By Goodluck Musinguzi

After Uganda’s Ministry of Health announced the confirmation of Sudan Ebola Virus, there was coordination and sharing of information with medical experts all over Uganda.  With support from the World Health Organization (WHO) and other partners, they promptly set up an Ebola treatment centre at the Mubende Regional Referral Hospital, where the first case had been detected, and deployed health workers and emergency services to the site.

Dr Diana Atwine, Permanent Secretary Ministry of Health coordinated the logistics to make sure Sudan Ebola Virus is nipped in the bud with infectious diseases experts deployed immediately and the health communication teams. President Yoweri Kaguta Museveni followed with an address to the Nation.

In Uganda, fighting Ebola one patient at a time

At the Mubende Regional Referral Hospital’s emergency unit, Nurse Halima Adam and her team of health workers gather for a meeting first thing every morning. But the morning of 19 September was different. “We had started getting very sick patients with bleeding,” she recalls.

A sample was taken from one such patient and sent to the Uganda Virus Research Institute. “In the evening, we had confirmation that this patient was positive for Ebola,” Adam says. The next day, an Ebola outbreak was officially declared by the government.

In Uganda, fighting Ebola one patient at a time
Adam was among the first health workers in the country to be trained by WHO in Ebola case management in 2014 and 2015. She now plays a pivotal role in taking care of Ebola patients at Mubende.
“As soon as Ebola was confirmed, we set up a small isolation unit where we transferred all suspected patients,” she recounts. “We were a team of five health workers. We didn’t shy away from the situation. As a nurse, I’m very proud because we worked 24/7 and we remained calm.”

About 10 days after the outbreak was declared, Adam still spends long days working at the back of the hospital compound, where the rapid response team continues to bolster the outbreak response. “We are already seeing improvement in patient care… they are doing better,” she says.

In Uganda, fighting Ebola one patient at a time
In the absence of a vaccine, supportive care is key to fighting the virus. Health workers treat the symptoms, including fatigue, muscle pain, headache, sore throat, vomiting, diarrhoea, as well as internal and external bleeding. Suspected and confirmed cases receive fluids and oxygen, and their blood and cardiac parameters are monitored.

At the start of the outbreak, WHO quickly provided the regional referral hospital with three Ebola treatment kits. Each kit contains enough medical supplies to treat 100 patients.

In Uganda, fighting Ebola one patient at a time
Jimmy Adriko
Dr Paska Apiyo (right) was among the first health workers to be deployed to Mubende. Typically working at Gulu Regional Referral Hospital in the north of Uganda, like Adam, she was trained by WHO in Ebola case management in 2014. In August, the Organization held a short refresher training as the country prepared to respond to a potential spread of Ebola from an outbreak in the neighbouring Democratic Republic of the Congo. That outbreak has since been declared over.
In Uganda, fighting Ebola one patient at a time
WHO/Vincent D.
“I’m not scared because we are trained and we are protected by our PPE (personal protective equipment),” Dr Apiyo says as she and her team gear up for their shift at the Ebola treatment centre.

With support from Médecins Sans Frontières (MSF) and other United Nations aid agencies, an isolation tent with 12 beds for confirmed cases was set up at the centre just five days after the outbreak was declared. Shortly after, it was complemented with another tent equipped with 24 beds and all the necessary medical equipment to monitor suspected cases, bringing to 50 the total number of beds at Mubende.

“If we take good care of the patients even before they are confirmed cases, we give them higher chances to recover,” Dr Apiyo says.

In Uganda, fighting Ebola one patient at a time
Jimmy Adriko
team lead in charge of case management in Mubende.
WHO also supports local health authorities in deploying health workers and managing a fleet of 11 ambulances to transfer patients from their communities to the hospital.

Seventeen health workers are currently working at the Ebola treatment centre at Mubende, including two doctors, two clinical officers and 13 nurses.

“We plan to bring in six additional health workers and to train health workers from the Uganda People’s Defence Force who could be deployed to other regions in case the outbreak spreads further,” adds Dr Kisimu.

In Uganda, fighting Ebola one patient at a time
WHO/Vincent D.
As of 8 October, the hard work of health workers like Nurse Adam and Dr Apiyo has helped to ensure that the outbreak’s case fatality rate remains at around 23% among the 44 cases confirmed thus far. The first two patients to recover were discharged on 30 September. A few days later, two more patients also went home with their certificates attesting they are now free from Ebola.
“One of my patients who was very sick yesterday told me today that she feels better,” says Dr Apiyo as she finally relaxes after her morning shift at Mubende, her face still bearing marks from her goggles. “I feel good when patients are doing better.”