US plan for Ebola isolation facility in Kenya divides health workers

Shock and uproar have greeted reports that the United States plans to send to Kenya its citizens infected with the deadly Ebola virus, even as the government says it welcomes the move, describing the engagement as necessary.

According to reports by The New York Times and The Wall Street Journal, a quarantine facility—approved by the Kenyan government—would be set up to hold American citizens who have been exposed to, or are at high risk of testing positive for, the virus in the region.

The reports further indicate that the Donald Trump administration would deploy US public health officers to Kenya to staff the proposed quarantine facility amid the Ebola outbreak in the Democratic Republic of the Congo.

Health Cabinet Secretary Aden Duale confirmed on Wednesday the possibility of setting up the proposed quarantine facility for Americans, adding that Kenya is also establishing screening centres and holding facilities at border points.

“The Government of Kenya notes ongoing discussions with the US government and other global partners regarding international collaboration on strengthening preparedness and response mechanisms for Ebola Virus Disease (EVD) and other emerging public health threats. Kenya welcomes partnerships that strengthen global health security and reaffirm our shared commitment to protecting lives through coordinated, science-based action,” said Duale in a press statement.

Speaking at Sir Ali Mosque in Nairobi, Duale said: “We are also putting up holding areas within the borders. In the event we get a case, the country is well prepared for this Ebola situation. We also have one laboratory at the border between Uganda and Kenya and South Sudan and Kenya.”

On Tuesday, The New York Times reported that the US government had initially planned to monitor infected Americans in Kenya before transferring those who developed symptoms to Europe for specialised care.

But under the revised plan to establish a centre in Kenya, Americans who test positive would be treated in the country.

Duale, however, insisted that any such arrangement would be implemented in line with Kenyan law.

“Any arrangements regarding international health cooperation will be guided by Kenya’s national laws, public health regulations, biosafety and biosecurity standards, and the overriding responsibility of government to safeguard the health and welfare of the people of Kenya,” he said. Protection of Kenyan citizens, frontline health workers and communities remains paramount.”

The international publication reported that the quarantine and treatment facility is being set up in Kenya as a joint effort between the US Department of State, Department of Defense and Department of Health and Human Services.

At present, US public health service officers are being trained before being deployed to Kenya.

Additional reporting by Reuters said that some members of the US Public Health Service Commissioned Corps, a uniformed branch under the Department of Health and Human Services, have received notices to deploy.

Urgent deployment

The US Centers for Disease Control and Prevention, Reuters reported, has asked staff to volunteer for an urgent deployment. The personnel are expected to support Ebola screening at Kenya’s entry points.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus announced that an American who contracted the virus while working in the Democratic Republic of the Congo was flown to Germany for treatment.

Six other American nationals were also evacuated to the Czech Republic and Germany.

Nevertheless, the WHO has warned that the Bundibugyo strain, circulating in Uganda and the Democratic Republic of the Congo, is spreading rapidly. The strain has caused 220 suspected deaths and more than 900 cases. Kenya has yet to record a single case of Ebola infection.

However, the move to send American nationals suspected of contracting Ebola to a designated quarantine and treatment facility in Kenya has sparked uproar.

Kenyans have expressed fears that this could be another government-to-government deal, as details of the proposed quarantine and treatment facility remain scanty, including where it will be set up and when it will become operational.

Dr Kireki Omanwa, a consultant gynaecologist and president of the Kenya Obstetrical and Gynaecological Society, described the move as unfair to Kenya’s strained health system.

“Unless there is a motive, unless they want us to get infected. Why should Trump send patients to Kenya?” said Dr Kireki.

He added: “I really do not know why it is happening. When Ebola broke out, Kenyans went to help fight it; some lost their lives. Some foreigners affected were taken to the US, some recovered and others died. What has changed that the US now wants to bring patients to Kenya?”

Dr Kireki said that while Kenya’s health system is superior compared to other states in the East African region, including the Republic of Congo, the Democratic Republic of the Congo, Uganda and Tanzania, it cannot be compared to the US system.

