Kampala, Uganda – A month after an Ebola outbreak struck Uganda in September 2022, Edward Kayiwa started feeling unwell: complications, fever and muscle ache. He knew one thing was unsuitable, and that he had two choices – go to a hospital or consider the rumours that had been circulating in his group and keep dwelling.
“I knew I used to be contaminated, however the worry was overwhelming,” the 32-year-old truck driver advised Al Jazeera concerning the epidemic that lasted 4 months and killed 55 individuals.
His worry stemmed from conspiracy theories that sufferers handled in the neighborhood had been being injected with substances that killed them immediately. It took him two days to understand nobody was being killed and a few had been even recovering. After that, “I personally known as an ambulance to choose me up,” he says.
The 2022 well being disaster was Uganda’s seventh outbreak of Ebola – a extremely infectious hemorrhagic illness – and its fifth of the Sudan virus (SVD) pressure, which has a greater than 40 % fatality charge.
Kayiwa – one in all 142 confirmed circumstances that point – was fortunate to outlive, although many others weren’t.
Now, simply two years later, on January 30, 2025, Uganda introduced its newest Sudan Ebola outbreak. The Ministry of Well being recognized a 32-year-old male nurse who had died as the primary documented case. He was an worker at Mulago Nationwide Referral Hospital, the nation’s prime medical facility.
The nurse initially developed fever-like signs and sought therapy at two well being services within the better Kampala space and one other in japanese Uganda, close to the Kenyan border.
Whereas there isn’t a authorized vaccine for the Sudan Ebola pressure, a vaccine for the Zaire Ebola pressure – which precipitated the 2013-2016 West Africa epidemic that killed greater than 11,000 individuals – was developed and authorized in 2022. The Zaire pressure, which was first found in 1976 within the Democratic Republic of the Congo (then generally known as Zaire), is probably the most deadly of the 4 ebolaviruses in existence.
“Within the absence of licensed vaccines and therapeutics for the prevention and therapy of SVD, the chance of potential critical public well being influence is excessive,” the World Well being Group (WHO) mentioned concerning the present outbreak in Uganda.
Based on the WHO, Ebola signs seem between two and 21 days after an infection, and might embody fever, extreme headache, muscle ache, fatigue, stomach ache, diarrhoea, vomiting, and bleeding from the nostril, gums, ears and eyes.
As it’s extremely infectious, sufferers must be remoted and handled. Medical staff dealing with Ebola sufferers are additionally required to put on full private protecting tools, adhere to strict hygiene protocols, and deal with useless our bodies safely to keep away from an infection.
Whereas the illness itself is a large problem for the continent, that is compounded by different obstacles, consultants say, together with conventional beliefs, witchcraft, and conspiracy theories that always impede Ebola therapy and management.
In Uganda, the Ministry of Well being mentioned the nurse who died final month had visited a conventional healer. His family additionally reportedly tried to exhume his physique to rebury it in accordance with Muslim religion dictates. Nevertheless, this poses critical dangers as our bodies can nonetheless be infectious for a interval after dying.
When a buddy of Kayiwa’s contracted Ebola in 2022 earlier than he did, they believed he had been bewitched, and their first possibility was to take him to conventional healers. Additionally they thought he was affected by an sickness recognized domestically as “Ettalo”, which causes unexplained ache, and tried native natural drugs to treatment it.
Deeper conspiracy theories additionally prevailed in the course of the 2022 outbreak, which began in Mubende District, an space about 160km (100 miles) from Kampala well-known for artisanal gold mining.
“Once we first heard concerning the outbreak, it was linked to the Kassanda-Mubende gold mines,” Kayiwa says. “Many individuals, together with myself, thought it was a plot by officers to drive out the artisanal miners and take over the mining areas.”
Lack of communication
The present outbreak, nevertheless, has include new challenges.
Key amongst them seems to be an absence of clear communication from authorities authorities concerning the outbreak; pushback from companies, particularly within the tourism sector, who argue that the way in which the outbreak was introduced hurts the business; and hesitancy amongst some individuals uncovered to the virus to simply accept a brand new vaccine, which has been supplied for trial.
At an occasion to formally launch the vaccine trial last Monday, Dr Daniel Kyabayinze, the director of public well being on the Ministry of Well being in Uganda, together with different officers, together with representatives from the WHO, wouldn’t present particulars on the Ebola outbreak.
Kyabayinze mentioned authorities “are going to be releasing the standing of the outbreak in a format that’s separate from the vaccination course of”. He argued that discussing Ebola standing updates alongside the vaccine trial would result in a “mix-up [of] messages”, which he deemed inappropriate.
Officers mentioned the minister of well being would maintain a media occasion later that day to offer an replace. However that didn’t occur.
