In The Gambia, Africa’s smallest country, located perilously closely to the affected territories, uncertainty is growing. Walk-in centers at its two hospitals remain full, spilling over with patients who, if Ebola hit the area, would be turned away with nowhere to go.

Elsewhere, in the country’s buses—cabs or minivans that skid along its sandy roads—the radio announces the latest deaths caused by the disease. The air is thick with a certain pondering about the damage it could cause should it reach here. Nobody brings up the virus, but when news surrounding it is announced, quiet reigns. With a population of less than 2 million people, an infection as deadly as this one could cause unprecedented problems—particularly as the government is yet to introduce any precautionary measures whatsoever. The threat of Ebola is incredibly real, and though mostly unspoken, it is a concern for many across The Gambia.

With the Ebola epidemic gripping Western Africa tighter than ever before, the need to stop the deadly disease spreading has never been more important. And, with frequent reports emerging of sufferers being stopped at the borders of other countries, containing it is crucial. Nearly 900 people across four countries have already fallen victim to the disease. Though the main crisis areas remain in Guinea, Sierra Leone, and Liberia, several doctors treating those infected have either contracted the virus—or died as a result of it—in a matter of weeks.

Controlling the problem has proved to be an as yet impossible task, but there have also been troubling tales of sufferers attempting to cross borders closer to home. Ebola testing has been ramped up in both the US and Europe, with travellers flying in from Western Africa being subjected to health checks at airports. After American economist Patrick Sawyer contracted the disease in Liberia and subsequently flew to Ghana, Togo, and Nigeria (where he died days later), running the risk of infecting those he encountered en route, security is rightfully tightening around people flying in from countries close to the epidemic.

This safer-than-sorry method is certainly the right one to be taking, but striking the balance between precaution and over-protectiveness is a delicate one in Africa’s west. “You can’t say that borders in nearby countries should have been closed quicker,” says Kevan Benn, an immunologist at The Gambia’s Medical Research Council. “But you need to come up with a reasonable way of controlling the virus without hindering the daily routine of a country and ensuring Ebola doesn’t take its toll on the economy.”

A burgeoning sense of distrust across the west of the continent has arisen since its bloody civil wars, creating a culture of oppression in which the medical authorities have failed to garner respect. “People need to overcome this,” urges Benn, as concerns that people will fail to seek treatment take hold.

Senegal closed its land border to Guinea in March—a move praised for keeping the country, and its neighbor The Gambia, disease-free. But the regular passage of migrant workers through these small territories does nothing to limit Ebola’s spread, and the initial lack of urgency in quarantining victims has further contributed to its rapid dispersal. Ground reports from Sierra Leone dating as far back as late May cite discussions around Ebola as not being taken particularly seriously, though the Western world seems to be learning from Africa’s mistakes.

Over the weekend, a British woman travelling between The Gambia and London collapsed upon her return to Gatwick Airport, at which point she was rushed to a hospital and tested for the disease. The country gave a collective sigh of relief after results came back that her death was not caused by Ebola—although the good news wasn’t enough for some, with tabloid The Daily Mirror running the story on their front page the following day.

Across the ocean, the disease has had a controlled entrance into America after two doctors suffering from Ebola being were flown to Atlanta for special treatment. After a man was tested for the disease at Mount Sinai Medical Center last week, it’s clear that nobody’s taking any chances. This sense of vigilance in recognizing the disease’s symptoms and getting checked out immediately yields promise that future victims will be treated before the disease has the chance to do its worst.

In Africa, too, an increasing number of cautionary measures are being introduced, with cross-continent football matches being cancelled in Sierra Leone and Liberia, and the latter country resolving to cremate the bodies of all sufferers going forward to minimize the risk of the disease spreading.

Indeed, fears over the level of protection afforded to health-care workers dealing with the virus remain, but bringing Ebola patients Dr. Ken Brantly and Nancy Writebol to the U.S. is the most pragmatic thing to do, Benn believes. “If there’s anywhere that can pull off quarantining an Ebola victim, it’s America,” he says. “It was the right move. You have to take care of your own.”