Kampala, Uganda – A month after an Ebola outbreak struck Uganda in September 2022, Edward Kayiwa began feeling unwell: headaches, fever and muscle pain. He had two options: going to a hospital or staying at home, depending on what he knew was wrong and had two options.
“I knew I was infected, but the fear was overwhelming”, the 32-year-old truck driver told Al Jazeera about the epidemic that lasted four months and killed 55 people.
His concern was fueled by conspiracy theories that community patients were receiving injected with substances that instantly killed them. He didn’t realize there were any victims or that some people were even recovering until two days later. After that, “I personally called an ambulance to pick me up”, he says.
Uganda’s seventh outbreak of Ebola, a highly contagious hemorrhagic disease, and its fifth outbreak of the Sudan virus (SVD) strain, which has a more than 40% fatality rate, was the 2022 health crisis.
Kayiwa – one of 142 confirmed cases that time – was lucky to survive, though many others were not.
Now, just two years later, on January 30, 2025, Uganda announced its latest Sudan Ebola outbreak. The first documented case was a 32-year-old male nurse who had passed away, according to the Ministry of Health. He was an employee at Mulago National Referral Hospital, the country’s top medical facility.
The nurse initially experienced fever-like symptoms, so she sought medical attention at two hospitals in the greater Kampala region, one in eastern Uganda, close to the Kenyan border, and at another.
A vaccine for the Zaire Ebola strain, which led to the 2013-2016 West Africa epidemic that resulted in the deaths of more than 11, 000 people, was developed and approved in 2022 despite the lack of an approved vaccine for the Sudan Ebola strain. The Zaire strain, which was first identified in the Democratic Republic of the Congo in 1976 (then known as Zaire), is the most fatal of the four ebolaviruses that exist.
The World Health Organization (WHO) described the current outbreak in Uganda as “high risk of serious public health impact” because of the lack of approved vaccines and therapeutics for the prevention and treatment of SVD.
According to the WHO, Ebola symptoms appear between two and 21 days after infection, and can include fever, severe headache, muscle pain, fatigue, abdominal pain, diarrhoea, vomiting, and bleeding from the nose, gums, ears and eyes.
As it is highly infectious, patients have to be isolated and treated. Ebola patients must be handled by medical professionals who are also required to wear full personal protective equipment, follow strict hygiene guidelines, and avoid infection by handling dead bodies.
While the disease itself is a huge challenge for the continent, this is compounded by other stumbling blocks, experts say, including traditional beliefs, witchcraft, and conspiracy theories that often impede Ebola treatment and control.
The Ugandan government claimed the nurse who passed away last month had visited a traditional healer. According to reports, his family members also allegedly attempted to exhume his body in accordance with Islamic law. However, this poses a significant risk because bodies can remain infectious for some time after death.
When a friend of Kayiwa’s contracted Ebola in 2022 before he did, they believed he had been bewitched, and their first option was to take him to traditional healers. They also tried local herbal medicine to treat the condition, which they believed to be “Ettalo,” which causes unresolved pain.
Deeper conspiracy theories also prevailed during the 2022 outbreak, which started in Mubende District, an area about 160km (100 miles) from Kampala famous for artisanal gold mining.
“When we first heard about the outbreak, it was linked to the Kassanda-Mubende gold mines”, Kayiwa says. Many people, including myself, believed that the government had planned to evict the artisanal miners and seize control of the mining areas.
Lack of communication
The current outbreak, however, has come with new challenges.
One of the biggest issues appears to be the lack of open communication between government officials regarding the outbreak, business criticism, especially in the tourism sector, who claim that the way the outbreak was announced hurts the industry, and a hesitant reaction from some people who have been exposed to the virus to accepting a new vaccine that has been tested for safety.
Dr. Daniel Kyabayinze, the director of public health at the Ugandan Ministry of Health, along with other officials, including WHO representatives, would not provide more information about the Ebola outbreak at an event held on Monday to officially launch the vaccine trial.
Authorities “are going to be releasing the status of the outbreak in a format that is distinct from the vaccination process,” according to Kyabayinze. He argued that discussing Ebola status updates alongside the vaccine trial would lead to a “mix-up]of] messages”, which he deemed inappropriate.
