Uganda: MSF helps boost country’s Ebola outbreak response capacity as need for vigilance remains

NEW YORK/KAMPALA, DECEMBER 13, 2022—While the current spread of the Ebola virus in Uganda appears to have slowed, sustained vigilance is crucial to ensure this outbreak ends, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF). In response, MSF has completed and handed over a new, high-quality, 32-bed Ebola treatment center in Kampala, bolstering the Ugandan Ministry of Health's (MoH) response capacity and increasing the country’s future outbreak preparedness.

“The downward trend of the current outbreak is encouraging, but we can’t let our guard down,” said Jason Rizzo, MSF’s emergency coordinator in Uganda. “There is always a risk of discovering new clusters of confirmed cases toward the end, as we have witnessed during past outbreaks. Opening the new treatment center strengthens the response to the current outbreak of this particular strain of Ebola, the Sudan ebolavirus—for which no proven vaccines and treatments exist—by increasing capacity to treat the sick.”

Since the outbreak was declared in September, 142 confirmed and 22 probable cases have been reported, leading to 56 deaths across nine districts, including in Uganda’s densely populated capital of Kampala. The last known Ebola case was identified on November 30, the stillborn child of an Ebola survivor. If there are no new infections reported, the outbreak will be considered over after 42 consecutive days of no new transmission.

Until this declaration is made, health staff responding to the outbreak need to keep up the essential close monitoring of the remaining 46 contacts of people who previously tested positive for Ebola, along with ongoing infection prevention and control measures at health facilities, community outreach, and health promotion activities so people know the signs of Ebola to ensure quicker admissions to health facilities like the new Ebola treatment center.

The new facility—along with potential Sudan ebolavirus vaccine clinical trials that may be conducted and the use of experimental treatments—offers the MoH more tools. Built by MSF in six weeks, the Mulago Ebola Treatment Center is right next to the Mulago National Referral Hospital in Kampala and increases the MoH’s ability to maintain the essential treatment of people suspected and confirmed to have Ebola. It can also help facilitate a better response to future hemorrhagic fever outbreaks, like Ebola, as it can be used as a training facility for Ugandan medical staff.

“Let’s not forget the trauma that families and communities go through during ebolavirus outbreaks,” said Dr. Roberto Scaini, MSF’s medical team leader in Kampala. “The center’s design enhances the ability for health care workers and patients to see one another via large plexiglass windows, which is crucial to provide high quality medical care—and to ensure there’s a real human connection in how the care is provided.”

Windows at patients’ bedsides in individual rooms let medical staff monitor patients from inside a safe isolated corridor without having to wear personal protective equipment. Additionally, secured inlets in the windows allow medical staff to administer oxygen and fluids, as needed, from outside the isolation zone. These features aim to help improve community trust in the outbreak response because people will be able to see their loved ones and the quality of care they’re receiving. This could help encourage people who become infected with Ebola to come forward to seek medical care more quickly, preventing community transmission.

“With Mulago Ebola Treatment Center, we have a facility that helps ensure preparedness for the future,” Rizzo said. “But it is only one part of the response; it’s not Ebola treatment centers alone that will end this outbreak. We have to ensure communities remain on board, that they know what Ebola is, and how to keep safe. We must also ensure health care workers have the knowledge and the tools to stay safe and to treat patients.”

The response to viral hemorrhagic fever outbreaks, like Ebola, must also include rapid adaptation of epidemiological tools for comprehensive data analysis and quick deployment of mobile laboratories. Additionally, it is critical that pre-existing protocols and drug stockpiles exist to ensure experimental vaccines and therapeutics can be safely studied and immediately made available for compassionate use to people who need them most during outbreaks.

MSF has been responding to the ongoing Ebola outbreak by carrying out prevention measures, working with communities to educate people about the virus and slow its transmission, providing case management and clinical care, and conducting ongoing epidemiology and disease surveillance. MSF first worked in Uganda in 1980. Today, teams are operating HIV/AIDS projects in the cities of Arua and Kasese, as well as in the Kitagwenda district and around Lakes George and Edward. In the refugee settlements in Arua and Terego districts, MSF provides clinical and psychological care for victims of sexual and gender-based violence, safe abortion care, and mental health services.