My Ebola Story: Key strategies that kept the Ebola virus at bay

When the Ministry of Health declared an Ebola outbreak in Mubende District on Tuesday, September 20, 2022, there were a number of decisions taken in order to stem the further spread of the virus.
The surprise announcement of  the lockdown and night curfew in Mubende and Kassanda districts, less than a year after easing the Covid-19 pandemic lockdown, was perhaps the most unfortunate, but necessary decision to stop the spread of the virus between September and December 2022.
A section of experts, leaders, and communities affected by the disease believe that the lockdown and night curfew that paralysed normal livelihoods in the affected areas was a magic bullet in reinforcing health guidelines, and quick emergency response plans by both the government and health partners.

During the first week of the Ebola Sudan virus disease outbreak, the government through the Health minister had ruled out a possible lockdown in Mubende and Kassanda districts citing the mitigation measures that were at hand to check the disease. But the government in a U-turn announced a lockdown on October 15, 2022.
That day, President Museveni announced a 21-day lockdown in the two districts. The night curfew hours were between 7pm and 6am.
“Movement into and out of Mubende and Kassanda is prohibited,” President Museveni said in his televised national address.
Both public and private transport and boda bodas were not permitted to move in Mubende and Kassanda districts to curb the spread of the Ebola virus disease. People travelling across Mubende and Kassanda were only permitted to move after a police clearance.
 
Cargo
The vehicles were also prohibited from transporting people in the two districts. Any cargo that was supposed to be picked up or dropped off had to operate between 6am and 5pm. The President revealed that this was a result of the non-compliance to the earlier government guidance in controlling the Ebola virus disease.
While the schools remained open, the places of worship and entertainment in the two districts also closed. The movement of government and security vehicles was not restricted, but limited to movement within the two districts of Mubende and Kassanda. Other guidelines included the suspension of all seasonal markets, and the deployment of 20 ambulances by the Ministry of Health to the two districts for the continuity of essential services.
The lockdown ended up being extended for the next 63 days so as to stop the spread of Ebola to areas outside Mubende and Kassanda.
 
Timely intervention
Mr Edward Habiyaremye, the chairperson of Madudu Sub-county in Mubende District, says the restriction on movement ensured that the suspected cases in the community could be easily traced.
“The Ebola Sudan virus disease was highly contagious and could not be checked without strict restrictions on the movement of people outside the district. You had cases that escaped from the Ebola Treatment Unit (ETU), including people who travelled outside the district after getting into contact with the Ebola patients. The lockdown ensured that the disease was checked,” he said at the weekend.
The virus had the ability to devastate Madudu Sub-county if the government did not quickly introduce strict health guidelines, Habiyaremye adds.
Ms Rose Mary Byabashaija, the Resident District Commissioner of Mubende District and the head of Mubende District Ebola Taskforce, says they paid attention to people entering and exiting Mubende District.

“You remember that the government was hesitant to restrict the movements during the first week, but the unfolding events and the rate at which the disease spread during the second week of the outbreak was a big concern. We faced a challenge in managing the lockdown, but it helped check the spread of the virus,” she reveals, adding: “With most residents locked out of movement except within their gardens and homes, it was easy for the emergency response teams to trace suspected cases for evacuation,” she says.
However, Mr Enoch Tebandeke, a resident of Mubende East Division in Mubende Municipality, while appreciating the different measures instituted by the government, shares the negative effects of the lockdown.
Tebandeke operated a bar business on Link Road in Mubende Municipality, but the lockdown and curfew guidelines made it hard for his family to survive. The business closed because the bar was frequented by travelers.
“I lost business, but this is the time to pick up because we are sure about our own health. The lockdown partly helped us secure our health from the threat the Ebola virus had posed. I lost business, but my family is safe,” he says.
 
Mobile testing lab
When the outbreak was first announced, the confirmatory test results were delivered at Mubende Hospital more than two days after the samples were referred to the Uganda Virus Research Institute in Entebbe for testing.
The blood samples picked from Mubende Regional Referral Hospital on September 17, 2022 had the test result delivered on September 19, the very day the patient died.
As patient numbers increased, the pressure on how to ensure a better turnaround time for samples gained momentum. The location of UVRI at Entebbe, a distance of more than 170kms from Mubende Regional Referral Hospital coupled with the unfavorable road network, perhaps complicated the turnaround time for the sample delivery.
This paper has learnt that at one time during the first week of the outbreak, it was deemed non-cost-effective to pick samples for immediate transportation as suspected Ebola pandemic numbers ticked upward.
While the Uganda Virus Research Institute (UVRI) hosts the national and international reference laboratories for highly infectious viruses, the need to have a shorter turnaround time for test results crossed the hands of donors and the Ministry of Health.
At the intervention of partners and the Ministry of Health, the Mobile Ebola Testing Laboratory managed by the Central Public Health Laboratories was set up on September 30, 2022.

The director of Mubende Regional Referral Hospital, Dr Emmanuel Paul Batiibwe, says the Mobile Ebola testing laboratory boosted case management systems at a time when the case numbers were surging.
“Having the turnaround time from collection of samples and release of results reduced greatly boosted management of cases at the Ebola treatment unit. The turnaround time for samples at the lab was six hours,” he says.
Statistics at the Mubende Hospital reveal that the Mobile Ebola testing lab with a diagnostic capacity of 50-60 samples per day had screened 1,646 blood samples as of November 13, 2022.