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Rwanda closes border with DRC over deadly Ebola outbreak Panic and confusion as Rwanda closes border with DRC over Ebola outbreak
(about 3 hours later)
Rwanda has closed its border with the Democratic Republic of the Congo, where a deadly Ebola outbreak that started a year ago has killed more than 1,803 people. Rwanda’s government briefly closed and then reopened part of a busy land border with the Democratic Republic of the Congo (DRC) on Thursday, prompting panic and confusion in both countries.
The closure came after a second death linked to the Ebola virus was confirmed on Wednesday in the densely populated Congolese city of Goma, which is on the porous border with Rwanda. The news came in the wake of two further confirmed cases of Ebola in Goma.
The World Health Organization, which declared the DRC outbreak a global health emergency last month, has recommended against travel or trade restrictions. It has also said the risk of regional spread was “very high”. The brief border closure happened a day after a second Ebola-related death was confirmed in the densely populated border city of Goma in DRC on Wednesday. Dr Aruna Abedi, the coordinator of the Ebola response in North Kivu, told the Guardian the dead man’s wife and one-year-old daughter have tested positive.
The DRC presidency’s office said it regretted what it described as a unilateral decision by the Rwandan authorities to restrict movement at the border, “which runs counter to the advice of the World Health Organization”. The Gisenyi-Goma border is used daily by hundreds of people who work and live on either side. Goma, which has a population of 2 million, is used as a transit hub for access to east Africa.
“On the basis of a unilateral decision by the Rwandan authorities, Rwandan citizens cannot go to Goma and Congolese cannot leave Gisenyi but are prevented from going home,” the statement said. News of the border closure – which lasted less than a day – caused the price of fruits and vegetables to surge in border towns and provoked panic among those who cross the border for work.
“This decision harms a number of Congolese and expatriates who live in Gisenyi but work in Goma.” “As residents at the border, yes, we are concerned about Ebola. Trading with DRC is [a] priority because we need to feed our families,” Eugene Barore, a fruit seller in Rwanda said.
It added: “The Congolese authorities regret this kind of decision, which goes against the recommendation of the World Health Organization. On Thursday morning, Rwanda’s foreign minister, Olivier Nduhungirehe, told the Guardian that the border between the two countries was closed. In the afternoon, the ministry of health said the reports of the border closure were the result of a “traffic slow-down” caused by heightened health checks.
“Response teams are continuing to ensure that the city of Goma is out of danger,” it promised. “We are only telling our people to be on alert, to take precaution. The border will remain open,” Diane Gashumba, Rwanda’s health minister told reporters in the capital of Kigali. “When there is [an] epidemic like Ebola, inaccurate information will be spread. They have said before that there are Ebola cases in Rwanda, which is not true.”
An AFP reporter at the Goma-Gisenyi crossing confirmed the frontier had been closed. There was no immediate announcement or reaction from Rwanda. Rwandans and Congolese on both sides of the border rely on the open crossing for trade and business. Many have family on both sides. Reports of Ebola-related deaths in Goma are a cause for concern in neighbouring Rwanda.
Earlier on Thursday, a DRC official said the one-year-old daughter of the man who died on Wednesday was at a treatment centre after showing signs of the disease. He had spent several days at home with his family while showing symptoms.
If this suspected case is confirmed, it could be the first transmission of Ebola in this outbreak inside Goma, a city of more than 2 million people and a major transport hub that shares the border with the Rwandan city of Gisenyi, which has a population of more than 85,000.
With more than 2,577 confirmed cases and more than 1,803 confirmed deaths, the outbreak in the eastern DRC is the second largest in history. It has a 67% fatality rate and 11 months after it began, the case numbers are still escalating. It is disproportionately affecting women (55% of cases) and children (28%).With more than 2,577 confirmed cases and more than 1,803 confirmed deaths, the outbreak in the eastern DRC is the second largest in history. It has a 67% fatality rate and 11 months after it began, the case numbers are still escalating. It is disproportionately affecting women (55% of cases) and children (28%).
