One Health Workers Join Uganda’s Rift Valley Fever Outbreak Response Team

A student’s account of experiences from the frontlines of the Rift Valley Fever outbreak investigation in the Kabale District of Uganda.

On March 4, 2016, Uganda’s first case of Rift Valley Fever (RVF) was reported in the Kabale District, about 400 km southwest of Kampala. Although only one other case was confirmed in Kabale, RVF is a viral disease that can be easily transmitted through infected mosquitoes or contact with infected animals. Since March 4, 2016, rapid response teams have been deployed by the Ministry of Health to respond to the outbreak. Six One Health Student Club members at Makerere University were chosen to join the rapid response team and were at the frontlines of the outbreak from March 21–24, 2016. The One Health students have been trained to prevent, detect, and respond to infectious disease outbreaks by the One Health Central and Eastern Africa network with the support of the U.S. Agency for International Development’s One Health Workforce project. Upon selection, the Ministry of Health provided additional training to the students as part of its operational response.

On March 18, fourteen days from the first outbreak, students were called to urgently convene at 2pm to leave for Kabale at 6pm. Tonny Tindyebwa, a member of the One Health Student Club based at Makerere University School of Public Health, is one of the students who was part of this investigation. He shares his experiences in this post.

The morning after we arrived, we had an early meeting with the District Task Force, followed by identification of activities to be completed. The tasks were based mainly on social mobilization and surveillance. Multi-sectoral teams were established and assigned duties. We also initiated a communication platform using WhatsApp.

The next day, Tuesday the 22nd, we identified new cases, including a truck driver from Burundi. This case caused a certain amount of panic among residents at the border who mistook the symptoms for those of Marburg virus disease, a hemorrhagic fever disease with a high rate of fatality.

During the rest of our time as part of the investigation team, we mainly took part in case tracking, sample collection, social mobilization, report writing, case management and records review. Illegal structures like slaughter houses/places were also visited and closed, while abattoirs were also inspected.

In the course of executing this assignment, I realized that there are areas that could be improved in the future, like the slow delivery time of the supplies, such as personal protective equipment, which discouraged medical workers from attending to cases, delay of laboratory results of the samples collected caused anxiety, and the slow response of the alert desk team to requests.

There was also a delayed dispatch of teams to the field, an absence of key district political leaders, and inadequate transportation vehicles, making it problematic for teams to get to the field in time.

There were also challenges with several media houses misinforming communities on the progress of the outbreak investigation and claiming suspected cases who had died as confirmed cases.

There were some positive practices that I think can be used as lessons and strengthened for future outbreaks. For instance, the population exhibited eagerness to report any suspected cases based on signs and symptoms of the disease they had, to the extent that some people just referred themselves to the health workers.

Social mobilization was performed in creative ways, using current popular technologies, as well as reaching out to specific populations and communities like schools and training institutions.

Key populations we worked with, like meat sellers, were very responsive in providing information about their counterparts who had exhibited signs and symptoms of RVF.

Overall, the participating One Health students improved their practical skills in disease investigation and response through community service.