Uganda: Fighting Ebola in the line of duty

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Mr. and Mrs. Kintu* are among the few medical personnel that contracted Ebola virus disease while in the line of duty in 2022. Fortunately, the timely and aggressive medical care that they received while admitted in the Ebola Treatment Unit (ETU) coupled with mutual support saved their lives.

At the end of 2022, a patient visited the couple's clinic with body pain and headache. After several laboratory tests, he was prescribed anti-malaria medication and sent home. He returned the next day looking even worse. On the third day, he got a nosebleed, which prompted the couple to refer him to Mulago National Referral Hospital. Unfortunately, they later learned that he had succumbed to Ebola Virus disease.

Despite being health care workers, the couple was scared. They knew they had been exposed to the Ebola virus. The health authorities later closed their clinic as the couple self-quarantined at their home.

During the first few days of the contact tracing period, the couple developed signs of Ebola virus disease. They were both tested positive to the disease. They were then evacuated to the Ebola Treatment Unit (ETU), leaving their lovely children with a relative.

“It was a bit difficult to explain to the children. We only told them we had gone somewhere,’’ Mrs Kintu narrated.

In the ETU, Mrs Kintu's situation deteriorated quite fast. Her husband would check on her, encourage her to eat and sometimes take her outside on the grass to get some fresh air. "I used to tell her she was going to be fine," explains Mr. Kintu.

Suddenly, he stopped going to her and was reported to have worsened. “I looked for him and even walked past him, I could not recognize him. In those 2-3 days, he had become a different person.” Mrs. Kintu narrated.

“Ebola virus disease patients may have a clinical presentation that is completely different from another,” explains Dr. Senyonga Muzafalu, Case Management Officer at the World Health Organization (WHO) in Uganda. “While she had symptoms such as severe headache and high-grade fever, her husband started with mild symptoms of mild body aches, mild headache, and mild fever that progressed into very severe ones and lasting for a long time.”

Later, Mrs Kintu tested negative and was eligible for discharge but did not accept to leave alone. “I told the heath care workers that we had entered the ETU together and we will leave together.” Mrs Kintu proudly explained. She stayed by his side on her mat, giving him at least a spoon of food, or a sip of juice.

To tackle issues faced by people recovering from Ebola, Uganda set up the Ebola Survivors Programme in 2023. The programme was implemented by the Ministry of Health with the support of WHO and other partners.

WHO, through funding from the European Union Humanitarian Aid Department (ECHO), has supported this programme since its inception. The organization has provided clinical support and interim public health staff to run clinics, as well as a range of medicines to manage the after-effects of Ebola. It also supported infection prevention and control assessments and mentoring and facilitated specialist involvement in the survivor clinics.

After discharge from ETU, the couple enrolled into the Ebola survivors’ programme. Thanks to awareness provided through this programme, the beneficiaries have improved their knowledge of the disease. "I would like this program to continue even after Ebola. Some people have been cured of COVID-19 but are still suffering the effects. A programme like this would have helped them,’ explains Mrs. Kintu.

The fact that both parents have stopped working has been difficult for the Kintu family. They had dependents, including school going children. This is where Mrs Kintu makes her only criticism of the Ebola survivor programme. While other survivors received a package of food and money while being reintegrated, she did not. "This package would have been of great help," she said.

On the other hand, the couple stresses that access to healthcare workers, advice, frequent check-ups, and viral persistence monitoring have been beneficial to them.

“Protection for health care workers is a top priority for the government of Uganda. They should remain vigilant and always have protective equipment, whether there is an outbreak or not,” explains Dr Kyobe Bbosa, the Incident Commander at the Ministry of Health.

In weathering the disease and resettling back into their lives, Mr. and Mrs. Kintu are glad to have each other.

*Names changed to protect identity.

Distributed by APO Group on behalf of World Health Organization - Uganda.