As Uganda steps up its response to its first confirmed Ebola cases, preparations made since the outbreak began in the neighbouring Democratic Republic of the Congo (DRC) are proving crucial to containing the disease.
“Uganda has invested heavily in preparing for Ebola cases and I’m looking forward to seeing how this investment has paid off,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa who begins a two-day mission today to see first-hand, the progress Uganda has made in fighting the Ebola Virus Disease.
“Health authorities have moved quickly to limit the spread of the deadly pathogen,” she said.
In Uganda, as of 24 June, there have been a total of three confirmed cases of Ebola Virus Disease. All three had recently travelled to the DRC, and all succumbed to the disease. In response, 108 of their contacts are registered for follow-up. Since the outbreak was declared, 980 people at high risk of Ebola have been vaccinated. There currently are no new confirmed cases of Ebola in Uganda.
Uganda shares a nearly 900-kilometre-long border with the DRC, where the disease has claimed over 1 400 lives since August 2018. Along much of the border, people mix and move across freely, often with family, friends and business contacts on both sides. Plugging the gaps is a major headache for emergency planners.
Uganda has called for the support of WHO and partners and together they have trained more than 16 000 community leaders and volunteers in remote border areas to spot the symptoms, provide medical attention to potential patients and to alert the authorities.
While huge risks remain, these local teams serve as the eyes and ears of a complex set of district and national emergency systems that cover surveillance, infection prevention and control, patient care, cross-border activities and coordination with communities.
All high-risk districts can now screen people, identify suspect cases and trace the contacts of potential patients when needed, and it’s a testament to Uganda’s preparations that Ebola was kept out for this long.
“In over 10 months since Ebola appeared in Congo, we dealt with over 600 alerts,” explained Dr. Henry Mwebesa, Director-General of Health Services for the Ugandan Health Ministry, shortly before the first case in Uganda was confirmed.
“Any case of high fever with some bleeding is considered an alert, and we’ve made sure we have enough infection prevention and control materials in place.”
“We can also test blood samples here in Uganda now, giving us the results in just 24 hours.”
Screening on the border, training over 9 000 health workers, repeated simulation exercises, and vaccinations for over 4 700 health workers – all supported by WHO – have been crucial in laying the groundwork for the response.
“The lesson [from the preparedness phase] is that it is vital to building up solid structures and systems,” said Dr Mwebesa. “So even if this outbreak stopped today, and if we got another outbreak- say two years later, we would be in a much stronger position to deal with it.”
Dr Mwebesa acknowledged that the challenges related to the often-porous border with the DRC remain.
“People cross. Some of them even have families on the other side, so people are coming over, including from affected areas,” he said. “But we have village health teams, we have volunteers who are trained to identify these cases.”
Gerald Misaleza, a nursing officer in the high-risk border district of Bundibugyo, explained that educating communities is key to securing the unmarked areas.
“We teach community leaders and volunteers about the dangers. We’ve trained them to spot the symptoms, isolate potential patients and alert the district Ebola task team.”