Travelers cross Busia border without visible Ebola screening despite surveillance claims

Despite official assurances of heightened surveillance at Kenya’s points of entry following confirmation of an imported Ebola case, gaps in health screening were evident at the busy Busia border crossing between Kenya and Uganda.

During a visit to the border on Tuesday, our investigation found travellers and border staff moving through the main crossing without undergoing visible temperature checks, routine health screening or symptom declarations.

At the main border point, about three health officers were observed seated near the crossing as travellers moved into and out of Uganda. No active screening of people passing through was visible during the period of observation.

The scenes raise questions about how consistently Kenya’s Ebola surveillance measures are being implemented at one of the country’s busiest land crossings.

The apparent gaps come as health authorities maintain that heightened surveillance is in place at major points of entry to detect travellers who may have been exposed to Ebola or developed symptoms.

Busia is a particularly important surveillance point because of the constant movement of people, traders and vehicles between Kenya and Uganda.

Public health experts have consistently emphasised the importance of early detection at borders, including identifying travellers with symptoms and directing those who may have been exposed for further assessment.

On May 20, Busia County health authorities intensified Ebola screening and surveillance  measures at the Busia and Malaba border points following an outbreak of the disease in the eastern region that has reportedly claimed at least 131 lives.

Senior officials from the Busia County Department of Health conducted an inspection of Port Health Units at the Busia and Malaba One Stop Border Posts to assess the level of preparedness and ensure screening protocols for incoming travellers were fully operational.

Speaking after the inspection, Busia Deputy Governor and County Executive Committee Member for Health Arthur Odera said the county government had activated heightened surveillance measures to safeguard residents against any possible outbreak.

He noted that health officers stationed at the border points were conducting screening on a 24-hour basis, targeting travellers entering Kenya through the busy crossings.

“We are targeting 100 per cent screening of all incoming travellers, including pedestrians, truck drivers and passengers using public transport,” Odera stated.

However, during our visit, we entered the customs border without being screened. We proceeded into Uganda, where we observed no screening. Children in high school uniforms and a St Mary’s school bus also passed through the border without screening.

Yet local traders and frequent border crossers described health monitoring at the crossing as inconsistent.

Alf Wanjala, a boda boda operator at the border, said they had been conducting business at the border without screening and were at serious risk of being affected.

“We carry people in and out of Uganda and no screaning is being done.We are among the victims who can be affected if Ebola was to affect us.Government please just give us water and sanitizer because you cannot know the kind of passenger you are carrying,” he said.

Ambuya Fred said the porous border had no screening, not even water for washing hands, and that boda boda operators were among those at greatest risk.

“We have no officers who conduct screaning.We just cross freely in and out and the ministry keeps saying that they have put enough measures.Look at kenya roads no screaning its only done in main customs,” he added.

He said they had received sanitizer from the Kenya Red Cross earlier, but it had not been replenished after running out.

Kelvin Mandela, a business operator at the border, said most of his clients came from Uganda and that the county government had done little to ensure their safety.

Local traders also said screening points could be unattended or bypassed during busy periods, raising concerns about whether travellers receive the same level of health checks throughout the day.

The concern is heightened by the nature of cross-border movement at Busia, where thousands of people and goods move between the two countries daily.

A gap at the border does not automatically mean that Ebola has entered Kenya through Busia. However, inconsistent screening can reduce the chances of identifying a symptomatic traveller early and referring them for appropriate assessment.

The risk is particularly important given that Ebola symptoms can initially resemble other common illnesses, including malaria and other infections that cause fever.

Health surveillance at border points is therefore only one layer of defence. Detection must also continue at health facilities, where clinicians need to ask about travel history and possible exposure and rapidly isolate anyone suspected of having Ebola.

When asked during a press interview at his office why no screening was taking place at the border, Odera said it was impossible to remain on high alert 24 hours a day for three months.

“There is a point on which the alert is heightened,we also depend on information to really know where the danger may be and when it may be,” said Odera.

He also maintained that screening was being conducted.

The Deputy Governor further said there was a shortage of health workers, making it difficult to deploy screening teams to unofficial crossing points, commonly known as panya routes.

“Panya routes are places that are not official border points but are crossing points.Because of the shortage of healthcare workers that we have,we have a challenge of removing healthcare workers from where they are attending to patients at the facility and deploying them to screen,” he said.

He, however, added that the county had support from partners and would deploy more workers to the panya routes.

Kenya has confirmed its first imported Ebola case, placing greater focus on whether the country’s preparedness measures are working in practice.

At Busia, the question is now whether the surveillance system on paper matches what travellers encounter on the ground.

The border remains open and busy.

The public health challenge is ensuring that the surveillance designed to protect both countries remains active wherever and whenever people cross.