Forgotten disease ravaging Kampala, Wakiso

In December last year, when Rosette Ngabire’s new boyfriend invited her to meet his family, she thought she had hit the jackpot. A single mother of two children, being introduced to her potential in-laws seemed like a dream come true. However, something sinister larked behind the dream, when she met her boyfriend’s family on Christmas Day. “We had fun. His family welcomed me. However, towards nighttime, my boyfriend told me he was feeling feverish and cold. It was so bad that he could not drive me home. He got worse, and was always thirsty,” she recalls. That is the day her ordeal began. A week after the visit to her in-laws, Ngabire’s pelvic lymph nodes swelled, causing her pain. She also developed a fever and a splitting headache. “I felt hot and cold at the same time. All these were signs of malaria, so when I went to a clinic, I was given antimalarial drugs. A day after I began the medication, my private parts started itching,” she says. When the itching worsened, Ngabire returned to the clinic.

This time, she was given medicated soap to use for bathing her private parts and drugs to insert after bathing. Instead, the itching got worse. When she sought a different opinion in another clinic, she was given treatment for a urinary tract infection (UTI). “The doctor did not run tests. He diagnosed me based on what I told him. The itching was so bad that I developed sores. After two days of treatment, the sores burst. I was in so much pain and I could not bathe,” she reminisces. By this time, Ngabire had developed a rash on her forearms. One day, while at work, one of her clients intimated to her that she might be suffering from mpox. “I had never heard of the disease, yet he told me some people had died from it. My workmates began isolating from me, distancing themselves. I decided to visit a third clinic.

Surprisingly, they also said I had a UTI and gave me another line of treatment,” she explains. For Maureen Acao, a resident of Matugga in Wakiso District, taking in her sick 25-year-old niece on December 18, last year, was the genesis of her problems. The niece had an unusual swelling on her private parts, which had multiplied from a simple pimple. “She had funny sores around her vagina and when I asked a doctor what they were, he said he did not know. However, he prescribed some injections for two days. There was no change in her condition,” she says. On the third day, the doctor advised Acao to take her niece to the isolation centre in Entebbe for better management. To ease her conscience, the girl intimated to Acao that her boyfriend had the same disease and had been taken to the isolation centre. “I was angry with her. I asked why she had not transported herself to Entebbe for treatment instead of coming to my home. I asked her if she wanted to kill us because she knew what she was suffering from.

I later learnt that she lived in a place that is a hotspot for prostitution,” Acao says, the anger still evident in her voice. The distraught woman called the isolation centre and an ambulance was dispatched to pick up her niece. Three days later, Acao and her three-year-old daughter came down with body weakness and headache. They were treated for malaria at a nearby clinic. “My baby began to get swellings on her body like she was suffering from chicken pox. I called Dr Alex Kakeeto and narrated to him our symptoms. He advised me to isolate myself and the baby and monitor the situation for two days,” she says. Acao called her cousin, who is a doctor, and got a prescription for some drugs. However, two days after taking the medication, there was no change in her condition. By this time, she could not swallow food, let alone her saliva. It was only her and the baby in the house, with no help. They were starving.

Extreme measures

Desperate times call for desperate measures, and the pain had pushed Ngabire out of her mind. When it seemed like no medication would help, she recalled that back in the village, there was a drug that was used to treat her father’s cows. “It was an injectable drug my father used to treat wounds and sores on the cows. I bought it and began injecting myself with it once a day. After each injection, I would feel relief from the pain for a few hours. The sores would even start to dry,” she explains. However, after three hours, the pain would return with a vengeance. The lesions would also begin running again. On the third day after she started injecting herself, Ngabire told her children that she was going to die and made a will. This was the third week since she had fallen ill. “I spent the entire day crying and fanning my private parts. At night, I would go to a bar and drink waragi (potent gin) until I blacked out. When I woke up, the pain would return. I had spent so much on treatment, that I was almost broke. A friend gave me Shs50,000 and advised me to go to a government health facility for treatment,” she narrates.

Unscrupulous health workers

By April 14, 2025, the Ministry of Health (MoH) had reported 5,386 cumulative cases and at least, 40 deaths from Mpox. The most affected age group were individuals between 25 and 29 years. Today, on average, 280 cases are reported per week countrywide, although this may be due to delays in case reporting. Districts with the highest number of cases include Kampala, Wakiso, Mbarara City, Mukono, Masaka City, Nakasongola, and Luweero. Dr Alex Kakeeto, an epidemiologist at Wakiso District local government and the Wakiso Incident Commander, notes that the district is registering about 10 new cases per day, with community deaths posing a serious threat. “As of April 13, we had registered more than 1,000 cases of mpox in the district. The number, though, is expected to be higher than that because several people are not coming to the health facilities for testing. Others come to the facility and receive treatment without testing,” he says. Mpox, previously known as monkeypox, is a viral illness that spreads through close contact with someone suffering from the disease.

