Stopping Ebola in the Nexus of Human Mobility: Borders

An IOM staff at the Border of Mali and Guinea.  © UNMEER

By Agyedho Adwok Nyaba

Before joining IOM in October last year, I was busy travelling between Ethiopia and Kenya. My first encounter with Ebola beside the media messaging was at Jomo Kenyatta International Airport in Kenya.  Upon my arrival from South Sudan, we were subjected to health screening.

“Can you please fill this form?” said the Kenyan public health official with a mask covered over his mouth before he went to record my temperature. “What is it for?” I asked. “The screening is a precautionary measure aimed at ensuring that no Ebola case gets into the country,” he replied. I complied and filled the form. There were several questions such as “Have you visited Sierra Leone, Liberia and Guinea in the last 21 days? Have you experienced any fever?” So many questions, so little time as all I wanted to do was get my visa and rush into the city. Little did I know months later, I would be working on an Ebola response programme.

It is early December, I’m attending one of my first coordination meetings at the IOM Headquarters in Geneva, in a room we have now come to call an Ebola unit house. I am listening intently to Bill Hyde, the Ebola Response Coordinator from the Department of Operations and Emergencies and Dr. Douglas Macpherson, Senior Health Advisor from the Migration Heath Division briefing the coordination team on Ebola Treatment Units (ETUs) in Liberia and Flow Monitoring Points in Guinea-Mali. They are talking about IOM’s approach to Health and Humanitarian Border Management (HHBM). That immediately got me thinking about borders and what they represent.

Borders are not only imaginary lines but are sometimes not readily visible. In fact, what started in a remote area in Guinea in March 2014 gradually spread to Liberia, crossing into Sierra Leone by May. Human mobility across the porous borders of the countries played a significant role in the spread of the disease.

IOM joined international partners in fighting Ebola immediately after it was declared an L3 Humanitarian emergency. Its regional response to the crisis has been multifaceted highlighting the need for a coordinated and harmonized approach. One way IOM is responding is through Cross Border Health and Humanitarian Border Management (HHBM).

“Our approach to HHBM is focused on restarting safe travel throughout West Africa, which is not only good for commerce, community development, but for improving knowledge and security as well. HHBM strengthens personal and community resilience at home pre-travel, while en route including across borders and at destinations,” states Bill Hyde. Hence to tackle cross border movements and to reduce the spread of Ebola further, IOM is using one of its innovative projects known as Flow Monitoring Points. The points generally provide an overview of population movements at main transit-entry hubs along the route of journeys.

I ask what role they play and how relevant they are in securing borders.  “IOM Flow Monitoring Points (FMP) help authorities track the health of people on the move. By monitoring symptoms of Ebola and other communicable diseases, and guiding suspect cases more swiftly to further assessment and treatment, IOM Flow Monitoring Points are minimizing the potential spread of disease, in turn making individuals, communities and nations stronger,” he replies.

To stop Ebola and “get to zero” cases will require intense efforts to trace all those who have come into contact with infected people. That requires tracking down the people who’ve been in contact with an Ebola patient; measure their temperatures and check on them daily for 21 days; if any turn up with a fever or display symptoms, put them into isolation. If they get sick, they will need to be quarantined. Tracing contacts, though, requires names, phone numbers, addresses, and trained public-health officials and that is where the Flow Monitoring Points are making a huge and significant difference.