The WHO declared the outbreak an international public health emergency in July 2019. The same month saw the the first diagnosis of a case in Goma, a city of 2 million people, which is a transport hub on the border with Rwanda. In early August Rwanda announced that it was closing its border with DRC.The WHO declared the outbreak an international public health emergency in July 2019. The same month saw the the first diagnosis of a case in Goma, a city of 2 million people, which is a transport hub on the border with Rwanda. In early August Rwanda announced that it was closing its border with DRC.
The WHO has long said that the national and regional risk levels are very high and containment of the spread to North Kivu and Ituri provinces was unlikely, unless a break in the fighting made it safe for health workers.The WHO has long said that the national and regional risk levels are very high and containment of the spread to North Kivu and Ituri provinces was unlikely, unless a break in the fighting made it safe for health workers.
Ebola hemorrhagic fever is caused by a virus that has a reservoir among forest animals, including monkeys and bats. It is spread through body fluids, which is why carers – mostly female relatives and nursing staff – are particularly at risk. It causes fever, aches and diarrhoea and attacks the immune system, causing blood clotting cells to malfunction so that victims bleed extensively and die if their immune system cannot fight off the viral infection.Ebola hemorrhagic fever is caused by a virus that has a reservoir among forest animals, including monkeys and bats. It is spread through body fluids, which is why carers – mostly female relatives and nursing staff – are particularly at risk. It causes fever, aches and diarrhoea and attacks the immune system, causing blood clotting cells to malfunction so that victims bleed extensively and die if their immune system cannot fight off the viral infection.
Drugs are still experimental. Patients are isolated and treated by nurses wearing full protective body suits and masks who try to boost their immune response. Friends and relatives are quarantined for 21 days. Prevention measures include washing hands at every opportunity and safe burial practices, with no touching or washing of the body, as is traditional in some cultures.Drugs are still experimental. Patients are isolated and treated by nurses wearing full protective body suits and masks who try to boost their immune response. Friends and relatives are quarantined for 21 days. Prevention measures include washing hands at every opportunity and safe burial practices, with no touching or washing of the body, as is traditional in some cultures.
The 2013 and 2016 outbreak in Sierra Leone, Liberia and Guinea spread for months through forest regions in west Africa where Ebola was unknown before the emergency was recognised. It escalated when it emerged in towns and cities, with 28,600 cases and 11,300 deaths.The 2013 and 2016 outbreak in Sierra Leone, Liberia and Guinea spread for months through forest regions in west Africa where Ebola was unknown before the emergency was recognised. It escalated when it emerged in towns and cities, with 28,600 cases and 11,300 deaths.
DRC successfully stamped out nine previous Ebola outbreaks in rural areas within a matter of a few months. Aid agencies, infectious disease experts and the WHO say it will be very hard to bring this outbreak under control, even though they have had vaccines and experimental drugs from the outset.DRC successfully stamped out nine previous Ebola outbreaks in rural areas within a matter of a few months. Aid agencies, infectious disease experts and the WHO say it will be very hard to bring this outbreak under control, even though they have had vaccines and experimental drugs from the outset.
There is almost no functioning state in much of eastern DRC. There is an almost total lack of basic services such as power, education, roads, healthcare, and the authority of the government only extends to the edges of urban areas.There is almost no functioning state in much of eastern DRC. There is an almost total lack of basic services such as power, education, roads, healthcare, and the authority of the government only extends to the edges of urban areas.
Police are corrupt, predatory and violent. In rural zones, militia and armed bands provide security and employment opportunities but also steal, rape and kill at will. It is one of the most hostile environments faced by aid and health workers anywhere in the world.Police are corrupt, predatory and violent. In rural zones, militia and armed bands provide security and employment opportunities but also steal, rape and kill at will. It is one of the most hostile environments faced by aid and health workers anywhere in the world.
Mistrust of officials and foreigners is harming efforts to tackle the disease and conspiracy theories are rampant. Some believe the outbreak is fake news spread by rapacious NGOs and the UN to justify their presence in the country and allow the extraction of valuable mineral resources. Mistrust of officials and foreigners is harming efforts to tackle the disease and conspiracy theories are rampant. Some believe the outbreak is fake news spread by rapacious NGOs and the UN to justify their presence in the country and allow the extraction of valuable mineral resources. 