Emmanuel Ainebyona, a Well being Ministry spokesperson, mentioned he had no standing replace to share and referred Al Jazeera to high-ranking officers within the ministry. The officers didn’t reply repeated telephone calls.
For the reason that outbreak was introduced, the federal government has offered no additional communication. Minister of Well being Jane Ruth Aceng advised journalists on Wednesday that updates can be given fortnightly fairly than each day.
“Don’t ask us for case numbers each day – that isn’t vital. What’s vital is that you just go to the communities, inform them they should shield themselves, and guarantee they go on data,” she mentioned.
With out offering specifics, she added: “The replace is that we have now Ebola circumstances within the nation. They’re receiving therapy and bettering.”
Pushback from tourism sector
From the onset, the way in which the present outbreak was communicated elicited sharp criticism from Uganda’s tourism business.
Amos Wekesa, a distinguished businessman within the tourism sector, posted on X criticising the federal government for poor strategic communication and arguing that the Ebola outbreak story had been extensively lined by worldwide media, resulting in journey advisories being issued in opposition to Uganda. International locations together with the USA, United Kingdom and Mauritius urged their residents to take precautions whereas travelling to the nation.
“Many nations may goal Ugandans,” he mentioned, including that life was persevering with as regular in Kampala.
“There’ll by no means be a illness outbreak or any assault that can ever kill extra Ugandans than poverty, ” he mentioned in a separate put up on X.
Martin Mugara, Uganda’s junior minister for tourism, mentioned on an area radio station final Saturday, “I used to be a bit shocked that they communicated the way in which they did,” referring to the Ministry of Well being’s announcement of the Ebola outbreak.
Muhereza Kyamutetera, CEO of the Uganda Tourism Affiliation, mentioned in an interview that there’s a want for “coordinated dialog and communication” earlier than saying well being outbreaks.
“The second information of an epidemic outbreak goes public, the following day, tour firms begin receiving emails for cancellations and refund requests,” Kyamutetera mentioned. He defined that the Ebola outbreak would have an effect on the tourism sector for your entire yr and, mixed with earlier incidents, have an effect on the nation’s fame as a journey vacation spot for years to come back.
“The fame of the vacation spot is crucial factor,” he mentioned. He added that many worldwide travellers might not be conscious of Uganda’s expertise in dealing with Ebola outbreaks.
Although at first hesitant to wade into what he described as a controversial debate, Kyabayinze, the director of public well being, advised Al Jazeera final week that worldwide well being rules require each nation to report any outbreak of a illness that poses a big menace to the worldwide group as per WHO necessities.
“Uganda saying the outbreak was vital and vital and I feel we did the appropriate factor,” he mentioned. Nevertheless, he hastened so as to add they “don’t need to disrupt journey, commerce and tourism”.
Vaccine hesitancy
The WHO praised the pace at which Uganda was capable of launch a randomised vaccine trial throughout an emergency Ebola outbreak final week.
In a press release, the organisation mentioned the trial, which started in Uganda simply 4 days after the outbreak was confirmed, is the first-ever one to evaluate the scientific efficacy of a vaccine in opposition to Ebola illness brought on by the Sudan virus.
Regardless of greater than half of the recognized contacts of the primary Ebola fatality being well being staff and sufferers from the nationwide referral hospital, just one individual acquired the trial vaccine final Monday. The trial itself was being carried out on the similar referral hospital.
An official concerned within the vaccination course of advised Al Jazeera that one contact who had initially agreed to obtain the trial vaccine later modified his thoughts. There have been hopes that the person may nonetheless be satisfied to take the vaccine with out media presence.
Dr Bruce Kirenga, principal of Makerere College Faculty of Well being Sciences and govt director of the Makerere College Lung Institute, who’s main the vaccine trials, acknowledged that vaccine hesitancy stays a problem.
“My job is to take away this hesitancy. I did it for COVID, and I’ll do it now,” he mentioned.
“What causes hesitancy is a lack of expertise. We’re going to present individuals with the data they want, and they’ll perceive the significance of taking part,” he added.
What will be completed higher?
Freddie Ssengooba, a public well being professor at Makerere Faculty of Public Well being, mentioned whereas the competence of the federal government to deal with the epidemic isn’t in query, the general public deserves extra data, particularly on measures and the way they need to behave.
“There’s an data hole, we’re all anxious to know what is occurring.”
In the meantime, survivors of earlier Ebola outbreaks urge individuals to be cautious and to not consider in rumours or conspiracy theories that would put their lives and communities in danger.
Throughout the time Kayiwa was in hospital in 2022, he says he witnessed many deaths, and the trauma of that stays with him.
“Within the first room the place I used to be first admitted, all of the sufferers died,” he says. “Ebola isn’t any joke.”
