Sunday November 17, 2019

Amid Ebola Crisis: Ugandan Medical Workers Lament Limited Support to Fight Epidemic

World Health Organization on Friday said the Ebola outbreak is an "extraordinary event" of deep concern but does not yet merit being declared a global emergency

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Ugandan medical staff inspect the Ebola preparedness facilities at the Bwera general hospital near the border with the Democratic Republic of Congo in Bwera, Uganda, June 12, 2019. VOA

The isolation ward for Ebola patients is a tent erected in the garden of the local hospital. Gloves are given out sparingly to health workers. And when the second person in this Uganda border town died after the virus outbreak spread from neighboring Congo, the hospital for several hours couldn’t find a vehicle to take away the body.

“We don’t really have an isolation ward,” the Bwera Hospital’s administrator, Pedson Buthalha, told The Associated Press. “It’s just a tent. To be honest, we can’t accommodate more than five people.”

Medical workers leading Uganda’s effort against Ebola lament what they call limited support in the days since infected members of a Congolese-Ugandan family showed up, one vomiting blood. Three have since died.

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FILE – Health workers dressed in Ebola protective suits are seen readying an Ebola preparedness facility at the Bwera general hospital near the border with the Democratic Republic of Congo in Bwera, Uganda, June 12, 2019. VOA

While Ugandan authorities praise the health workers as “heroes” and say they are prepared to contain the virus, some workers disagree, wondering where the millions of dollars spent on preparing for Ebola have gone if a hospital on the front line lacks basic supplies.

“Even the gloves are not enough,” the hospital administrator said Thursday. “I give them out small small.” A nurse nodded in agreement.

The World Health Organization on Friday said the Ebola outbreak is an “extraordinary event” of deep concern but does not yet merit being declared a global emergency . Such a declaration typically triggers more funding, resources and political attention. WHO said $54 million is needed to stop the outbreak.

And yet both Congo and Uganda appeared to lobby against a declaration, with Congo counting the Uganda-related Ebola cases as its own, saying Congo was where the family members began developing symptoms. Ugandan authorities on Friday said they had only one suspected Ebola case remaining in the country.

More than 1,400 people have died since this outbreak was declared in August in eastern Congo, one of the world’s most turbulent regions, where rebel attacks and community resistance have hurt Ebola response work. The virus can spread quickly via close contact with bodily fluids of those infected and can be fatal in up to 90% of cases, and identifying people who might have been exposed is crucial.

Possible exposure

While Ugandan health workers aren’t facing the violent attacks that have killed several Ebola responders in Congo, they remain at risk as they seek to isolate, test and treat for the virus. Basic equipment such as gloves is essential.

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FILE – People crossing the border have their temperature taken to check for symptoms of Ebola, at the border crossing near Kasindi, eastern Congo, June 12, 2019, just across from the Ugandan town of Bwera. VOA

At least two nurses at Bwera Hospital might have been exposed as they offered first aid to the infected family. They and some other contacts have since been quarantined in their homes. WHO says at least 98 such people have been identified in Uganda since the outbreak crossed the nearby border.

A nurse, who spoke on condition of anonymity to avoid possible retribution, questioned why some people who might have been exposed to Ebola are allowed to stay at home.

“I wish we could coordinate,” the hospital administrator said of the apparent confusion over how to manage the outbreak.

Ugandan Health Minister Jane Aceng told the AP on Saturday that district officials in Kasese were to blame for limited medical supplies after delaying in submitting their budget.

“It is clearly the responsibility of the district to order supplies,” she said. “If they haven’t done the orders we can’t supply because we don’t know how much they need.” As for upgrading the makeshift isolation ward in the hospital garden, she said “it is not economical. It is not cost-effective” to build permanent structures.

Government criticism

Uganda has faced multiple Ebola outbreaks and is a regional leader in battling Ebola, even if this part of the country has never experienced an outbreak. Some Ugandan physicians were deployed to the West African outbreak of 2013-2016, the deadliest in history.

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FILE – A Congolese man holds a cross during the burial service of Congolese woman who died of Ebola, at a cemetery in Butembo. VOA

Health workers in this outbreak now have the benefit of an experimental but effective Ebola vaccine that is being widely used, with more than 130,000 doses distributed. Uganda has vaccinated nearly 4,700 health workers, with more vaccinations set to begin Saturday.

Still, corruption is rampant, and many local people are scornful of government officials seen as out of touch.

As Bwera Hospital tried to arrange a safe burial Thursday for one of Uganda’s first Ebola victims, officials quickly realized there was no vehicle. The burial took place hours later and in darkness , which some residents called a sign of the government’s shortcomings.

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“This should have been done by the health office, the district health office,” said Moses Mugisa, clerk of the border town of Mpondwe-Lhubiriha, who eventually found transport for the corpse.

In addition, he said, voluntary health teams screening for Ebola on the border have gone unpaid for about four months. He criticized the decision of government officials from Kampala, the capital, to visit only briefly after Uganda’s first Ebola case was announced. “We have a lot of work to do,” he said. (VOA)

Next Story

Uganda Begins Largest-Ever Ebola Vaccine Trial to Prevent Disease from Speading

An epidemic across the border in neighboring Democratic Republic of Congo has killed over 1,800 people

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FILE - Ugandan health workers speak to civilians before carrying out the first vaccination exercise against the Ebola virus in Kirembo village, near the border with the Democratic Republic of Congo in Kasese district, Uganda, June 16, 2019. VOA

Uganda has started its largest Ebola vaccine trial to date, health authorities announced Monday, in an apparent effort to prevent the disease from spreading. An epidemic across the border in neighboring Democratic Republic of Congo has killed over 1,800 people, making this outbreak the second-deadliest to date, with fatality rates nearing 70%.

The experimental Johnson & Johnson vaccine will be administered to health care professionals, as well as ambulance drivers, burial teams and cleaners. The trial is expected to last two years and cover 800 people in the Mbarara district in southwest Uganda.

Vaccinations have already begun, according to Uganda’s Medical Research Council. There are no licensed treatments for Ebola, but one vaccine, manufactured by Merck, was used effectively at the end of the 2013-2016 outbreak in the DRC and has been used during the current epidemic. Over 180,000 people have received this vaccine.

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As the Ebola epidemic in the eastern Democratic Republic of Congo enters its second year, experts from the World Health Organization (WHO) are voicing concern. Pixabay

But the supply is sporadic, and vaccine administrators are typically 1,000 doses short of what they need, according to Doctors Without Borders as reported by Bloomberg News. Health professionals have called for the use of both the Johnson and Merck vaccines to maximize the number of people protected from Ebola.

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Some people, including the DRC’s former health minister, opposed the move, arguing that another vaccine with a different administration schedule would stoke vaccine distrust in vulnerable areas. While the Merck vaccine is administered through one shot and takes 10 days to be effective, the Johnson & Johnson vaccine requires two shots, two months apart.

Aside from sparking anti-vaccine fear, the Johnson & Johnson drug could be difficult to administer in practice, as violence in northeastern DRC hampers disease-control efforts. Neighboring countries have been on high alert since three people died of Ebola in the DRC city of Goma, located on the border with Rwanda and just a few hours from Uganda. (VOA)