Health surveillance at South Africa’s many borders, Sue Jean Taylor

Borders are regions of great stress, where illegality, human trafficking and the smuggling of goods occur on a daily basis, along with exploitation of vulnerable cross-border travellers, often to enrich border officials .  Some borders are more busy and notorious than others, and in South Africa this would be the Beit Bridge border post with Zimbabwe.  The Beit bridge border post and the border between Zimbabwe and South Africa is a high stress border with the number of needy travellers posing a challenge for both the town and surrounding farming landscape as desperate work seekers try and settle with some work to earn enough money to progress on to Johannesburg. As well as the actual transit through border posts, border towns receive new travellers who are often destitute, and often this places towns like Mussina under considerable stress to accommodate desperate persons, often women.

Busy transport routes moving hundreds of thousands of travellers. Image SJ Taylor

This stress is related to the level of need in the travellers, as well as their legal or illegal status, and other medical conditions, for example, women about to give birth. These issues would be important for disaster planning at borders.   

Because of the high volumes of travellers passing through this border, one wonders about the efficiency of inspections of people and goods. For example, it is possible to bring highly endangered Warburgia salutaris (the highly endangered pepper bark tree) through Beit Bridge into South Africa for the medicinal plant trade, seemingly undetected. This type of border control negligence also has important phytosanitary implications: we are already experiencing the Polyphagous Shot Hole Borer infestation of South Africa’s trees because of a beetle which probably came into the country (legally)  on wooden pallets that no-one checked.

We are also seeing very worrying trends in the rapid spread of novel zoonotic diseases which are diseases that can cross from animal hosts to human hosts, mutating along the way. A good example of this is the new corona virus that the UN health agency has formally called  Corona Virus Disease “COVID-19” and which represents a “very grave threat” for the world but the World Health Organisations says although this is a global health emergency, there is a “realistic chance” of stopping it.

The new Corona virus COVID-19, first identified in Wuhan, China in 2019.

South Africa has many informal border crossings with its neighbours and let’s hope for the spread of new diseases, that anyone traveling through any border and who is seriously ill, will be too sick to travel far. Let’s also hope they did not sit on a cramped bus for 13 hours in transit to the border!

The question remains, is there adequate disease surveillance at Beit Bridge or other regional borders should persons show unusual symptoms, for example fever (possible COVID-19 infection) or haemorrhagic symptoms arrived (as in Ebola)?  Are border officials at the border trained to recognise new diseases in travellers? COVID-19 may be very subtle in its manifestation, and detecting fever in hot African countries may not be adquate for surveillance.

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