deaths in West Africa caused by the latest epidemic of the Ebola virus, health officials in East Africa and the African Union Mission in Somalia (AMISOM) are taking special precautions to prevent the spread of the disease.

So far the Ebola outbreak has been concentrated in Guinea, Liberia, Sierra Leone and Nigeria, according to the World Health Organisation (WHO), which warned Thursday (August 14th) that the scale of the epidemic had been vastly underestimated and that "extraordinary measures" were needed to contain the disease.

With 1,069 deaths reported so far, the WHO said it was co-ordinating "a massive scaling up of the international response".

"The outbreak is expected to continue for some time," it said. "WHO's operational response plan extends over the next several months."

Medical charity Doctors Without Borders (MSF) also said the outbreak was moving faster than aid agencies could handle.

The WHO declared a global health emergency last week -- far too late, according to MSF, which months ago warned that the outbreak was out of control.

"It is deteriorating faster and moving faster than we can respond to," MSF International President Joanne Liu told reporters Friday in Geneva. "It is like wartime."

Kenya, Somalia at risk

No cases of Ebola have been reported in Kenya or Somalia, but the countries are at particular risk for an outbreak of the disease due to frequent transcontinental flights into Nairobi and Sierra Leone being one of AMISOM's troop contributing countries.

The latest epidemic has killed the greatest number of people since the disease was identified in 1976, but with a 55% fatality rate, it is not the deadliest on record, according to WHO data. The 2003 epidemic in Congo was the deadliest, killing 90% of those infected.

There is no vaccine against the Ebola virus and there is no known cure for treating the disease.

Considering Somalia's almost non-existent healthcare infrastructure, an outbreak of Ebola could have catastrophic consequences in the country, said Somali lawmaker Osman Mohamud Duffle, a doctor of internal medicine and chair of the parliament's health services committee.

Therefore, he said, it is necessary for the Somali government to start putting in place stringent measures to prevent Ebola from entering the country.

"The only way to fight this disease is to isolate the people and animals it affects in order to prevent them from spreading the disease," Duffle told Sabahi. "So far no testing has been done on the people entering the country, so it is necessary to draw blood from the people and run tests on them."

Because Ebola has spread in countries whose troops are present in Somalia, he said, the peacekeepers could potentially bring the disease from those countries if they are deployed while the outbreak is ongoing.

Duffle said the health services committee was working with the Somali Ministry of Health to engage in new efforts to prevent an outbreak of the disease, just as other countries in East Africa have done, such as Kenya and Tanzania, which are screening people at the borders.

AMISOM, Somali Ministry of Health working together

For his part, AMISOM spokesperson Colonel Ali Aden Humad said AMISOM is monitoring the Ebola disease closely.

"We have decided to delay the deployment of the troops that would have come in July from Sierra Leone to replace the troops that have been in the country for a year," he told Sabahi.

Furthermore, he said, AMISOM tested the troops currently in the country and none of them have contracted the Ebola virus so far.

"The health status of the troops is verified constantly and their health is screened before they come to Somalia," Humad told Sabahi. "Therefore, their health has been ascertained."

"AMISOM's decision to delay the troops who were coming in from West Africa came as a result of a request by the [Somali] government," said Director General of the Ministry of Health and Human Services Mohamed Abdi Farah.

He said the ministry was working on a plan to screen people entering Somalia, especially those coming from areas where the disease is present.

"By next week we will announce our plan for screening people who are coming into the country," he told Sabahi. The plan will include putting in place healthcare teams specialised in containing outbreaks and screenings co-ordinated with the Ministry of National Security's Immigration Department, he said.

"Some people come through several countries and it is possible that they initially came from a country where there is an outbreak of the disease," Farah said. "Therefore, the Immigration Department will take part in identifying where every person is coming from. Also, a plan will be put in place for the people who are travelling to the areas where the disease is present."

Kenya Airways, government implement preventative measures

Kenya Airways Chief Executive Officer Titus Naikuni said all passengers travelling with the airline from Sierra Leone, Liberia, Ghana and Nigeria will undergo temperature checks at the points of departure.

Handheld thermometers, gloves and hand sanitizers have been provided to Kenya Airways staff at these airports, he said in a statement released August 11th.

In addition, all passengers arriving at Nairobi's Jomo Kenyatta International Airport from West Africa and Uganda will use a separate gate where they will be screened again before undergoing immigration checks and leaving the airport.

For his part, Cabinet Secretary for Health James Macharia said the government has established isolation wards at Nairobi's Kenyatta National Hospital and Mbagathi Hospital in case Ebola is found in Kenya.

The ministry is seeking 530 million shillings ($6 million) from the government to carry out the preventive measures, Macharia said at a press conference August 13th.

But despite authorities' assurances that the country is well prepared to handle the disease if an outbreak should occur, some critics say the steps being taken are not enough.

Simon Ontiri, 35, a shopkeeper in Nairobi's Kayole neighbourhood, questioned Kenya Airways' insistence on operating in West Africa despite the Ebola outbreak.

"It will be a miracle that the disease is not already in Kenya because of the flights," he told Sabahi. "Sometimes it is better to prevent than cure. The airline should cut its losses and save lives."

Shikanga O-tipo, an epidemiologist with the Ministry of Health, told Sabahi that Kenya's porous borders present the greatest challenge to monitoring the disease.

"Medical officers may be stationed at official entry points at the border, forgetting that most people use unofficial entry points to escape the clearance processes," he said, adding that well-trained and equipped security personnel will now need to work with health personnel to man the borders.

He said the government will also have to carry out awareness programmes and work closely with the WHO and neighbouring countries to combat the disease.

"Doctors and nurses in the country have issued a strike notice over unpaid salaries [for June and July] and shortage of drugs and essential equipment," said Dancan Bwire, a medical student at Maasai Mara University. "These are the same health officials the government is banking on to counter Ebola."

"We do not want to even imagine a suspected case of Ebola being reported in Kenya coinciding with a health workers strike," he told Sabahi.
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