How travellers get Yellow Fever cards without vaccination

Monday October 28 2019

Genuine. The Yellow Fever card got from Norvik Hospital, one of the accredited health facilities.

Yellow Fever vaccine cards are being sold on the streets for Shs60,000 to unvaccinated Ugandan travellers, who upon presenting them at Entebbe International Airport, are cleared to proceed to their destinations. Daily Monitor has established the scam has been ongoing for some time.
Our three-week investigation shows how one can easily get a Yellow Fever immunisation card without being vaccinated.
According to our investigations, these cards are acquired majorly by people scheduled to travel out of the country but do not want to pay the higher fee charged by hospitals accredited to administer the vaccine.
Hospitals charge about Shs100,000 for the vaccination. According to World Health Organisation (WHO), Yellow Fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes of the Aedes and Haemogogus species.
Its symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue.
The Yellow Fever card became a mandatory requirement for travellers following the outbreak of the disease in Masaka and Rukungiri districts in 2016.
The Ministry of Health directed that all travellers exiting or entering Uganda must be vaccinated against the disease to prevent infection or spreading.


Forgery. The Yellow Fever card from Kisenyi Health Centre IV. photos by RACHEL MABALA

Yellow Fever cards are only issued by the Health ministry and given to accredited hospitals to administer the vaccine.
The cards are engraved with the ministry’s logo but accredited hospitals are required to stamp and engrave them with a seal to validate them.
A list of all the accredited hospitals is sent to Entebbe airport and other border posts for officials to verify the seal of the hospital on the card when it is presented by a traveller.
According to the Health ministry’s guidelines, the card is supposed to only be given to someone who has been vaccinated against Yellow Fever.
It is this card that a traveller presents to officials at either the airport or immigration offices at borders before they are allowed to enter or travel out of the country.
However, our investigation shows that while officials at Entebbe airport and border immigration offices have a list of accredited hospitals, they cannot tell whether a traveller, who carries the card, was vaccinated or not because details of all those vaccinated remain at the hospitals.
This has given leeway to unscrupulous people to forge the cards.
Mr Jacob Siminyu, the spokesperson of the Ministry of Internal Affairs, which oversees the directorate of Citizenship and Immigration, told Daily Monitor that the Health ministry has not alerted them on the ongoing scam.
But he added that whereas immigration officials are mandated to allow only travellers with the cards to leave the country, they do not have the means to determine whether a traveller was vaccinated or not.
“The Ministry of Health needs to put mechanisms which can help our officials ascertain whether a traveller was vaccinated or not. Otherwise, it is very hard for our officials to identify those who were not vaccinated because they come with valid cards at the borders,” Mr Siminyu said.
The scam involves a cartel of city medical practitioners, who use brokers to carry out the fraudulent transactions on their behalf to avoid detection.
The brokers only accept to meet you after being satisfied that you are a genuine traveller, not a spy.
Our reporter carried out an undercover to unravel the cards scam and how it is executed.
The reporter disguised as a labour worker scheduled to travel to South Africa. He shares his findings.
“I was connected to a medical officer working at Kisenyi Health Centre IV in Kampala’s Central Division. The official asked for Shs60,000 but he declined to discuss much on phone and proposed that they meet the next day.
He postponed the meeting several times and after four days of pleading, he told me to meet a man at Kisenyi Health Centre IV on October 9.
The health officer at the centre said he only had Yellow Fever cards from Norvik Hospital. Norvik Hospital, located on Bombo Road, Kampala, is one of the hospitals accredited to vaccinate against the disease.


Sarah Opendi, State minister of health in charge of general duties

Upon reaching the health centre, a man ushered me into an office within the hospital.
The official opened one of the drawers and pulled out a bundle of Yellow Fever cards and filled in the forged details of the passport number and name which I had given him.
The bundles of cards were meticulously arranged in the drawer and were engraved with the Ministry of Health logo with a stamp and seal reading Norvik Hospital.
He backdated the time of issuance to July 14, 2019, and forged the batch number of the Yellow Fever vaccine and signature. As I waited for the card, two women, who had made an earlier appointment, sauntered in to pick their cards too.
I later learnt from their conversation with the health official that they were scheduled to travel to United Arab Emirates in the next three days.
When I inquired why the official was issuing out cards from Norvik Hospital, a private facility, yet he works in a government one, he said they get the cards from their colleagues at the hospital.
He also claimed that Norvik receives a big number of the cards from the Ministry of Health hence it becomes easy for his colleagues to get some of them, which they sell to desperate travellers on the black market. However, Daily Monitor could not independently verify the claims.
Kisenyi Health Centre IV is among the eight public facilities managed by Kampala Capital City Authority (KCCA).
It is only City Hall Health Centre II out of the eight that is accredited to administer the vaccine. The KCCA health centre charges Shs102,000 per vaccine but other hospitals in the country have varying charges.
The official told us that many travellers prefer to acquire the cards without being vaccinated because of the high cost at the accredited hospitals and the urgency of the flight.
“We have helped very many people and they have never met any resistance at the airport and other borders. I am very sure of what I am giving you,” he said before handing the card to me.

