Three Responders talk about their experiences in UgandaPosted on by
Vance Brown, Ebola Coordinator and Deputy Director for the Division of Global Health Protection Program in Uganda. Vance and team provide technical support to the Government of Uganda to prevent, detect and respond to especially dangerous pathogens, including Ebola.
“It was 8:00 p.m. on a Friday when I got the call. CDC colleagues in the Democratic Republic of the Congo had urgent news: a known contact of an Ebola patient, thought to be at high risk of carrying Ebola, was headed to Kampala. It was close to Christmas, and with unrest around the elections, Ebola screening had been suspended on the DRC side of the border. I worked well into the early hours of the next morning, coordinating with the Ministry of Health, WHO, and other partners to find out more information. By 2:30 a.m., they were confident that they had found the contact—and with additional details, ruled that the individual was not an immediate risk and considered a secondary contact. It was a real test of our coordination and systems.”
“This response has a very unique aspect; it took 10 months for Uganda to experience the first imported cases of Ebola from neighboring DRC. This put staff and systems through a long-term preparedness posture that needed to be ready to respond in rapid succession. The fact that we had not actually seen a case of Ebola meant as much as we were in ‘response’ mode, much of our work focused on preparedness and building systems to quickly identify, isolate, and notify from frontline facilities to the central level.”
“Thankfully with the leadership of the Uganda Ministry of Health and partners on the ground those systems sprang into action and we were able to contain this outbreak at its source. The battle is not over and we will continue to adjust our focus as we continue to prepare for the next event. Credit to the Minister of Health Dr. Jane Ruth Aceng and the Incident Manager Dr. Allan Muruta and a host of exceptional responders, we have crossed a critical threshold of 21 days since the last high risk contact had exposure with the confirmed cases in Kasese but we know we need to remain prepared until the outbreak is contained in DRC. ”
Uganda “Home-Grown” Experience
Dr. Joseph “OJ” Ojwang is a Global Health Security disease detective with Division of Global Health Protection Program in Uganda CDC. Dr. Ojwang is deeply involved in the Ebola preparedness and response.
“Since June 2019, I have spent time working closely with the Kasese District health teams to visit facilities and communities at risk of the spreading Ebola. Together with other team members we rapidly set up an electronic system (Epi-Info), to track and monitor high-risk contacts, including the doctors and nurses, who originally treated the first confirmed case.”
“I’m a ‘home-grown’ disease detective and responder, tutored in the field by CDC’s finest public health experts. This is key to permanent institutionalization of Uganda’s surveillance and response capacity. It is now a sacred job to work closely with competent teams of disease surveillance, laboratory and Ebola treatment experts at Uganda’s Ministry of Health and other global partners.”
Rosalind Carter, GID
For the first time, an unlicensed Ebola vaccine tested in clinical trials during the West African outbreak is being offered under “compassionate use” to health care workers (HCWs) and front line workers (FLWs) at health facilities and border crossings in countries bordering Ebola hotspots in the Democratic Republic of Congo (DRC). CDC is providing technical expertise and our experience continues to be valued in each new country undertaking Ebola vaccination.
Successfully implementing an experimental vaccine in field conditions and convincing HCW and FLW to receive a vaccine before a case occurred in Uganda was a major achievement. Several hours after we opened the first vaccination site in Ntoroko District, a health center in a remote area near Lake Albert, we successfully vaccinated the first participant, a senior clinical officer at the Health Center. When I asked why he had decided to take the vaccine he responded: “I was a medical officer during the 2008 outbreak of Ebola Bundibugyo in the next District. We did not have a vaccine then and I watched people die. Now you bring me a vaccine. Of course, I want it. In addition, I am making sure all my staff at the health center are getting it today. It will make us feel safe if this Ebola comes to our facility.” Throughout the day, he brought all of the nurses, clinical officers and laboratory staff to the vaccination site and stayed with them, providing emotional support for those who were scared and encouraged. It was an incredible display of leadership and caring—while also respecting individual level decision-making and the right of each person to consent to vaccine or not. It was a stressful time for the team supervising the work, but the inspiration of this first vaccination carried me through many long days and nights to come as we continued to roll out to new sites and new Districts.