How Sierra Leone is screening travelers for Ebola

With 2,240 Ebola cases now reported , the World Health Organization is urging the four countries affected by the deadly outbreak to perform exit screening at “international airports, seaports and major land crossings.” But what exactly does this screening entail?
I don’t know the answer but I can tell you what I saw last week when I flew out of Lungi International Airport in Sierra Leone, where I recently spent about a week reporting on the Ebola outbreak in Kailahun, the country’s hardest-hit district.
I first noticed some safety measures before I even entered the airport — and before I left the capital city, for that matter. Upon my arrival at the boat terminal in Freetown (yes, getting to the airport usually means lugging your suitcases onto a speedboat and taking a bumpy 20-minute boat ride), I was greeted with plastic buckets of chlorine water and asked to wash my hands before entering. Sodium hypochlorite, the active ingredient in your household bleach, is recommended as a disinfectant for killing Ebola virus and I saw plastic buckets with diluted chlorine everywhere in Freetown and Kailahun (though not so much in the small, remote villages that I visited, where people kept asking aid workers to bring them chlorine). I must have washed my hands in chlorine water between five and ten times a day; one of the Canadian scientists I met in Kailahun showed me the backs of his hands, where some skin had turned pale from all the bleach.
When we reached the other side of the water crossing, we were picked up by a minibus for the final leg of our journey to the airport. But as we approached the front gates, everyone was asked to get off the bus — no explanation was really given and a few of us exchanged confused looks before realizing we were being asked to wash our hands once again. We all climbed out of the bus and lined up before three buckets — but they were mostly empty and I washed my hands as best I could under the thin stream of water trickling from the tap.

It’s tough to say whether these screening measures are sufficient; there was no attempt to verify the information I filled out on my form and the health worker who assessed me was both distracted and non-communicative. It’s good to see that passengers’ temperatures are being taken with infrared thermometers , however (see the image at the top of this post); when I first arrived in Sierra Leone, a local nurse told me some patients were being screened for the virus with armpit thermometers — this raises obvious concerns when the virus being screened for can be transmitted through sweat.
And of course, airports aren’t the only way for people to exit the country. In fact, Sierra Leone’s porous borders with Guinea and Liberia have been a major contributor to the uncontrollable spread of this outbreak — for some of the villagers I met in Kailahun, getting to the country next door is as easy as climbing into a boat or taking a 30-minute walk.
I leave you now with a photo taken in a village called Sambalu in eastern Sierra Leone. This man, Moses Msellu, is pointing at Guinea, which is just a short paddle across the Moa river.
Before Ebola came along, Msellu made this crossing three or four times a week, he said; in fact, he first found out about the Ebola outbreak from friends in Guinea, not from health officials in his own country. He said the boats are all now held on the Guinea side, grounded until the outbreak is over, but there were no policeman here to reinforce this border when I visited — and as you can see, a determined person could still easily slip across.