Bwera, Uganda — "When it comes to health, it should not be compromised at the expense of business and livelihoods."
At the Bwera border crossing in Uganda's southwestern Kasese District, trucks and tuktuks filled with plantain, tomatoes, cabbages, and fish normally shuttle back and forth into neighbouring Democratic Republic of the Congo (DRC), making it one of the region's busiest trade routes.
That hectic hustle has slowed to a crawl since the Ugandan government imposed border restrictions in May to try and contain the outbreak of a rare and deadly strain of Ebola in northeastern DRC, with its epicenter roughly 160 kilometres from Bwera.
Lines of trucks now sit idle on the DRC side, with many waiting days to return to Uganda. For traders and transporters dealing in highly perishable goods, every day of delay carries a cost, leaving both cargo and livelihoods in limbo.
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"It pains us so much," said Kanyama Farouk, 32, a truck driver who was stranded in DRC for four days. Forced to sleep in his vehicle, his cargo of plantain had spoiled by the time he was allowed to cross, after undergoing a health screening, disinfection procedures, and lengthy customs checks introduced as part of the Ebola response on both sides of the border.
"They must allow these trucks to keep moving for the community to survive [economically]," he told The New Humanitarian. "When you say there is Ebola, there is also hunger, so there are two diseases."
Counting the costs
The Ebola outbreak has so far killed 127 people in eastern DRC with 635 confirmed cases - although the true toll remains unclear because people are dying outside health facilities without laboratory confirmation. The virus has already reached Uganda, which has confirmed 19 infections and two deaths.
This is one of the largest outbreaks recorded and involves the rare Bundibugyo strain, for which there are no approved vaccines or treatments. It first emerged in DRC's conflict-affected Ituri province - possibly going undetected for months - but has since spread to North Kivu, South Kivu, and now Uganda.
The World Health Organization (WHO) says the outbreak does not pose a pandemic threat, but has warned of a severe regional risk given the high fatality rate, estimated at up to 50%.
To keep people safe, the authorities suspended public transport and non-essential cross-border movement, while individuals returning from DRC face a mandatory 21-day isolation period, matching the virus's incubation window.
Although the border was initially closed completely, fuel tankers and cargo trucks carrying essential goods, including food shipments like those transported by Farouk, are now permitted to cross without drivers undergoing quarantine - provided they comply with strict health screening measures.
These include temperature checks, symptom screening, and the registration of travellers and cargo crews so they can be monitored for any signs of illness after crossing. Vehicles and cargo are also subject to disinfection.
As a result, trade flows have slowed significantly, with queues up to two kilometres long at the Mpondwe border post near Bwera, creating bottlenecks across the supply chain and adding pressure to already strained border economies that depend on rapid and easy movement between the two countries.
Bilateral trade between Uganda and Congo exceeded $1 billion in the 2024/25 financial year, according to local media.
"My store is full of Congolese goods," said James Thongo, a 38-year-old shop owner in Bwera. "It has been almost one week without getting any money [due to the business slow-down], so I'm suffering."
The restrictions are also creating knock-on health concerns. Nearly 900 Congolese living with HIV receive treatment at Arua Regional Referral Hospital in northwestern Uganda, and there is worry their care could become disrupted as they are unable to cross the border.
"We need to ensure those essential services continue," said Remmy Buhuguru, an epidemiologist at the hospital.
lrene Nakasiita, a spokesperson for the Uganda Red Cross - which is supporting the Ugandan government with screening at border points - acknowledged that some decisions were a "little painful," but said: "When it comes to health, it should not be compromised at the expense of business and livelihoods."
Do border closures work?
Yet international health agencies note that restrictions can become counterproductive in a region where unofficial cross-border movement is routine. Questions also remain over how effective containment can be when the virus's incubation period makes detection at entry points inherently uncertain.
WHO has cautioned against blanket border closures, warning they may drive movement into informal crossings where surveillance is weaker and transmission harder to track. "Restrictions don't really help," said WHO's director general, Tedros Adhanom Ghebreyesus. "Addressing the epicentre is the solution."
The International Organization for Migration (IOM) instead is calling for coordinated cross-border systems that keep mobility visible, safe, and traceable. "Viruses do not stop at borders, and neither should our response," said IOM's deputy director general, Ugochi Daniels.
Fears over the permeability of the frontier are well founded. In Arua City, close to Uganda's northwestern border, health officials say Congolese nationals are using unofficial routes, complicating surveillance and tracing.
"Two Congolese came from Bunia after burying their mother and entered Arua, but we have failed to get where they have gone, and they are now within Uganda," said Alfred Amandu, acting principal health officer for environmental health in Arua City. "Many Congolese are coming in across these borders which are not manned."
Zambia's alternative approach
Zambia, which shares a 1,600-kilometre border with southern DRC, is taking a different approach and is keeping its crossings open.
Sody Munsaka, a professor of neuroimmune and infectious diseases at the University of Zambia, noted that border closures are difficult to enforce in countries with vast frontiers.
"People will still cross anyway, so people should be encouraged to cross at formal checkpoints, because at least there's some kind of screening and health information at those points," he told The New Humanitarian.
Eugene Njovu, president of the Southern Africa Truck Drivers' Association of Zambia, which represents around 2,500 drivers - many operating routes to eastern DRC - said border checks offer some reassurance, but enforcement gaps still exist.
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He called for more regular and coordinated screening: "We want to see consistency regarding that matter, because it's a very, very desperate situation."
Munsaka offered a note of caution. Given the virus's long incubation period, "it's very, very difficult" to do effective border control, even at formal crossing points. But that doesn't mean screening is worthless. It can still identify people showing early signs of Ebola, such as a fever, which makes it important as part of broader surveillance efforts, he added.
Uganda, with an efficient surveillance and tracing system developed over years of epidemic control, remains unmoved over criticism of its border restrictions. Officials point to the absence of confirmed cases in Kasese as evidence that heightened monitoring and movement controls may be helping to limit local transmission.
But for residents of Uganda's border communities, the debate over whether the restrictions are effective remains secondary to their immediate consequences.
"We have lost a lot of money, and this is a common man's money," said Zawadi Musa, a 42-year-old truck driver and businessman, at the Bwera border. "People are going to have it rough with this kind of situation."
Edited by Obi Anyadike.
Alex Wandeba, Uganda-based radio journalist
Freddie Clayton, British journalist who covers climate, the environment, and public health