“The US has better equipment, better diagnostics and medication, and even access to experimental medicine, which we do not have,” said Kireki. “Setting up an Ebola centre in Kenya is like a volcano erupting in Congo and then we try to put out the fire in Kenya. Does it make sense? Logically, let them put quarantines in the DRC.”

The Kenya Medical Practitioners, Pharmacists and Dentists Union also opposed the plan to set up an Ebola isolation and treatment centre in the country.

The union’s chairman, Dr Abidan Mwachi, said this could risk importing Ebola into Kenya.

Dr Mwachi said Kenya should prioritise its own national interests.

“I see no direct benefit in quarantining people for a disease that is not currently a local threat,” he said.

He added that setting up the facility could expose Kenyans to the highly infectious disease.“We cannot guarantee a completely foolproof system to prevent a possible Ebola leak into the population. Ebola has existed in Central African countries for a long time, and bringing it closer home, in my opinion, amounts to importing the disease. The benefits do not match the risks.”

Nurses and clinical officers have also questioned the motive, insisting that the centre should instead be set up in affected countries.

Kenya National Union of Nurses Secretary General Seth Panyako questioned why Kenya was being selected despite having no reported cases.

“Why set up a centre in Kenya? Do we have an outbreak?” Panyako posed, adding that the facility should instead be established in the Democratic Republic of the Congo and Uganda.

Clinical officers’ representative George Gibore questioned why the US government is preferring to set up a centre in Kenya and how the facility would operate. He urged the Ministry of Health to remain focused on World Health Organization (WHO) protocols for infectious diseases and avoid exposing the population.

But virologist Moses Masika said Kenyans should not be alarmed, as long as the hospital and healthcare workers are properly equipped and supported.

He said it is preferable to treat patients locally rather than transport them over long distances.

“Technically, it can be done safely if all measures are in place,” Dr Masika told The Standard.

Prof Julius Oyugi, a virologist, said there is no need for alarm and that Kenyans will remain safe as long as healthcare workers are well trained and proper infection control measures are in place.

He said the rationale for setting up a centre in Kenya is understood by both the US and Kenyan governments as part of a government-to-government arrangement, which the public may not fully grasp or have a say in.

“America cannot come and set up such an entity without permission from Kenya, particularly the Ministry of Health. The Government of Kenya has experts who understand diseases like Ebola and the implications of establishing such an institution in Kenya, and such a decision would not be allowed if it were deemed risky,” said Oyugi.

He noted that healthcare workers are often the first victims in Ebola outbreaks. “People making decisions at the Ministry of Health would not be keen to compromise the transmission of Ebola to the public,” he said, adding that it would be ideal for quarantine facilities to be set up in Uganda or the DRC.

Still, he maintained that even if the US establishes a quarantine centre in Kenya, there is no risk of Ebola spilling into the general population. He said any cases would be confined within the facilities and closely monitored by well-trained healthcare workers under strict disease control measures.

He noted that transmission of Ebola differs from Covid-19, saying Ebola is spread through direct contact with bodily fluids, while Covid-19 is airborne. He also said the incubation period for Ebola ranges between two and 21 days, during which suspected cases would be monitored, with those developing symptoms treated within the centre.

Health workers handling such cases, he said, must also be trained in PPE use, infection control, and safe laboratory handling of specimens.

“I don’t think it will have a spill, as long as the Government of Kenya, through the Ministry of Health, has put stringent measures to handle the cases,” said Oyugi.

He observed that, according to WHO protocols, quarantine or isolation centres are typically not set up far from borders between Kenya and Uganda.

However, he said that even if established in Nairobi, the centres would be properly managed, with suspected cases treated under strict infection control measures and healthcare workers equipped with PPEs.

He added that protocols for setting up isolation or quarantine facilities for infectious diseases such as Ebola require them to be located away from densely populated areas.

Health workers handling such cases, he said, must also be trained in PPE use, infection control, and safe laboratory handling of specimens.

“Quarantine should not be where we have a lot of people around who may end up getting into contact with blood and other body fluids,” said Oyugi.