Rwanda has closed part of its border with DR Congo, where an Ebola outbreak has killed more than 1,800 people in the past year.
At least two people have died from the virus in the past month in the crowded Congolese border city of Goma.
It is the worst Ebola outbreak in the nation’s history, with at least 2,700 people so far infected with the virus.
And the outbreak has been complicated by an active conflict zone, leading to attacks on healthcare workers.
About 12 new cases are being reported every day in DR Congo, the World Health Organization (WHO) reports.
The border was closed “to avoid unnecessary crossings” to Goma, said Gilbert Habayarimana, mayor of Rubavu district in western Rwanda which borders Goma.
“We are closely monitoring the situation at Goma, the border can be reopened anytime, when the situation improves,” he told .journalists.
What has the reaction been?
In a statement, the Congolese presidency said that they “deplore this decision, which runs counter to the advice of the WHO”.
The WHO previously warned against trying to contain the virus by restricting travel or trade.
Last week, it designated the outbreak a global health emergency. It is the highest level of alarm the organisation can sound and has only been used four times previously – including during the Ebola epidemic that killed more than 11,000 people in West Africa between 2014 and 2016.
Rwandans who cross the border for work have also voiced their concerns.
“The closure is terrible for me. My seven children and I get something to eat when I go to Goma for work. Yes, Ebola is a terrible thing, but living is what matters most,” Ernest Mvuyekure, a builder who works in Goma, told the BBC.
“I am more afraid of hunger than Ebola, they should not close the border. I would rather die of sickness than of hunger.”
Claudine Uwitonze, who works in both Gisenyi and Goma, said: “I am so shocked now, because my life depends on DR Congo. I am afraid I am going to die of hunger because I have nothing else to do.”
Although the border has now been closed, it is likely that people will continue to travel using unofficial crossings.
What is the situation in Goma?
Ebola is affecting two provinces of DR Congo – North Kivu and Ituri. Goma, home to two million people, is the capital of North Kivu and lies just across the border from the Rwandan city of Gisenyi.
Until now, the virus has been mostly confined to more remote areas, mostly around Beni and Butembo, to the north of Goma.
A priest in Goma died last month from Ebola, and earlier this week an artisanal miner became the second person in the city to be killed by the disease.
The miner came from the north-eastern province of Ituri and had been admitted to a health centre in Kiziba, on the outskirts of Goma, on 13 July. He tested positive for Ebola on Tuesday and died on Wednesday morning.
According to a report by the AFP news agency, a third person – believed to be the miner’s daughter – is also infected.
Is there no vaccine?
Yes there is. It is 99% effective and more than 161,000 people have been given it.
However, not everybody is vaccinated – only those who come into direct contact with an Ebola patient, and people who come into contact with them. And some of those people refuse to take it.
People give a variety of reasons for not taking the vaccine:
- They may not want to put any external liquid in their body
- They may have religious beliefs that do not want them to take vaccines
- They may think they do not need it
- They may not believe in Ebola
The vaccine, made by Merck, was developed during the epidemic in West Africa and has been available throughout the latest outbreak.
It has proven effective but is in relatively short supply, so the WHO recommended a second vaccine made by Johnson & Johnson to complement it.
But DR Congo’s Health Minister Oly Ilunga complained that the Congolese were being treated as “subjects of experimentation”, reports Reuters news agency, and he resigned over the issue.
Why has the outbreak not been brought under control?
Tackling the disease has been complicated by conflict in the region.
Since January, there have been 198 attacks against healthcare workers or Ebola treatment facilities leading to seven deaths and 58 injuries.
Another major problem has been distrust of healthcare workers. As a result about a third of deaths have not been at specialist treatment centres, but in the community – where there is a greater risk of the disease spreading to neighbours and relatives.
Is the world doing enough to help?
The UK’s International Development Secretary, Alok Sharma, said he was “proud of our support to create a life-saving Ebola vaccine”.
“Diseases like Ebola have no respect for borders,” he said. “It is essential the rest of the international community steps up to help. If we don’t act now, many thousands more lives could be lost.”
But the WHO has for months been clear that it has insufficient money to tackle the problem. It had estimated that it needed $98m to tackle the outbreak between February and July, but it faced a shortfall of $54m.
What is Ebola?
- Ebola is a virus that initially causes sudden fever, intense weakness, muscle pain and a sore throat
- It progresses to vomiting, diarrhoea and both internal and external bleeding
- People are infected when they have direct contact through broken skin, or the mouth and nose, with the blood, vomit, faeces or bodily fluids of someone with Ebola
- Patients tend to die from dehydration and multiple organ failure