African governments are sealing their ports and airports in an attempt to halt the spread of Ebola. But will fever checks and entry bans really make any difference?
With more than 1,100 dead and 2,100 suspected cases of Ebola, authorities in many African countries are holding their breath. Many are nervous, and some have begun to isolate themselves.
From Tuesday onwards, Kenya Airways has suspended flights to Liberia and Sierra Leone. Ivory Coast is no longer allowing ships from Ebola-hit countries to pass through its waters. In Nigeria, no one is allowed to board a plane unless their temperature is normal and they have passed the airport's "fever check."
"I think the restriction of air traffic is an expression of the helplessness of the authorities there when it comes to containing the disease," said Dieter Häussinger, director of the Hirsch Institute of Tropical Medicine. He thinks that monitoring people's temperature is a questionable method, because it's impossible to separate those infected with Ebola from people who've got the flu.
Häussinger added that many issues remain unresolved: "What happens to the patients who have a fever but don't have Ebola? Will they be quarantined, too?"
Action for the sake of action?
Tomas Jelinek, the medical director at the Berlin Center for Travel and Tropical Medicine (BCRT), thinks measures like those taken in Nigeria are simply action for the sake of action. He points out that 12 years ago, during the SARS pandemic, similar checks were done but achieved very little. "We mustn't kid ourselves that we're going to achieve any great degree of security with checks like these," he said.
Four people have now died of Ebola in Nigeria. All the cases can be traced back to a man from Liberia who collapsed at Lagos airport in July and died in quarantine shortly afterwards. Fever checks are now in place for internal flights, too - and yet the majority of Nigerians travel by bus. But given the sheer number of bus travelers and the lack of infrastructure, it would be nearly impossible to implement checks here.
"The general public is far more concerned with flights. People barely register what's going on on the buses," said Jelinek. "Bu the government must adopt some kind of measures, so it's gone for ones that are visible."
"Why is nationality the problem, not the disease?" asks one traveler. Anyone flying from West Africa to Nairobi runs the risk of being banned from entering the country - unless they're Kenyan, that is
Kenya fears isolation
Kenya seems to be adopting a similar strategy. Jelinek sees the decision to suspend flights to Liberia and Sierra Leone and impose an entry ban on people from the Ebola-hit countries as a precautionary measure, with Kenya hoping that it will be able to avoid international isolation.
A few days ago the World Health Organization announced that there was a high risk of the West African epidemic spreading to Kenya. The airport in the capital, Nairobi, is an important hub for air traffic all across Africa. Korean Air has already announced that from Wednesday it is cancelling all its flights to Kenya on account of Ebola - even though the country has not yet reported a single case of the disease.
"At the moment, on the international level, what we are clearly seeing is an overreaction that is not justified by the danger posed by the virus," said Jelinek. He explained that with other diseases, such as tuberculosis, the risk of infection is far greater, because the virus can be communicated not only via bodily fluids but also through the air.
Mistrust among the people
Häussinger believes that the isolation measures being taken by African governments only serve to create more alarm among the population. He said it's more important to ensure that people are well-informed so that they'll cooperate with doctors and aid workers, especially in the directly-affected areas.
But according to Jelinek, in many places this course of action is hardly possible now. People are already highly distrustful of Western medicine, and in many places the rumor is spreading that the medical aid teams, with their full-body protective clothing and masks, are in fact the ones who brought the virus to West Africa.
On the weekend, a mob in the Liberian capital Monrovia stormed a quarantine center, shouting "There is no Ebola in Liberia," and released the infected patients. They assert that President Ellen Johnson Sirleaf is simply trying to obtain international aid by spreading reports of an epidemic.
Jelinek warned that action must be taken to calm the situation, "which would also include scrapping pointless checks straight away - such as fever checks at airports."