Ebola: Govt learned no lessons from past

The Mubende District Ebola burial team loads a casket containing a body of an Ebola victim onto a pick-up truck on Tuesday . PHOTO/ FILE 

What you need to know:

  • Mr Tony Walter Onena, who won a presidential medal on Ebola care and management in 2015, says government has since 2007 been dragging its feet over resolving key matters around past recommendations on handling the virus.

A frontline specialist and expert in Ebola case management and treatment has revealed that a failure by the government to heed past reports and recommendations on Ebola case management and control renders the country defenceless and vulnerable in the worst case scenario.

Mr Tony Walter Onena, who won a presidential medal on Ebola care and management in 2015, said the government has since 2007 been dragging its feet over resolving key matters around past recommendations on handling the virus.
The retired medical practitioner cited the stock-out of personal protective equipment (PPE), drugs, and hot water systems in case management facilities as the country attempts to get on top of the current outbreak reported in Mubende District.

“Once the World Health Organisation deployed us to Monrovia in Liberia in 2014 following an outbreak there, the hot water system was very key to cooling their [patients’] temperatures down because these patients are constantly in high fever, and this is still existing in key treatment facilities,” Mr Onena said in an interview with Saturday Monitor on Thursday. 
“Where there were no hot water systems in the wards in Liberia, the patients suffered because the pain and fever makes one very cold due to the extreme fever, every time they require to be dusted with warm water… and hygiene is very paramount in treating these patients.”

Mr Onena was deployed by the Health ministry in all previous Ebola outbreaks experienced in the country. He was among the frontline health workers deployed in Gulu in 2000 when the deadly viral infection broke out in the country. The Health ministry also used his expertise in 2007 to help manage an outbreak in Bundibugyo District.
He was also part of the team of health workers deployed by the government to manage an outbreak of Ebola in Kagadi District in 2012, and an outbreak of Marburg in Kabale District later the same year. It was then when he joined other health workers in generating a report in which the Health ministry was brought up to speed with the critical requirements needed to manage epidemics.

Key among the recommendations was the provision for hot water systems wherever the government established Ebola patients management units which, adds Mr Onena, “I am not sure whether it has been done.”
“The government was also asked to secure and avail all health centres across the country with necessary PPEs  so that once there is an outbreak, health workers do not have to wait from the ministry or WHO as infection spreads,” he added.

Mr Tony Walter Onena

Cracked control plans
Early this week, this publication reported that cracks had emerged in the plans by the government to contain the spread of the disease. Health workers at Uganda’s border points with the Democratic Republic of the Congo (DRC) and South Sudan have decried the lack of tools to screen inbound travellers for Ebola Virus Disease (EVD).

The government, in a hastily-organised press conference in Kampala on Tuesday, confirmed that a 24-year-old man in Mubende District had died of Ebola Sudan variant, hours after this publication broke the story.
With the origin of the infection and indeed the index case unknown, the news triggered panic, despite assurances by the government that it is prepared to manage this outbreak or any epidemic.

However, in various interviews conducted on Friday to assess the readiness at entry and exit points, border health officials said they had no machines to check incomers, no PPEs and gloves.
At Elegu Border Point, for example, authorities confirmed that frontline health workers lacked PPEs and even detergents such as JIK to guarantee hygiene.
Elsewhere, in Kanungu District, the Resident District Commissioner (RDC), Mr Ambrose Mwesigye, said logistical challenges continued to impair response.

In Kasese District, which borders DR Congo, where there are subsisting Ebola Zaire infections, Ms Agnes Mbabu— the district health educator—said the thermal scanner at Bwera Border Point, a key equipment for detecting unusual body temperatures of travellers, was damaged in a fire incident six months ago. It is yet to be repaired or replaced.
In Buliisa, where trade with and travel to Mubende, the ground zero for the current outbreak, is common. The District Health Officer, Dr Alex Afeti, said they are awaiting guidance and logistical supplies from the Ministry of Health headquarters in Kampala, about 290kms away.

Ministry responds
On Friday, Mr Emmanuel Ainebyoona, the Health ministry spokesperson, told this publication that a response plan in managing Ebola and other hemorrhagic diseases has over time been developed.
“We have clearly developed guidelines on managing it (Ebola), and there are booklets and other manuals that clearly guide our health workers during outbreaks,” he revealed, adding, “The health workers have also over time been trained on how to manage the situation once there is an outbreak.”

Asked about the availability of PPEs at health facilities across the country, Mr Ainebyoona dismissed claims of any stock-outs.
“These are always available at the National Medical Stores and are dispatched based on need,” he said, adding, “In Mubende District, where we have the Ebola outbreak now, the management kits and other PPEs have been dispatched there.”