How effectively can the Ugandan government handle epidemics?

Sep 21, 2008

LESS than a year after the Ebola epidemic in western Uganda and yellow fever outbreak, Uganda is suffering another outbreak — Hepatitis E in northern Uganda.

By Frederick Womakuyu

LESS than a year after the Ebola epidemic in western Uganda and yellow fever outbreak, Uganda is suffering another outbreak — Hepatitis E in northern Uganda.

Hepatitis E is a viral disease found in the stool of persons and animals infected with it and is spread by drinking contaminated water or eating contaminated food.

It has an incubation period of 3-8 weeks, making it hard for the victims to realise its symptoms — headache, general body weakness, diarrhoea and yellow eyes early enough to prompt one to seek medical attention.

Although the disease is easily preventable through observing good sanitation and personal hygiene, it has already left 8,060 people infected and 126 dead in the northern region.

The question on many Ugandans’ minds is: What measures has the Government put in place to fight epidemics?

Dr. Emmanuel Otaala, the minister of state for primary health, said in the past, Uganda was not well-prepared to handle epidemics.

However, through negotiations with the Atlanta-based Centre for Disease Control in the US, the Uganda Virus Research Institute, Entebbe, is being upgraded to level three to handle testing for epidemics.

“The equipment is already in place and will be put to use by the end of the year. We shall have the capacity to test for epidemics like Ebola and others that had previously eluded us,” Dr. Otaala says.

Dr. Sam Zaramba, the director general of health services in the health ministry re-affirms that national and district epidemic task forces have been formed to carry out surveillance, case management, social mobilisation, supervision, monitoring and evaluation of intervention strategies in an event of an epidemic.

“We have also devised measures on how to predict possible outbreaks. For example, last year, we predicted that cholera may break out after the heavy floods and when it did, we managed it well,” he says.

Dr. Otaala adds that the task forces are also charged with the provision of health education to the community on a routine basis. “This is done through seminars, workshops and drama groups.

A film van provided by the Ministry of Health for each district moves around sensitising the people,” he says.
He says in the past, the ministry depended on donor funding to fight epidemics and this slowed down the intervention measures. Recently, the ministry drew a sh100m budget to fight epidemics.

“It is little money, but it is better to start somewhere than having nothing at all. We hope that this money will increase so that we have the capacity to address health education in the country adequately,” he said.

During the Hepatitis E outbreak in northern Uganda, the Government sent sh10b to help address the emergency needs of the people, like providing safe water and construction of pit latrines.

But despite this measure, Dr. Otaala believes there are still challenges the country faces in fighting the epidemics.
“There is still a shortage of funds.

A lot more funding is needed, so that mass sensitisation and mobilisation can be done effectively,” he adds. But even if there was enough money, the country does not have personnel competent enough to diagnose epidemics and use the laboratory technologies.

He adds that the laboratory gear is expensive and even if it is in place, maintaining it may be another dilemma.

According to a coordinator of the Hepatitis E taskforce in Kitgum district who preferred anonymity, inefficiency and implementation of agreed control measures by NGOs is also hindering the eradication of Hepatitis E in the region.

He says when the epidemic first struck Madi Opei, one NGO he declined to name reported to them that latrine coverage in the area stood at 20%, but when they inspected it, they found that it was less than 1%.

The source adds: “One NGO went to distribute 50 slabs for pit latrines in Madi Opei and when we (the taskforce) inquired about their progress, they told us they had constructed 50 pit latrines.”
Other NGOs work in only one parish, but claim that they are working in the whole sub-county.

“It is such dishonesty that is slowing down the progress in eradicating Hepatitis E. NGOs need to improve their efficiency, be accountable to the donors and to the people they serve.”

But most NGOs The New Vision interviewed, denied these allegations, saying they were transparent and worked with the community to fight Hepatitis E.

“We are trying our best to sensitise the people and provide them with the basic sanitation services. The Government will have to re-settle people, give them good facilities and empower them,” one source from an NGO, who refused to disclose her name, says.

Amid these controversies, the public is skeptical about the implementation of certain measures being put in place.

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