It was just part of international headlines for the past six months. And while Ugandans empathised with headlines like ‘Ebola outbreak in Guinea unprecedented’ and ‘Ebola Death Toll in West Africa reaches 467’, the gravity of the disease did not resonate with many until ‘Ugandan doctor dies of Ebola fever in Liberia’ made it to the news.
Dr Samuel Mutoro from Kasese District died in Monrovia, Liberia where he was the head surgeon at Redemption Hospital and had been working there for the past three years.
His death brought back memories of two other doctors Uganda has lost to the virus –Dr Matthew Lukwiya and Dr Jonah Kule who died in 2000 and 2007 respectively. Dr Mutoro contracted the Ebola virus while treating a nurse at the hospital.
Dr Mutoro’s is one of the 539 lives the Ebola epidemic has claimed in Liberia, Sierra Leone and Guinea since February. This is out of the 888 cases of Ebola that have been found, according to the World Health Organisation.
During a report on CNN, Dr Peter Piot, the scientist said to have discovered the virus in the 1970s says this particular strain of Ebola is uncontainable and kills over 90 per cent of its victims.
Unlike previous attacks like the 2000 case in Uganda, the ongoing case of Ebola is the first in West Africa, affecting three different countries. It is also the first time that an outbreak has occurred in capital cities, an issue that makes it hard to contain the virus, since cities are typically congested.
The first cases of the virus were reported in Guinea, in the towns of Guéckédougou, Macenta, and Dabola in February. On May 23, the outbreak spread to the country’s capital of Conakry, making its over two million inhabitants at high risk.
The Zaire ebola virus, as it’s being classified later spread to Liberia and Sierra Leone.
What is Ebola?
In an a analysis drawn up on the CNN news site, the Ebola hemorrhagic fever is defined as a virus caused by one of five different Ebola viruses.
Four of the strains can cause severe illness in humans and animals. The fifth, Reston virus, has caused illness in some animals, but not in humans. Incubation is always around 21 days.
The first human outbreaks occurred in 1976, one in the Democratic Republic of Congo and the other, in present day South Sudan. The virus is named after the Ebola River (in DR Congo), where the virus was first identified in 1976, according to the Center for Disease Control and Prevention.
The virus is spread from human to human, once there is direct contact of body fluids like saliva, blood and stool from an infected person.
This also involves weakness, fever, aches, diarrhoea, vomiting, stomach pain and internal bleeding are some of the symptoms of the virus.
Typically, symptoms appear eight to10 days after exposure to the virus, but the incubation period can span from two to 21 days.
Managing different strains
When asked whether Uganda would survive the kind of strain that is in West Africa, the minister of state for Health in charge of general duties, Dr Elioda Tumwesigye, says management is the same for all strains.
“First of all, whether it’s Ebola Bundibugyo, or Sudan, the management is the same so when giving treatment, we don’t give medication basing on disease type,” he explains.
He adds that as a country, we are able to handle any of the strains, because to deal with such a calamity, it all depends on how fast you respond and handle the cases.
The minister of state for Health in charge of general duties, Dr Elioda Tumwesigye, states that Uganda has built a health capacity, including laboratories’, over time, given the experience from past attacks, making it easy for us to handle another strain.
He adds that Uganda as a country has the critical asset which is population.
“The population is aware. In case people suspect anyone in the community to have Ebola, they will alert the medical personnel. This is a total contradiction to the situation in countries like Liberia where people are hiding their sick relatives, and others are reported to have even run away from the hospitals,” he points out.
Dr Tumwesigye also points out that because of the vast knowledge in handling Ebola cases here in Uganda, many of the medical persons here have been asked to go and help out with the on-going edpidemic in Liberia, and Sierra Leone.
Fear of spread
With the laxity at many of our border points, there are fears that it may be very easy for the virus to find its way back into Uganda, but like Dr Elioda Tumwesigye states, the government has learnt from the past attacks, and he believes, we would be able to handle another attack.
The World Health Organisation has also issued a travel advisory that explains the virus, lists which people are at risk and recommends which precautions the transport sector and public health authorities should take.
The people at risk
Tourists and business people returning from affected areas. It, however, stresses the risk of being infected simply because you visited an infected area is extremely low.
n Visiting families and relatives. WHO explains that “the risk for travellers visiting friends and relatives in affected countries is similarly low, unless the traveller has direct physical contact with a sick or dead person or animal infected with Ebola virus.”
n Patients travelling with symptoms and fellow travellers. The organisation stresses that “risk to fellow travellers in such a situation is very low”.
However, contact with such persons should reported as a precaution.
Uganda has in the past been hit with the Ebola epidemic, with the first case arising in 2000 where it killed at least 170 people in Gulu. It hit again in 2007and claimed 37 lives in Bundibugyo, western Uganda.
The most recent attack was in 2012 in Kibaale District where 16 people died and by October that year, the World Health Organisation had declared the country Ebola-free.
Responsibility by the public
While there was widespread awareness about how dangerous Ebola is, several people in West Africa did not heed to the precautions they were advised to take.
For instance, the proper handling of Ebola victims requires one to hand them with gloves, zero contact with fluids of the affected persons. Also, the bodies of the deceased are supposed to be buried immediately, with help from medical persons that are well versed with the handling of these cases.
Instead, media reports had the following incidences:
-Families hid relatives suspected to have the virus.
-Patients ran away from health centres.
-Medical personnel took inadequate precaution.
-Improper funeral practices.
- Suspicion that Ebola is caused by witchcraft or that doctors are killing patients. The Chicago Tribune reported a case of villagers stoning ebola trackers in Sierra Leone.
It is these incidents that are partly to blame for how fast the virus has spread through the three countries, a report by Doctors Without Borders (MSF) explains.
How different is the strain in West Africa?
According to the commissioner for community health services at the Ministry of Health, Professor Anthony Mbonye, there are three types of Ebola, that have affected Africa; Ebola Sudan that we had in Gulu, Ebola Bundibugyo, and
Ebola Zaire, that is currently in West Africa.
He adds that Ebola Sudan and Ebola Zaire are both known to spread very fast and also have a high death rate.
“The strain in West Africa right now, is not any different. The only difference is that in Uganda, we have been able to learn how to handle these calamities, given our past attacks, so it would be easy for us to manage it, just in case it got here,” he says.
In addition to this, he says many of the Ebola attacks in Uganda, normally lasted one-to-two months, a clear indication of how easy it is for us to handle the epidemic.
“All districts have a medical task force, that is on hand to deal with any outbreaks incase Ebola erupted again,” says Dr Mbonye.
However, he explains that this is not a guarantee that medical personnel may not get exposed to the virus and lose their lives as it happened to Dr Matthew Lukwiya.