The next disaster must not catch Uganda napping
Dec 12, 2007
FOLLOWING the serious outbreak of Ebola in August 2000 in Gulu which took many lives, Uganda’s Ministry of Health should have been prepared with robust medical response for another outbreak such as the one currently raging in Bundibugyo.
Opiyo Oloya
FOLLOWING the serious outbreak of Ebola in August 2000 in Gulu which took many lives, Uganda’s Ministry of Health should have been prepared with robust medical response for another outbreak such as the one currently raging in Bundibugyo.
By January 2001, that original outbreak of Ebola Hemorrhagic Fever (EHF) had caused 393 deaths in Gulu district, 27 in Masindi and five in Mbarara. Yet, looking at the inadequate bungling in Bundibugyo this past week, where the population as well as medical staff are left to fend for themselves, the usual cries of “We did not know what it was until it was too late†will not wash.
Someone must take responsibility for the inadequacy surrounding the response to this new outbreak. The whole point of crisis response is that you use all your experiences from one disaster to think about the next one. You cannot be caught with your pants down scrambling at the last minute in the middle of the crisis, pretending to be doing something about it which is what the Ministry of Health is doing now.
When there was an outbreak of the deadly Severe Acute Respiratory Syndrome (SARS) in Toronto and Vancouver in March 2003, the various levels of health authorities immediately sprang into action, setting up numerous points of information for the public, isolating those thought to have been exposed to the deadly virus transmitted through person to person contact especially through coughing and sneezing.
Officials were firm in isolating suspected cases of SARS until they were ruled to be in the clear. Large gatherings were particularly discouraged and everyone was asked to observe strict hygienic protocol including the religious washing of hands. All entrances to hospitals were equipped with ethyl alcohol-based hand sanitizers which have remained to this very day as standard equipment. In the wake of SARS, Canadian health officials, including those in areas not touched by SARS sat down to review response to the SARS to plot plan for future outbreaks of highly contagious diseases, including the avian flu.
There was not a moment to waste in preparing for the next fight. What was done right during SARS that saved lives? What worked and what didn’t, and how could the system be improved to minimize failure the next time around? What was the role of the media in helping combat the outbreak? What about the general public, how should it behave in the event of a highly contagious disease?
Among the lessons that Canadian health officials identified as extremely crucial for combating contagion was the importance of wearing protective masks, gowns and gloves. These rather pedestrian, cheap and widely available medical equipments were crucial throughout the fight against SARS, and instrumental in protecting healthcare professionals caring for those who were strickened.
Following the 1994 earthquake in California which killed 57 people and injured over 9,000, the Los Angeles County Department of Health Services (LA/DHS), preparing for the next disaster, purchased five fully equipped mobile medical clinics to the tune of $300,000 per van.
Another $50,000 per year, excluding the salary of staff, was necessary to run the mobile clinics. Similar models are operating elsewhere in America with names such as Care-A-Van, Take Care-A-Vans, Mission of Mercy in Arizona and Texas, and so forth. The idea is simple—take healthcare where it is needed at a moment’s notice.
Simply put, the case for clear response to disaster should not be made at a time like this, but rather as an ongoing evaluation and re-evaluation of national preparedness. Specifically in thinking about potential Ebola outbreak, the Government of Uganda should have immediately purchased at least a dozen modified mobile clinic buses equipped with highly specialized isolation beds and adequate medical supplies to last several days.
These buses would only be deployed in cases where the government has declared an emergency such as earthquake, a plane crash, Ebola outbreak, and other serious medical emergencies that require quick response within two to three hours.
Not surprisingly, lives were and will be needlessly lost in Bundibugyo to Ebola because basic medical equipment is lacking, including protective gloves, masks and gowns. Brave healthcare professionals stood their ground in the face of sure death not because they were reckless, but because to flee was not an option either. They completely depended on their government to provide the resources needed to do their jobs safely.
Tomorrow, they will be hailed as heroes (which they are), but their deaths were needless had the government learned any lessons from the last outbreak of Ebola in 2003. There is nothing more maddening than seeing people die because we have been caught napping again, uncaring, burying our collective heads in the sand because we hope that the problem will go away by itself.
Today, Uganda has some of the world’s best trained health professionals and medical technicians who know how to think and deliver healthcare. Yet, what do we do, we send blood samples to be tested in South Africa.