Vaccination at Norvik Hospital
To verify the authenticity of the Yellow Fever card, which we acquired undercover from Kisenyi Health Centre IV, I visited Norvik on October 16 to be vaccinated.
I was asked to pay Shs60,000 and a receipt was issued to me. My details, including date of birth, age, nationality and date of vaccination, were entered in the system.
Upon vaccination, I was asked to sign in a book to prove I had been vaccinated and given the card. The card bears the stamp and seal of the hospital and is also engraved with the logo of Ministry of health.
Both the Norvik Hospital card and one I acquired undercover at Kisenyi bear the same stamp and Ministry of Health’s logo. It is hard to detect forgery.
However, the serial numbers differ in length. The genuine Norvik Hospital card’s serial number has six digits while the forged one from the Kisenyi health centre has nine digits. The rest of the features look the same.
When contacted yesterday, Mr Emmanuel Ainebyoona, the Health ministry senior spokesperson, advised that we ask Norvik Hospital to explain the variations since both cards bear their stamp and seal but with different serial numbers.
He added that he was unable to confirm the features by yesterday.
However, this newspaper’s attempt to speak to Norvik Hospital authorities for the past one week hit a snag.
Ms Mildred Obeja, hospital’s client care officer, declined to comment on the matter, saying it is only the medical director who is mandated to speak to the media.
She promised to have an interview with me with the hospital’s medical director, but our efforts to have it were futile.
Our follow-up calls to her mobile phone number went unanswered. She did not reply our WhatsApp messages either.
When contacted on Thursday, the Health State Minister for General Duties, Ms Sarah Opendi, said the ministry was not aware of the cards scam.
“I am shocked that this is happening because we thought that we had solved this challenge. Now that you have alerted me, I need to inform the officials at the Civil Aviation Authority about this fraud. We shall look into it and take action,” she said.

Health warning
Ms Opendi wondered why someone would choose to travel with a fake card yet vaccination would prevent them from acquiring the deadly haemorrhagic disease.
“Why are people risking their lives by travelling outside the country without vaccination? When you choose to use a fake card, it means you are taking your life for granted,” she said.
Asked why the details of those who are vaccinated from accredited hospitals are not shared with officials at the airport for verification, Ms Opendi said the ministry would look into that option.
However, she warned all accredited hospitals against loopholes in the issuance of the cards, saying such an anomaly not only points at laxity in their systems to fight fraud, but also breaches the agreement they made with the ministry.

Laxity at airport
On October 18, I visited Entebbe airport to ascertain how immigration officials verify the cards presented by travellers.
I found out that unlike passports, which are scanned to prove authenticity, Yellow Fever cards are not.
Officials look at the seal and stamp of the hospital on the card and if these details correspond with the list of hospitals which they have, they let the traveller to proceed.
I also found out that officials cannot tell whether a traveller was vaccinated or not because they do not have details of all those who were vaccinated at the accredited hospitals.
I spoke to at least three different officials at the airport and they intimated that they only look out for the Ministry of Health’s logo, seal and stamp of the accredited hospital and whether the card bears the passport number.
If the name of the hospital on the seal corresponds with the list of the accredited hospitals they have, they allow the traveller to proceed.
They also said there is no digital verification of the cards except that of the passport.
I also interviewed several people, who recently travelled out of the country to corroborate my findings at the airport and they confirmed immigration officials only looked at the seal and stamp of the hospital on the cards and allowed to travel.”
Dr Simon Abachu, a health personnel at Entebbe airport, confirmed by telephone on Friday that some travel lers use forged cards.
Dr Abachu said checking the cards at the airport is no longer done by medical officers.
“Initially, our medical doctors used to check at the departure centre but there were some internal issues where it was found out that verifying the travellers’ Yellow Fever cards was delaying flights. It is now handling agents who check the cards,” he said.
According to Dr Abachu, the scam is most common among labour export companies, which he alleged acquire the cards for their workers without vaccination.
Asked how they intend to close this loophole, Dr Abachu said the Ministry of Health must give full mandate of verification of the cards to health officers at the airport, adding that currently, they do not have powers over the exercise.
• Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The “yellow” in the name refers to the jaundice that affects some patients.
•Symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue.
•A small proportion of patients who contract the virus develop severe symptoms and approximately half of those die within seven to 10 days. The virus is endemic in tropical areas of Africa and Central and South America.
•Large epidemics of yellow fever occur when infected people introduce the virus into heavily populated areas with high mosquito density and where most people have little or no immunity, due to lack of vaccination.
•Yellow fever is prevented by an extremely effective vaccine, which is safe and affordable. A single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against the disease.
•A booster dose of the vaccine is not needed. The vaccine provides effective immunity within 10 days for 80-100 per cent of people vaccinated, and within 30 days for more than 99 per cent of people vaccinated.
Source: WHO