Mubende, Uganda ‒ Uganda declared the end of Ebola disease outbreak caused by Sudan ebolavirus on 11 January 2023. The health authorities worked intensely, ramping up outbreak control measures that helped to halt the virus in less than four months after it was confirmed. Improved testing, surveillance, contact tracing, supportive clinical care and boosting community participation in the response were critical in ending the outbreak.
While the outbreak has been declared over, the country is maintaining disease surveillance to respond promptly to any flare-up. It is also stepping up support to people who recovered from the virus by providing comprehensive medical and psychosocial support. A total of 87 people recovered from Ebola. At the heart of the support is the national Ebola survivors programme, which the Ministry of Health, with support from World Health Organization (WHO) and partners, has established in the three most affected districts – Entebbe, Kasanda and Mubende.
He is grateful for the care he received that helped him to recover. “The health workers who attended to us were very supportive and gave us hope that full recovery was possible,” he says.
After a month at the centre, Ssebayigga was discharged. He then realized that he had just commenced a long journey back to the life he had before Ebola.
Ssebayigga’s symptoms are common among Ebola survivors, who face a host of physical and mental health challenges after recovery. The most predominant complaint is muscular and skeletal pain; and half of the male survivors have experienced scrotal pain. Visual and hearing impairments are also very common
The programme aims to improve access to quality health care for survivors and has established two survivor’s clinics - one in Mubende district and the other in Entebbe, just outside Kampala, and will soon open a third in Kasanda district.
These clinics are staffed with medical professionals such as internal medicine specialists, ophthalmologists, Ear, Nose and Throat specialists, psychologists as well as anthropologists to support survivors for a range of conditions.
All but one of the 87 survivors have had their first consultation at one of these clinics and will be seen every month for the next year and then quarterly for another six months to a year after that.
“Thanks to support in the form of medical supplies and human resources from WHO, we can offer medical support to the survivors who come for review with services like complete blood count, urinalysis, semen and liver tests to assess possible effects the virus could have had on the body system,” he says.
Ssebayigga is grateful for the assistance he is receiving at the clinic. “I had red eyes after I was discharged, but this was treated, and I am fine now,” he says. “I believe the rash and hearing problems will also be treated,” he says.
“Our observations indicate that a month after discharge, more than half of the survivors followed up show signs of post-traumatic stress disorder and depression. Some also suffer from memory loss and recurrent nightmares,” says Dr Jerome Ntege, a WHO anthropologist supporting the response in Mubende. The clinic has so far provided more than 100 outpatient consultations.
“To many in our village, surviving Ebola meant coming back to an empty house where most of their loved ones passed away; to a job that is no longer there; to a neighbourhood where old friends are now avoiding them,” says 43-year-old Rebecca Nanyonjo, a local council member in Kiruuma village in Mubende. “Survivors need a lot of support to get out of that depression.”
In addition to offering psychosocial support, the clinics are ensuring that community
He experienced the trauma of suffering from Ebola and losing people close to him. He says that at the peak of the Ebola outbreak, he saw people being taken away every day in ambulances. So when the ambulance came for him, he thought he would not return alive.
“But thanks to God, I made it, and I am thankful to the medical workers for their tireless efforts,” he says. “Life in the treatment unit was not easy, but we were always encouraged. I am happy that I made it.”
The survivors association plays an integral role in the lives of its 13 members. They remind each other not to miss appointments at the hospital and sensitize communities to avoid discriminating survivors.
The association supports its members as they get back on their feet, helping them to source financial assistance to regain their livelihood.
Leveraging its experience in West Africa and the Democratic Republic of the Congo, the Organization has provided technical guidance to the Ministry of Health, including clinical care guidelines and tools. At least seven WHO staff, including case management experts, psychologists and anthropologists have been deployed to the clinics in Mubende and Kasanda districts. It is also supporting the drafting of the national operational plan that will guide the country’s approach to the survivors programme, ensuring that communities are resilient during recovery and that the country remains on high alert for the risk of resurgence.
“The national survivors programme is a continuation of the tireless outbreak control efforts by the Government of Uganda,” says Dr Yonas Tegegn Woldemariam, WHO Representative in Uganda. “I am pleased that WHO has been able to support the government on its journey to end this outbreak and ultimately the health and wellbeing of every Ebola survivor.”
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