Why does Uganda not have the requisite testing equipment for emerging illness like Ebola? Why must we wait for someone somewhere to find out what is ailing our citizens before we can do something about it? Enough lives have been lost, and the time for action is now.
Opiyo.oloya@sympatico.ca
FOLLOWING the serious outbreak of Ebola in August 2000 in Gulu which took many lives, Uganda’s Ministry of Health should have been prepared with robust medical response for another outbreak such as the one currently raging in Bundibugyo.
By January 2001, that original outbreak of Ebola Hemorrhagic Fever (EHF) had caused 393 deaths in Gulu district, 27 in Masindi and five in Mbarara. Yet, looking at the inadequate bungling in Bundibugyo this past week, where the population as well as medical staff are left to fend for themselves, the usual cries of “We did not know what it was until it was too late†will not wash.
Someone must take responsibility for the inadequacy surrounding the response to this new outbreak. The whole point of crisis response is that you use all your experiences from one disaster to think about the next one. You cannot be caught with your pants down scrambling at the last minute in the middle of the crisis, pretending to be doing something about it which is what the Ministry of Health is doing now.
When there was an outbreak of the deadly Severe Acute Respiratory Syndrome (SARS) in Toronto and Vancouver in March 2003, the various levels of health authorities immediately sprang into action, setting up numerous points of information for the public, isolating those thought to have been exposed to the deadly virus transmitted through person to person contact especially through coughing and sneezing.
Officials were firm in isolating suspected cases of SARS until they were ruled to be in the clear. Large gatherings were particularly discouraged and everyone was asked to observe strict hygienic protocol including the religious washing of hands. All entrances to hospitals were equipped with ethyl alcohol-based hand sanitizers which have remained to this very day as standard equipment. In the wake of SARS, Canadian health officials, including those in areas not touched by SARS sat down to review response to the SARS to plot plan for future outbreaks of highly contagious diseases, including the avian flu.
There was not a moment to waste in preparing for the next fight. What was done right during SARS that saved lives? What worked and what didn’t, and how could the system be improved to minimize failure the next time around? What was the role of the media in helping combat the outbreak? What about the general public, how should it behave in the event of a highly contagious disease?
Among the lessons that Canadian health officials identified as extremely crucial for combating contagion was the importance of wearing protective masks, gowns and gloves. These rather pedestrian, cheap and widely available medical equipments were crucial throughout the fight against SARS, and instrumental in protecting healthcare professionals caring for those who were strickened.
Following the 1994 earthquake in California which killed 57 people and injured over 9,000, the Los Angeles County Department of Health Services (LA/DHS), preparing for the next disaster, purchased five fully equipped mobile medical clinics to the tune of $300,000 per van.
Another $50,000 per year, excluding the salary of staff, was necessary to run the mobile clinics. Similar models are operating elsewhere in America with names such as Care-A-Van, Take Care-A-Vans, Mission of Mercy in Arizona and Texas, and so forth. The idea is simple—take healthcare where it is needed at a moment’s notice.
Simply put, the case for clear response to disaster should not be made at a time like this, but rather as an ongoing evaluation and re-evaluation of national preparedness. Specifically in thinking about potential Ebola outbreak, the Government of Uganda should have immediately purchased at least a dozen modified mobile clinic buses equipped with highly specialized isolation beds and adequate medical supplies to last several days.
These buses would only be deployed in cases where the government has declared an emergency such as earthquake, a plane crash, Ebola outbreak, and other serious medical emergencies that require quick response within two to three hours.
Not surprisingly, lives were and will be needlessly lost in Bundibugyo to Ebola because basic medical equipment is lacking, including protective gloves, masks and gowns. Brave healthcare professionals stood their ground in the face of sure death not because they were reckless, but because to flee was not an option either. They completely depended on their government to provide the resources needed to do their jobs safely.
Tomorrow, they will be hailed as heroes (which they are), but their deaths were needless had the government learned any lessons from the last outbreak of Ebola in 2003. There is nothing more maddening than seeing people die because we have been caught napping again, uncaring, burying our collective heads in the sand because we hope that the problem will go away by itself.
Today, Uganda has some of the world’s best trained health professionals and medical technicians who know how to think and deliver healthcare. Yet, what do we do, we send blood samples to be tested in South Africa.
Why does Uganda not have the requisite testing equipment for emerging illness like Ebola? Why must we wait for someone somewhere to find out what is ailing our citizens before we can do something about it? Enough lives have been lost, and the time for action is now.
Opiyo.oloya@sympatico.ca