A total of 13,470 people were screened at Paro airport until December 28, 2014

Health: Even if one case of Ebola virus disease is reported in the country, Bhutan should declare it as a national emergency, public health officials cautioned.

It’s for this reason that despite being a low risk region for the disease that had claimed 20,206 lives so far, Bhutan is not being complacent with its preparedness.

“Our main focus is to not have any Ebola case,” chief programme officer of communicable diseases division Dr Karma Lhazeen said at an Ebola sensitisation workshop to media yesterday in Paro. “If we have one case, then we have to activate our disaster response team because it’s a disaster for us.”

Since the World Health Organisation declared Ebola a “public health emergency of international concern” on August 8 last year, health officials in Paro international airport have screened 13,470 people until December 28, 2014.

Of the total screened, 35 were from Africa of which three had flown in from Ebola affected country, Liberia, while one was from Senegal.

As part of its surveillance, the health ministry’s task force for Ebola has introduced Eloba screening forms in the airlines and has set up a counter to screen people flying into the country from affected countries.

Health officials said it was with much difficulty that they managed to get some space at the airport to open the health counter.

But despite announcing in the flights, airport health officials said, Bhutanese passengers have not been cooperating.

They either leave the screening forms in the aircraft or don’t fill up the forms properly, officials said. “We ended up arguing several times or informing the immigration desk to hold them until the papers are filled.”

Health officials are also waiting to receive from WHO two hand-held scanners to measure body temperature and discussions have been held with BAFRA to use some part of its plant and animal quarantine infrastructure to create an Ebola treatment centre.

Paro hospital has already been instructed to keep about two rooms to keep Eloba patients in isolation as well as Thimphu referral hospital for patients who need critical care, said health officials.

A total of 15 laboratory personnel have been trained on personal protective equipment (PPE), sample collection and shipment of Ebola cases while 40 health officials have been sensitised on Ebola case management. Some 200-airport staff have also been sensitised on Ebola and on the donning and doffing of PPE.

“Ebola or no Ebola, we have to sensitise all sectors,” Dr Karma Lhazeen said adding that the immigration department has been referring cases to the health ministry for clearance before people are allowed to enter the country.

But public health officials assured that infection control is not new to the country and that there was no need to panic. The Ebola outbreak has helped Bhutan gear up its ports of entry and set up a chain of communication, not just for Ebola, but also for any health emergencies.

“We are pretty confident that Ebola outbreak will not happen in Bhutan,” WHO’s representative to Bhutan, Dr Ornella Lincetto said. “But for Bhutan, the most important is preparedness even with low risk of outbreak as it gives us a chance to strengthen our capacity and prevent other infectious diseases.”

Dr Karma Lhazeen said importation of a single Ebola case, would be the main risk for Bhutan but the risk is still low because all travellers are screened from any port of departure. “In our surveillance system, Ebola would present as fever with haemorrhage,” she said.

The Ebola response is based on three scenarios – if an infected Ebola flies into the country; if neighbouring countries that Bhutan shared borders has an Ebola case and if an Ebola case is reported in the country.

The preparedness is divided into three phases and the budget estimated for the first phase is about Nu 1.2M.  On what was there to show that Bhutan was prepared, Dr Karma Lhazeen said, preparedness and response is different.

“We have to spend much more on response and if we had prepared and set up everything and then see no cases, then who will be responsible for the cost,” she said.

By Sonam Pelden, Paro