Busia: At the border where Kenya meets Uganda lies Busia County, a strategic gateway and a public health pressure point. With an estimated 1,800 people crossing daily through the Busia and Malaba border points, the county has found itself repeatedly on the frontline of outbreaks from COVID-19 to cholera and now Mpox.

According to Kenya News Agency, between 2020 and 2023, Busia County recorded a total of 6,418 cases of COVID-19, followed by a measles outbreak in November 2021, with four cases reported. In July 2023, the county faced a cholera outbreak with 17 cases. The latest challenge is Mpox, with 59 cases recorded in 2024, including two fatalities in patients with underlying health conditions.

Susan Outa, Busia County Chief Officer for Public Health and Sanitation, explains that the county's status as a gateway exposes it to higher outbreak risks, necessitating active surveillance systems. 'When Mpox cases were first reported, we quickly designated Alupe Sub-County Hospital as the Mpox isolation center,' said Outa, acknowledging the challenges associated with this decision due to stigma from its previous role as a COVID-19 isolation center.

To address this, the county has launched public sensitization campaigns, reopening Alupe Hospital to general patients and promoting home-based care for stable Mpox cases to reduce stigma and facility congestion. Outa mentions the county's proposal for a dedicated isolation center and a budget allocation of Sh2 million for Mpox response, emphasizing the need for further support.

Partnerships with the national government, Red Cross, and UNICEF have enhanced staff training, public education, and stakeholder sensitization, involving religious leaders, sex workers, truck drivers, and local administration officers in awareness campaigns. 'Our hope is to establish an emergency response fund at the county level and deploy surveillance vehicles for real-time contact tracing,' Outa states.

Busia's collaboration with Ugandan counterparts through 'One Health' forums aims to improve cross-border outbreak management. 'We contained a cholera outbreak in 2023. We can handle Mpox too, but it requires preparation, partnerships, and policy,' Outa asserts confidently.

The county's Emergency Operations Centre (EOC), launched during the COVID-19 pandemic, plays a crucial role in managing outbreaks. According to Centre Manager Jude Oduor, the EOC collaborates with stakeholders to screen travelers and quarantine suspected cases, managing 59 Mpox cases as of August 1, 2025.

Jude Oduor highlights the dual-testing approach at the Busia County Referral Hospital laboratory for Mpox, ensuring diagnostic accuracy and collaboration between county and national health systems for timely interventions.

Jane Achodo, a nurse at Alupe Hospital, recalls the initial panic when Mpox first appeared. Rapid sensitization efforts equipped staff with the necessary knowledge, allowing them to apply COVID-19 protocols and use supportive drugs to manage symptoms, despite the absence of a specific Mpox drug.

Achodo notes the ongoing battle against stigma and the need for more health workers at Alupe Hospital. 'People are not coming back for regular services,' she admits, emphasizing the need for public trust in health facilities.

Kevin Fredrick, a patient at Alupe Hospital, shares his journey from symptoms to isolation, highlighting the importance of seeking medical help early. Similarly, Peter Gakuru and Geoffrey, other survivors, recount their experiences with Mpox, urging others to seek timely medical attention.

Linet Munyasa, Lab Manager at Busia County Referral Hospital Laboratory, discusses the lab's critical role in Mpox detection, facilitated by advanced molecular testing machines. The lab's capacity to test locally has likely saved lives, despite challenges with reagent shortages.

In Busia County, the fight against Mpox represents a story of resilience. Health workers, patients, and the community collaborate to tackle the outbreak, supported by national agencies and international partners. The county continues to advocate for more resources and reduced stigma to enhance its public health response.