Friday, November 21, 2014

How Mali braces borders and beyond amid Ebola crisis

In this photo taken Monday, Nov. 17, 2014, a Mali soldier, center, controls a crowd of people during a visit by their president, Ibrahim Boubacar Keita, at the border village of Kouremale, Mali, between Mali and Guinea. On Mali's dusty border with Ebola-stricken Guinea, travelers have a new stop: Inside a white tent, masked medical workers zap incomers with infrared thermometer guns and instruct them to wash their hands in chlorinated water. (AP Photo/Baba Ahmed)
On Mali's dusty border with Ebola-stricken Guinea, travelers have a new stop: Inside a white tent, masked medical workers zap incomers with infrared thermometer guns and instruct them to wash their hands in chlorinated water.

After five recent Ebola deaths, Mali has become a front line in the fight against the virus, especially in the border town of Kouremale which two of those victims passed through last month. Malian authorities, with help from the U.N. and aid groups, this week deployed medical teams at the border to try to stop the disease's spread.

"You are Mali's portal. Don't be the weak link in the fight against Ebola. Mali must not become a land of propagation for Ebola in the world," President Ibrahim Boubacar Keita urged medical staffers and border guards during a visit as the deployment began. "We are counting on you to meet this challenge."

Mali's Ebola deaths began with a two-year-old girl, whose father was Malian, and a 70-year-old imam from Guinea who passed through Kouremale last month. While no cases have been identified from contact with the girl, three people who came into contact with the elderly man also died. Officials are monitoring 413 others, the Health Ministry said Monday. Stephane Dujarric, spokesman for U.N. Secretary-General Ban Ki-moon, said in New York on Tuesday that 554 contacts with the imam have been identified and nearly all have been placed under surveillance. There was no way to immediately reconcile the different numbers.

Controls on 15 percent of people monitored for Ebola in Bamako, the capital, were not conducted correctly, the World Health Organization estimated Monday in an internal memo obtained by The Associated Press. Local health officials say they've been overburdened as monitoring demands grew.

Jean-Francois Delfraissy, who heads the French president's task force on Ebola, warned this week that this poor, landlocked country "could be the start of a new epidemic."

The response in Kouremale is part of a string of quick initiatives from Mali's government, with international support, that include increasing staffing to trace those who may have been in contact with the imam. Officials are recruiting local medical students to help and screening more passengers at Bamako's airport.

Authorities hope that a quick and effective response in Mali will mirror successful reactions to individual Ebola cases in Senegal and Nigeria. The U.N.'s mission chief for Ebola emergency response, Anthony Banbury, was in Bamako on Tuesday, Dujarric said. Other international health officials were heading there too.

UNICEF spokesman Christophe Boulierac said Tuesday that the U.N. agency's efforts with Mali's government include helping improve public awareness by reaching out to religious leaders, labor groups and truck drivers in the region. Under the plan, it will also help equip 77 bus stations near Bamako with hand-washing materials, he said.

"Regrettably, the number of infections still occurred during burials, and an estimated 20 percent of transmissions were still happening on such occasions," a U.N. statement said on Tuesday. Burial teams have been formed and trained, "but the work with communities was still in progress."

On Monday, a large crowd waited four hours to enter at Kouremale for security reasons because of the president's visit. Staffers in two tents filtered travelers as they got out of cars or buses and received a zap of the thermometer and washed their hands in chlorine-infused water. Anyone showing Ebola symptoms can be held in a transit station for up to 72 hours so that a test can be conducted. A positive test would merit transport to an isolation center in Bamako. A third checkpoint awaits 8 kilometers (5 miles) inside the border.

The paved highway at Kouremale crossing sits along Mali's fastest road access to the Atlantic, and is a crucial thoroughfare for manufactured goods - like cars - from Europe.

The imam, who evaded the initial border control last month, was stopped at the interior checkpoint. But once there, the Kouremale village chief used his customary authority and intervened with police - and the elderly man was waved through, said Kouremale toll agent Mamadou Diawara.

Now locals are no longer taking such crossings lightly.

"At first, we didn't believe in Ebola disease," said Falaye Keita, who heads the local transporters union in Kouremale, a town of about 3,000. "Ever since the elderly man died, we know now that Ebola is a reality, and we are really afraid that the disease will enter our village."

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