Sarah Boseley and Jason BurkeSarah Boseley and Jason Burke
Cross-frontier links are intense. Many people have jobs on the other side of the border while others have homes or put their children in schools in the neighbouring city. The Rwandan government faced intense pressure from international agencies to keep the border open, the Guardian learned.
Health experts fear outbreaks of contagious diseases in major cities. In an urban setting, density of population, anonymity and high mobility make it far harder to isolate patients and trace contacts compared to the countryside. In July, the World Health Organization declared the Ebola outbreak in DRC an international public health emergency. But in an accompanying statement, the organisation also called on countries to keep their borders open. “No country should close its borders or place any restrictions on travel and trade. Such measures are usually implemented out of fear and have no basis in science,” the statement said.
The painstaking work of finding, tracking and vaccinating people who had contact with the man who died on Wednesday and the contacts of those contacts has begun. Tamba Emmanuel Danmbisaa, Oxfam’s humanitarian programme manager in the DRC, said on Thursday morning that the flow of movement at the Gisenyi-Goma border was restricted. “People were not denied exit, but were denied re-entry into Rwanda,” he said.
The escalating crisis has led to a row within the DRC’s health ministry, which is co-ordinating national efforts to contain the spread of the virus. Danmbisaa said a border closure at Gisenyi would have a huge impact on cross-country trade and disrupt aid agencies working to contain Ebola and respond to other humanitarian crises in DRC.
Last week the DRC’s health minister, Oly Ilunga Kalenga, resigned in protest against the country’s handling of the Ebola outbreak. He said international agencies were pressuring his government to allow the testing of a new vaccine developed by Johnson & Johnson. The row over the vaccine trials began after Ilunga reportedly banned clinical trials of the new vaccine in DRC.
Ebola vaccines are difficult to develop because they have to be tested during outbreaks.
In the previous outbreak in west Africa, one vaccine, produced by Merck, was successfully trialled in Guinea. The success of that trial meant preventative Merck vaccines could be given to citizens in the DRC and potentially contain the outbreak.
Ilunga has argued trialling vaccines in Ebola-affected regions could erode public trust in the government.
Ebola in the DRC: everything you need to knowEbola in the DRC: everything you need to know
Merck’s vaccine requires only a single shot, whereas Johnson & Johnson’s new vaccine has to be taken in two doses. For security reasons, staff from Oxfam and other aid organisations are contractually obliged to live in Gisenyi in Rwanda, which is considered safer than Goma, Danmbisaa said.
Officials and NGOs fear discrepancies in the vaccination schedules – with some people getting one shot and others two – could fuel rumours about the vaccines in local communities. He warned closing the border would disrupt aid agencies’ ability to participate in the Ebola response effort in DRC. “Any restriction is likely to have an adverse effect, not only on Ebola, but on the wider humanitarian crisis in the DRC.”
Ilunga also said delivering two doses would be logistically difficult in a region where there was a high rate of displacement. Emanuele Capobianco, director of health and care at the International Federation of the Red Cross, said that closing borders could exacerbate the crisis.
Last week Saudi Arabia stopped issuing visas to people from DRC while citing the Ebola outbreak, shortly before the annual hajj pilgrimage there this month. “Our main concern is that shutting down the border can contribute to the virus spreading because it pushes people to use unofficial crossings and hide their connection to DRC,” he said.
Rwanda’s health ministry highlighted the country’s preparedness for an Ebola outbreak in a press statement.
The government has vaccinated 3,000 health workers in high-risk areas as a preventative measure, and has trained over 23,957 public health workers to respond to a crisis, it said. It also has a fleet of specialist ambulances, and 23 hospitals in priority districts have prepared special isolation centres for Ebola patients.
Global developmentGlobal development
Democratic Republic of the CongoDemocratic Republic of the Congo
RwandaRwanda
EbolaEbola
AfricaAfrica
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