Since the initial discovery of orthoebolavirus during the 1976 disease outbreaks in Zaire and Sudan, nearly 40 additional incidences have occurred. While these Ebola disease (EBOD) episodes have been reported globally, Sub-Saharan Africa accounts for most of them. Countries such as Sierra Leone, Guinea and Uganda have all experienced EBOD outbreaks. In fact, Uganda itself has had several different episodes over the last 20 years. While these disease outbreaks cause harm and disruptiveness to many communities, they also provide valuable learning opportunities. Additionally, information that medical professionals glean from previous events can be useful for addressing future epidemics. To successfully control emerging outbreaks of Ebola disease in Uganda, medical professionals should heed lessons they learned from past orthoebolavirus outbreaks.

Knowledge Gains

Lessons learned from past orthoebolavirus outbreaks are plentiful and many partnerships between the country’s Ministry of Health (MOH) and global agencies have led to positive improvements for addressing Ebola disease in Uganda. These include:

• Enhanced disease testing, diagnosing and the tracking of orthoebolavirus through support from United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), the Medecins Sans Frontières (MSF) and the CDC.
• Faster deployment of necessary resources during disease outbreak with quick funding from WHO’s Established Contingency Fund for Emergencies (CFE).
• Greater capacity for responding to disease emergencies through the formation of the Public Health Emergency Operations Center (PHEOC) in partnership with CDC and Makerere University School of Public Health in Uganda.
• Better sharing of updated disease information with hospitals in rural areas through the development of the Extension of Community Healthcare Outcomes (ECHO) created in partnership with CDC and the Health Resources and Services Administration (HRSA). ECHO is also supporting the infrastructure for adding telemonitoring to more than 400 health care settings.
• Increased access to clean water, sanitation and hygiene (WASH) supplies with support from UNICEF.

Additionally, lessons learned from past orthoebolavirus outbreaks in Uganda involves supporting culturally appropriate burial processes. For this, the MOH is working closely with Uganda’s Red Cross teams. These teams include individuals from the community who understand the culture and who can work directly with those who have lost loved ones due to EBOD. Team members receive training in using personal protective equipment (PPE) and following rigid universal precaution requirements. This is especially important when addressing orthoebolavirus outbreaks.

Ongoing Challenges

While progress has occurred in addressing Ebola disease in Uganda, communication remains a challenge. Even though the government shares disease information about orthoebolavirus outbreaks, people do not always trust it and are hesitant about vaccines.

Because of the current Ebola disease in Uganda, many countries have implemented travel bans and advisories. Those in the tourist industry believe that the lack of clear communication from the government is causing a decrease in their revenue. This is significant for an industry that gained more than $1 billion in revenue during 2023. This is of great concern for the more than 42% of the people living in poverty.

Lessons learned from past othoebolavirus outbreaks also revealed the depth of distrust and culturally embedded conspiracy theories developed from previous Ebola disease in Uganda events. Some believe the outbreaks are a way for the government to remove certain populations or cover up the selling of people. They also believe that those infected with EBOD have had a hex cast upon them.

To remove communication barriers, more engagement with local communities needs to occur. Besides clear information, people also need increased education regarding Ebola disease in Uganda, especially as the country tries to initiate a new vaccine trial to fight the EBOD outbreak of 2025.

Summary

Uganda is located in East-Central Africa. It is home to six major lakes including Lake Victoria, which is the second-largest inland freshwater lake in the world. The country has a population of more than 48 million people of which almost 75% live in rural communities along Lake Victoria, roughly 72% of the rural population does not have access to improved sanitation facilities and nearly 20% of the rural population does not have access to clean drinking water.

These are significant aspects to consider when managing any orthoebolavirus outbreak. As Peter Piot, (the Belgium-British microbiologist involved with identifying Ebola) states, “We shouldn’t forget that this is a disease of poverty, of health systems and of distrust.” But with the lessons learned from past orthoebolavirus outbreaks and ongoing global support, efforts to contain future outbreaks of Ebola disease in Uganda will prevail.

– Kelly Chalupnik

Kelly is based in Kirkland, WA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr