Uganda town battles Ebola with few gloves, little support

BWERA, Uganda — The isolation ward for Ebola patients is a tent erected in the garden of the hospital. Gloves are given out sparingly to health workers. And when the second person in the Uganda border town of Bwera died after the virus outbreak spread from neighboring Congo, the hospital for several hours couldn’t find a vehicle to take away the body.

“We don’t really have an isolation ward,” said Pedson Buthalha, Bwera Hospital’s administrator. “It’s just a tent. To be honest, we can’t accommodate more than five people.”

Medical workers leading Uganda’s effort against Ebola lament what they call limited support in the days since infected members of a Congolese-Ugandan family showed up, one throwing up blood. Three have since died.

While Ugandan authorities praise the health workers as “heroes” and say they are prepared to contain the virus, some workers disagree, wondering where the millions of dollars spent on preparing for Ebola have gone if a hospital on the front line lacks basic supplies.

“Even the gloves are not enough,” the hospital administrator said Thursday. “I give them out small small.” A nurse nodded in agreement.

The World Health Organization said Friday that the Ebola outbreak is an “extraordinary event” of deep concern but does not yet merit being declared a global emergency. Such a declaration typically triggers more funding, resources and political attention. The agency said $54 million is needed to stop the outbreak.

And yet both Congo and Uganda appeared to lobby against a declaration, with Congo counting the Uganda-related Ebola cases as its own, saying Congo was where the family members began developing symptoms. Ugandan authorities said Friday that they had only one suspected Ebola case remaining in the country.

More than 1,400 people have died since this outbreak was declared in August in eastern Congo, one of the world’s most turbulent regions, where rebel attacks and community resistance have hurt Ebola response work. The virus can spread quickly via close contact with bodily fluids of those infected and can be fatal in up to 90% of cases, and identifying people who might have been exposed is crucial.

While Ugandan health workers aren’t facing the violent attacks that have killed several Ebola responders in Congo, they remain at risk as they seek to isolate, test and treat for the virus. Basic equipment such as gloves is essential.

At least two nurses at Bwera Hospital might have been exposed as they offered first aid to the infected family. They and some other contacts have since been quarantined in their homes. The World Health Organization says at least 112 such contacts have been identified in Uganda since the outbreak crossed the nearby border.

A nurse, who spoke on condition of anonymity to avoid possible retribution, questioned why some people who might have been exposed to Ebola are allowed to stay at home.

“I wish we could coordinate,” the hospital administrator said of the apparent confusion over how to manage the outbreak.

Ugandan Health Minister Jane Aceng said Saturday that district officials in Kasese were to blame for limited medical supplies after delaying in submitting their budget.

“It is clearly the responsibility of the district to order supplies,” she said. “If they haven’t done the orders we can’t supply because we don’t know how much they need.” As for upgrading the makeshift isolation ward in the hospital garden, she said “it is not economical. It is not cost-effective” to build permanent structures.

Uganda has faced multiple Ebola outbreaks and is a regional leader in battling Ebola, even if the Bwera region of the country has never experienced an outbreak. Some Ugandan physicians were deployed to the West African outbreak of 2013-2016, the deadliest in history.

Health workers in this outbreak now have the benefit of an experimental but effective Ebola vaccine that is being widely used, with more than 130,000 doses distributed. Uganda has vaccinated nearly 4,700 health workers, with more vaccinations beginning on Saturday.