Transmission occurs through exposure to bodily fluids, lesions on the skin, or respiratory particles. “From the information we get from the people who come for treatment, the disease is being spread mostly through sexual intercourse. We cannot stop people from having sex, but we advise them to look out for the signs. They should also be careful about being part of sexual networks,” Dr Kakeeto advises. The good news is that there are many recoveries from the disease. For instance, Wakiso District has so far had more than 9,000 recoveries and 26 deaths. However, some deaths in the community are not reported to the district health officials. “The most affected areas in Wakiso District are Entebbe and Nansana Municipalities as well as Wakiso Sub-county. Wakiso and Nansana are hotspots because of the high and mobile population, while Entebbe could be a hotspot because the isolation centre is located there,” Dr Kakeeto adds. One of the challenges in containing the disease is the population’s affinity to receiving treatment from private clinics. 

“In Uganda, we see people who have never studied a medical course setting up clinics. When people go to them with mpox, they try to treat the disease and fail. Some mpox patients need to be admitted. This means other patients who visit the clinic are exposed to the disease,” Dr Kakeeto laments. He adds that the district is now sensitising the owners of clinics on how to refer the cases to the government health facilities. However, only those who studied medical courses are being sensitised. “Mpox cases should be treated in isolation to protect other patients. Those clinics should refer the mpox patients to us or they can call us requesting ambulances to transfer the patients. However, some witch doctors are also trying to treat the disease, while some pastors are praying for the patients in their churches,” Dr Kakeeto narrates.

Getting the right treatment

With the Shs50,000 from her friend, Ngabire was at Wakiso Health Centre IV by 6am. Unable to wear a knicker, she only wore a long white dress. “When the doctor came to me, I just lifted the dress and squatted. On seeing what was going on, he was alarmed. He lifted his hands to his head and exclaimed, ‘Oh my goodness! We cannot manage you. You have reached a point of no return!’ I nearly lost my mind when I heard those words,” she recalls. The doctor told Ngabire to wait for an ambulance to take her to Entebbe Isolation Centre. However, she sneaked out of the health facility to bid farewell to her workmates. In her absence, the ambulance returned and picked up other victims. When she returned, there was no ambulance. “I was in so much pain, yet the doctors were avoiding me. I spent the entire day writhing on the grass in the gardens. In the evening, I berated the doctors for abandoning me. One of them, pitying me, gave me an injection. I will never forget the pain of that injection,” she says. The doctor advised her to stop taking alcohol. Another doctor prescribed an ointment and medicated bathing soap, which Ngabire had to buy in a pharmacy in Wakiso Town.

She was down to Shs7,000, yet the medication cost Shs6,000. “The pharmacists cautioned me to return the next day for transportation to Entebbe. I did not. Instead, I waited two days and went back for another injection. I began to notice an improvement and within a week, I could sit,” she says. For Acao, getting sores on her back was the catalyst that prompted her to seek treatment at the health facility. She took some pictures of her back and sent them to Dr Kakeeto. He advised her to find her way to Wakiso Health Centre IV where an ambulance would transfer her to Entebbe. “When I got to the health centre, I found many other victims, some of them worse off than my daughter and I. The doctors took samples from us and prescribed medication. They told me to go back home, while the other patients boarded the ambulance,” she narrates. However, the glitch was that Acao had to buy the drugs she was prescribed from a pharmacy outside the health facility, yet the information she had received was that the treatment would be free of charge. “We took the medicine, and the sores began to dry. After four days, the health centre called to inform us that we had tested positive for mpox.

The doctor asked how we were and wondered if we needed more treatment. I told him we were healing,” Acao recalls. The health centre kept up constant communication with Acao until she healed. Even today, Dr Kakeeto still calls to check on the woman and her daughter. Acao says she has not seen her niece since then. Today, Ngabire hates the man who gave her the disease although she admits that he probably did not do it intentionally. “I saw him again in mid-February and I attacked him. I accused him of wanting to kill me. He knew what I was talking about. He asked for forgiveness but how can I forgive him? He still calls, asking that we continue with the relationship but I am no longer interested,” she says. Dr Kakeeto says several survivors of mpox need counselling to fit back into the community. To meet this need the district health authorities have trained health workers to offer a psychosocial support pillar. “The health workers go out into the communities where these survivours live and hold sessions with the villagers to sensitise them about the disease. It is only uninformed people who stigmatise others, so we tell them that anyone can contract mpox,” he says.

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General Manager Editorial Daniel Kalinaki Acting Managing Editor Allan Chekwech
Editor, Sustainability Hub Gillian Nantume, Features Editor Caesar Karuhanga Abangirah, Contributor Simon Peter Emwamu