Later that day, health ministers announced that they would hold a media update event. But that did not happen.
Emmanuel Ainebyona, a Health Ministry spokesperson, said he had no status update to share and referred Al Jazeera to high-ranking officials in the ministry. The authorities did not respond to a number of calls.
Since the outbreak was announced, the government has provided no further communication. On Wednesday, health minister Jane Ruth Aceng announced that updates would be published biweekly rather than every day.
“Don’t ask us for case numbers every day – that is not important. What is important is that you go to the communities, tell them they need to protect themselves, and ensure they pass on information”, she said.
Without providing specifics, she added: “The update is that we have Ebola cases in the country. They are receiving treatment and improving”.
Pushback from tourism sector
From the onset, the way the current outbreak was communicated elicited sharp criticism from Uganda’s tourism industry.
A prominent businessman in the tourism industry, Amos Wekesa, posted a critique of the government on X, claiming that the Ebola outbreak story had been covered extensively in international media, leading to the issue of travel advisories for Uganda. The citizens of nations like the United States, the United Kingdom, and Mauritius were urged to take precautions when visiting their respective nations.
“Many countries might target Ugandans”, he said, adding that life was continuing as normal in Kampala.
In a separate post on X, he declared, “There will never be a disease outbreak or any attack that will ever kill more Ugandans than poverty.”
Martin Mugara, Uganda’s junior minister for tourism, said on a local radio station last Saturday, “I was a bit shocked that they communicated the way they did”, referring to the Ministry of Health’s announcement of the Ebola outbreak.
Muhereza Kyamutetera, CEO of the Uganda Tourism Association, said in an interview that there is a need for “coordinated conversation and communication” before announcing health outbreaks.
According to Kyamutetera, tour companies begin receiving emails asking for cancellations and refunds the day after an epidemic outbreak is reported. He explained that the tourism industry would be impacted for the entire year by the Ebola outbreak and that the nation’s reputation as a destination for tourists would also be affected by previous incidents.
“The reputation of the destination is the most important thing”, he said. He added that many foreign visitors may not be aware of Uganda’s handling of Ebola outbreaks.
The director of public health, Kyabayinze, told Al Jazeera last week that international health regulations require that every nation report any outbreak of a disease that poses a significant threat to the global community in accordance with WHO requirements.
He claimed that Uganda’s announcement of the outbreak was important and crucial, and that he believed they had made the right decision. However, he hastened to add they “don’t want to disrupt travel, trade and tourism”.
Vaccine hesitancy
During a critical Ebola outbreak last week, the WHO praised the quickness with which Uganda was able to conduct a randomised vaccination trial.
The trial, which began in Uganda just four days after the outbreak was confirmed, is the first to evaluate the clinical efficacy of a vaccine against Ebola, the organization said in a statement.
Only one person received the trial vaccine last Monday despite the fact that more than half of the contacts for the first Ebola fatality were national referral hospital patients and health workers. The referral hospital where the trial was taking place was the same.
One contact who had initially agreed to receive the trial vaccine later changed his mind, according to a source familiar with the vaccination procedure. Without the presence of the media, there was a chance that the person would still be persuaded to get the vaccine.
The Makerere University College of Health Sciences’ Dr. Bruce Kirenga, the lead investigator of the vaccine trials, acknowledged that there is still a challenge to vaccine hésitation.
“My job is to remove this hesitancy. I did it for COVID, and I will do it now”, he said.
“What causes hesitancy is a lack of information. We are going to provide people with the information they need, and they will understand the importance of participating”, he added.
What can be done better?
The public deserves more information, especially regarding measures and how to behave, according to Freddie Ssengooba, a professor of public health at the Makerere School of Public Health.
“There is an information gap, we are all anxious to know what is happening”.
In the meantime, survivors of previous Ebola outbreaks urge people to be cautious and not to believe in rumors or conspiracies that could endanger their lives or communities.
He claims he witnessed numerous fatalities while Kayiwa was in a hospital in 2022, and that the trauma still resonates with him.
Source: Aljazeera
Leave a Reply