Storm water from the peaks of the Rwenzori Mountains swells the muddy Lhubiriha River that marks the often porous border between western Uganda and the Democratic Republic of Congo.
Less than 70 kilometres (40 miles) away, authorities have already confirmed one case of Ebola, part of the second worst outbreak of the virus now spreading in the east of the DR Congo.
Fearing Ebola will easily pass across the deeply intertwined border communities, which share family ties, farms and markets, international organisations are working to keep the frontier on high alert.
“I’m scared,” says 50-year-old Stephania Muhindo as she eyes her home village of Lhubiriha on the Congolese side of the river, shortly after crossing a bridge to Mpondwe in Uganda.
“Ebola hasn’t reached our village but I hear it’s coming.”
Around her Red Cross volunteers marshal edgy commuters, directing them to wash their hands and shoes in chlorinated water and have their temperature taken for signs of fever before they are permitted to cross into Uganda.
Regular travellers have red rashes on their hands from repeated washing in the harsh chlorine, one of several measures to try and prevent the virus from spreading.
Several times a week, Ms Muhindo crosses to Uganda to stock up on supplies for her salt shop before returning to the DRC.
Since Congolese authorities declared an outbreak on 1 August more than 300 people have died from the haemorrhagic fever, spread by contact with the body fluids of an infected person – with a death rate of almost 60 percent.
With border communities often connected by family, the World Health Organisation (WHO) says there is a “high risk” that the virus will spread to Uganda, which has already had several scares.
“We have relatives in Congo, subsistence farmers have a garden here and another garden in Congo, children can live on one side and go to school on the other side,” explains Samuel Kasimba, a local health official in charge of coordinating the effort to stop Ebola from entering Uganda.
On twice-weekly market days, more than 20,000 people cross the border at Mpondwe and the festive season is expected to see even greater numbers moving between the two countries.
“Christmas is a particular concern because we know there is a lot of movement as people buy food and visit family,” says Andrew Bakainaga a senior WHO official in Uganda.
“We expect the number of people moving across the border might increase from around 300,000 to 500,000 per month,” he told AFP.
On 23 December, the DRC is scheduled to hold long-delayed elections and with a history of political unrest there is a concern that people may flee to Uganda increasing the chance the virus will reach the neighbouring country.
More than 123,000 Congolese refugees have come to Uganda seeking refuge from communal violence in the past year.
Mr Kasimba, the Ugandan health official, is focused on identifying suspected cases as early as possible.
“We aim at detect any suspected cases early, before that person has many contacts. We use radio programs and village health teams to educate people about Ebola,” he explains.
“Confirmed cases are within 70 kilometres and this distance keeps on reducing. The outbreak is moving closer to Uganda. In case it comes, God forbid, we are ready.
Suspected cases are rushed to the grounds of Bwera Hospital, six kilometres from the border, where a newly constructed isolation ward sits inside white tent-like structures.
Without any patients during a recent visit, Esther Businge and Joseph Kamabu rehearse donning the layers of protective suits they hope will keep them safe.
Without any skin left exposed it is difficult to tell who is who so the pair use a marker pen to write each other’s name on their disposable gowns.
The ward is carefully divided between green – clean – and red – potentially contaminated – zones and before crossing into the red zone both carefully examine themselves in a mirror to ensure they are as protected as possible.
The pair move slowly and awkwardly, as if in zero gravity.
“My old mum was a bit scared when I started because I took the blood sample from the first suspected case alone,” says 55-year-old Businge, a lab technician.
“I tell her that I am trained and it will be fine but I hear that 24 nurses in Congo have died,” she says.
During the worst ever Ebola outbreak which hit three west African countries in 2014, many health workers died from the disease.
In collaboration with WHO, Ugandan authorities have vaccinated about 3,000 frontline health workers with an experimental drug designed to protect them against the virus but fears remain about its effectiveness.
“After a couple of hours in these suits we are covered in sweat. When they’re wet they tear easily and absorb moisture. What if a patient vomits on it?” asks Businge.
Back in Mpondwe, Ms Muhindo prepares to make the return journey across the dilapidated bridge to her village.
“I’d like to be vaccinated but they say there is not enough for everyone,” she says.
“I’ll go home to Congo because I have nowhere else to go.”
Public officers above 58 years and with pre-existing conditions told to work from home: The Standard
Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.
However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
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Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
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Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.
Uhuru convenes summit to review rising Covid-19 cases: The Standard
President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
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Drastic life changes affecting mental health
Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.
Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.
Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.
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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.
In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020. It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.
A study by Dr. Habil Otanga, a Lecturer at the University of Nairobi, Department of Psychology says that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.
The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.
KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.
Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.
As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.
“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”
Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.
“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.
Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.
“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”
Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.
“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.
Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.
Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.
She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.
Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.
“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added
Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.
“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and also engage in reading that would help expand their knowledge.