Frequent cross-border travel complicates Ebola preparedness in South Sudan
Credit: IOM South Sudan
Frequent and repeated cross-border travel between South Sudan, Uganda and the Democratic Republic of Congo could complicate efforts to detect and contain Ebola outbreaks, an International Organization for Migration survey found.
The IOM recorded 38,379 movements into South Sudan and 27,791 movements out of the country between July 8 and 31 at eight flow monitoring points. Nimule Border, Jale and Kaya accounted for 93% of all recorded movements, with Nimule Border alone accounting for 57%.
The survey found that most cross-border journeys were short-term, with temporary visits, daily commuting, work and family reunification accounting for about three-quarters of movements out of South Sudan and more than 60% of movements into the country.
Only 5% of respondents said they intended to remain at their destination for more than a year. Juba was the most frequently reported destination, accounting for 54% of arrivals and 57% of departures.
Repeated travel was particularly common along the route to the Democratic Republic of Congo. About 51% of respondents travelling to the country said they had made the same journey at least twice before, while 85% of those who had crossed more than twice said they travelled at least weekly. On the Uganda corridor, 26% had made the same journey more than twice.
The IOM said the recurring movements create potential epidemiological links between communities on both sides of the borders and could increase the number of contacts that need to be monitored during an outbreak.
Despite the movement patterns, awareness of Ebola was relatively high among surveyed travellers. Eighty-eight percent said they had heard of Ebola, 82% knew where to report a suspected case and 77% had received Ebola prevention information during the previous month.
However, awareness and preparedness varied considerably between monitoring points. Sakure recorded the lowest Ebola awareness at 61%, while only 40% of respondents there had received prevention information and 42% knew where to report a suspected case.
Knowledge of Ebola symptoms was generally strong among people who had heard of the disease. Ninety-five percent could identify at least one symptom, with fever the most commonly recognized at 84%, followed by headache at 55% and skin eruptions or rash at 42%.
But gaps remained in understanding how Ebola spreads. While most respondents identified contact with an infected person or animal as a means of transmission, 23% incorrectly believed the virus could spread through the air and 4% did not know how it was transmitted.
The survey also found that 95% of respondents could name at least one formal health service they would use if they became ill. Health facilities were the most commonly identified option, at 67%, followed by doctors at 29% and health workers at 19%.
The IOM began incorporating an Ebola module into its Flow Monitoring Survey in July to assess travellers’ awareness of the disease, knowledge of where to report suspected cases and intended care-seeking behavior if they became ill.
