Kampala, Uganda – Calling for sustained vigilance during the ongoing Sudan ebolavirus outbreak, international medical humanitarian organisation Doctors Without Borders/Médecins Sans Frontières (MSF), has completed a new 32-bed Ebola treatment centre next to the capital’s Mulago National Referral Hospital, bolstering crucial response capacity of the Ugandan Ministry of Health while also increasing the country’s future outbreak preparedness.
“The downward trends of this current outbreak are encouraging, but we can’t let our guard down. 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 centre strengthens the response to the current outbreak of Sudan ebolavirus for which no proven vaccines and treatments exist by increasing capacity to treat the sick. And crucially, it also helps in setting a clear and efficient response framework for future infectious disease outbreaks in Uganda,” says Jason Rizzo, MSF’s emergency coordinator in Uganda.
Since September, the outbreak has seen 142 confirmed and 22 probable cases leading to 56 deaths across nine districts – including in the densely populated urban centre, Kampala. The last known Ebola case was identified on 30 November. Should there be no new infections, the outbreak would be considered over after 42 consecutive days of no new transmissions.
Until then, responder teams from the Ministry of Health and MSF need to keep up the essential close monitoring of the remaining 46 case contacts, 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 that they can quickly be admitted to health facilities like the Mulago Ebola Treatment Centre.
The new facility, along with the prospects of Sudan ebolavirus vaccine clinical trials and experimental treatments offers more tools in hands of the Ministry of Health. Built by MSF within six weeks, the Mulago Ebola Treatment Centre increases the Ministry of Health’s ability to maintain the essential treatment of suspect and confirmed Ebola patients now, and in the future, once the outbreak is over, by using it as a training facility for Ugandan medical staff for haemorrhagic fever outbreaks and infectious disease isolation.
With Mulago Ebola Treatment Centre we have a facility that helps ensure preparedness for the future. But it is only one part of the response, as it’s not Ebola treatment centres alone that will end this outbreak. We need to maintain a rapid and responsive approach closer to where communities live.
Jason Rizzo, MSF’s emergency coordinator in Uganda
“Let’s not forget the trauma that families and communities go through during this ebolavirus outbreak. The centre’s design enhances the ability for healthcare 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 the patients’ bedside in individual rooms also allow medical staff to monitor patients from inside a safe isolated corridor without having to wear personal protective equipment (PPE). Secured inlets in the windows ensure medical staff are able to administer oxygen and fluids, as needed, from outside the isolation zone,” says Dr Roberto Scaini, MSF medical team leader in Kampala.
These features, along with a safe visitors’ corridor, ensure that the community can gain more trust in the outbreak response because they’ll be able to see their loved ones and the quality of care much improved. It’s only through greater trust that people who become infected with Ebola will come forward to seek help more quickly.
“With Mulago Ebola Treatment Centre we have a facility that helps ensure preparedness for the future. But it is only one part of the response, as it’s not Ebola treatment centres alone that will end this outbreak. We need to maintain a rapid and responsive approach closer to where communities live. We have to ensure communities remain on board, that they know what Ebola is and how to keep safe. We must ensure healthcare workers have the knowledge and the tools to stay safe and to treat patients – this includes public facilities, private facilities and even traditional healers,” Rizzo says.
“The response to viral haemorrhagic fever outbreaks of tomorrow must include rapid adaptation of epidemiological tools for comprehensive data analysis and quick deployment of mobile laboratories. What is also crucial is the need for pre-existing protocols and drug stockpiles that ensure experimental vaccines and therapeutics can be safely studied and immediately made available for compassionate use to people who need it most.”
About the Mulago Ebola Treatment Centre
The Mulago Ebola Treatment Centre is 32-bed facility, scale-able to double that capacity with the addition of tents, which is ready to immediately admit 16 patients for isolation and treatment. The facility was constructed by MSF teams from the ground up on what used to be a football pitch, within six weeks, integrating supplies offered by several international partners of the Ministry of Health.
It offers unique features that enhance the quality of care medical staff are able to deliver to Ebola patients, while offering patients comfort and privacy, as well as the ability to safely interact with visitors while undergoing treatment thanks in great part by using a system of safe corridors and windows.
The facility’s design gives equal priority to the needs of patients, the community and healthcare workers. It consists of four eight-bed wards. Each patient has their own room and their dignity is ensured by having a private toilet in the room and a door leads to an outside area where they can stretch their legs, and receive visitors at safe 2-meter distance, thanks to a special outside visitors’ corridor. A morgue offers deceased patient’s bereaved families the opportunity to identify their loved one behind a plexiglass window, and take a moment to pay their respects before bodies are taken for burial. All these features ensure that communities gain greater trust in the outbreak response and care.
The centre is equipped with two 45kVA generators, 60,000 litres of water storage capacity, a laundry and safe waste management system and a plumbing system that distributes water for hand washing and drinking as well as a chlorine solution for decontamination at all the essential points.