Saturday July 20, 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.

ALSO READ: Ebola Epidemic Hampers Global Health due to Lack of Funds

“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

Children Under Five at Higher Risk of Ebola Outbreak; Represent One-third of Current Total Cases

The World Health Organization reports more than 2,500 cases of Ebola in eastern Congo, including nearly 1,670 deaths. 750 of those cases are children

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FILE - A woman and her children wait to receive Ebola vaccinations, in the village of Mabalako, in eastern Congo, June 17, 2019. VOA

The current Ebola outbreak in the Democratic Republic of Congo is affecting more children than normal.  The United Nations Children’s Fund says kids represent nearly one-third of current total cases, compared to about 20 percent in previous outbreaks.

The World Health Organization reports more than 2,500 cases of Ebola in eastern Congo, including nearly 1,670 deaths. The U.N. Children’s Fund says about 750 of those cases are children.

UNICEF spokeswoman Marixie Mercado says children under age five are especially hard hit, and account for 40 percent of infections.  She notes an exceptionally high number of children are succumbing to the virus.

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FILE – Mwamini Kahindo, an Ebola survivor working as a caregiver to babies who are confirmed Ebola cases, holds an infant outside the red zone at the Ebola treatment center in Butembo, DRC, March 25, 2019. VOA

“The case fatality ratio or the number of cases who die among this group of under-fives is 77 percent.  That is compared with 67 percent among the general population, which means that young children are at higher risk than adults,” she said.

Mercado says Ebola affects children very differently from adults.  Consequently, she says they need specialized care, both medically and psychologically.

She says children infected with Ebola receive the same drugs as adults, but they require smaller dosages. She says they also require treatment for diarrhea, against intestinal parasites and special nutritional feeding.

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A man receives a vaccine against Ebola from a nurse outside the Afia Himbi Health Center on July 15, 2019 in Goma. VOA

She says children who are separated from their parents or orphaned from Ebola need longer term psycho-social care and support to help them get over their loss.

ALSO READ: WHO: Rise of Ebola Epidemic in DRC’s Goma Could be a ‘Game Changer’

“Virtually all of them need help to counter the debilitating effects of stigma and discrimination that taints children affected by Ebola.   They need to be accepted, valued and loved by their families and communities,” she said.

ln Congo, Mercado says dedicated pediatricians provide special medical care for children in Ebola treatment centers.  She says every child is assigned a dependable caregiver who also is an Ebola survivor and therefore immune to the disease. (VOA)