‘Raising the bar’ in Ebola preparedness
As the risk of an outbreak in Uganda appears imminent, the World Food Programme (WFP) is stepping up assistance
At the beginning of August, the Ministry of Health in the Democratic Republic of Congo (DRC) confirmed an outbreak of Ebola in the territory of Beni in North Kivu Province.
To date, 124 cases and 102 deaths have been confirmed in eastern DRC. Ebola is a deadly virus that can spread rapidly through direct contact with body fluids from those infected. Control of outbreaks requires coordinated medical services and community engagement. This includes rapid detection, contact tracing of those who have been exposed, quick access to laboratory services, care for those infected, and proper disposal of the dead.
While the outbreak within DRC is of great concern, it is the recent death of a person in Tchomia, close to Kasenyi, located along the shores of Lake Albert, an area previously unaffected that has raised the emergency level for the Ugandan authorities. This is because more than 100 people cross the lake on a daily basis, and cross-border movement is often unregulated and uncontrolled, representing a high risk of geographical spread.
“The scale of the problem is huge, the responders cannot trace some of the affected people and so we do not know the real number of infections and deaths so far,” says Dr. Isa Makumbi, who heads the Government’s Public Emergency Operations Centre. “Our borders are porous and there is great movement of people and goods between our countries. With a death reported near Kasenyi, we see the virus coming toward Uganda and we need to establish systems to detect it early, respond immediately and isolate and treat the affected people.”
Providing support
At the request of the Ugandan national task force, WFP has provided 11 multi-purpose tents to aid case management at key border crossings, in addition to engineering support for their installment. WFP has also provided three ambulances in the same border risk areas and at the Public Emergency Operations Centre in Kampala. More ambulances are due to arrive from the WFP-hosted United Nations Humanitarian Response Depot in Dubai to beef up the national response.
Cross border trade
Fridays are particularly busy at the border town of Mpondwe as it is market day, with people arriving in droves despite the sizzling temperatures. Men push bicycles overloaded with fresh produce while women arrive with more merchandise, some carrying it in baskets tied to their heads. School children come through carrying their bags of books.
Ugandan policemen watch to ensure no one escapes washing their hands in chlorinated water before dipping their shoes in more disinfectants and lining up to have their body temperature checked. Red Cross workers, their faces fitted with plastic protective gear, manage the screening process and scan each person’s forehead using hand-held thermometers. Meanwhile a man in protective overalls sprays the bare ground with more disinfectant.
“Fridays are especially busy but we can handle the high numbers,” explains Francis Tumwiine, a Red Cross volunteer, as he counts the number of people in the screening tent. “The only thing we fear is getting infected if we do not protect ourselves but the WFP tent provides space for us to isolate suspected cases and we also use it to keep records and data on the people we handle.”
A Red Cross ambulance remains on standby to take any suspected cases from the ‘isolation ward’ to the nearby Kilembe hospital.
Technical support for WHO thermo scanners
The isolation tents at Mpondwe will soon be modified to allow the installment of a thermo scanner procured by the World Health Organization (WHO). Thermo scanners are fitted in locations with high and fast-moving foot traffic to simplify and quicken the process of scanning body temperatures. They function in regulated temperatures of 30 degrees Celsius and below. WFP has also fitted a WHO thermo scanner at Uganda’s Entebbe International Airport.
Renovation of national referral hospital
WFP is providing further support to the Government of Uganda by offering engineering, construction and logistics services to revamp the Ebola isolation/treatment unit at the national referral hospital of Mulago in the capital city of Kampala. Doctors without Borders initially carried out an assessment to determine the feasibility and location of the unit, which has helped Uganda handle four outbreaks since 2000. In the past 18 years, the disease has claimed 285 lives in Uganda.
Emergency preparedness
“WFP has helped Uganda to raise the bar in preparedness,” says Dr Makumbi. “It is supporting us with surveillance, storage infrastructure, transportation and preparing us for case management. With ambulances, for example, we are now in position to move Ebola cases in isolation. WFP’s support it critical at this time.”
Emergency preparedness and prevention is a WFP corporate priority. As donor funding becomes available, WFP will carry on providing critical supply chain services, human resources, vehicles and multi-purpose storage units, a regional warehouse for the high-risk districts in western Uganda and international transportation of goods on the Government’s behalf.
“We and our partners believe preparedness saves lives and is an efficient way of managing emergencies in volatile, unpredictable and high-risk situations. We will do what we can to support the Government in stopping or mitigating this dangerous epidemic,” explains Robert Dekker, who heads the Crisis Response unit at WFP in Uganda.
WFP has also developed a package to guide its staff in establishing adequate preparedness and response capacity. The package includes risk assessments, a checklist of minimum and advanced preparedness actions and concepts of operations. In line with these measures, in October, WFP will double its general food distribution by providing two months of food to refugees living close to Uganda’s western border. This will minimize risks arising from large gatherings of people, which will help protect refugees as well as it’s own staff.
For many attending the market in Mpondwe they believe life must go on as usual, with extra precautions in place. A Congolese woman, Gladys Musime, who has come to Uganda to buy clothes, says Ebola is a stubborn virus, so her family back at home is avoiding unnecessary movements and washing their hands with tough detergents. Musa, a man who sells maize flour in a well-kept stall at the gate on the Ugandan side of the border, says the people are aware of the risks, but business in moving on normally. As he speaks, people trek past his stall, going into the DRC, unfazed by the continuous surveillance checks for those coming in.
