What is MSF doing in Uganda, one month after the declaration of the Ebola epidemic?

Since September 20, 2022, the day the Ebola epidemic was declared in Uganda, MSF has been working alongside the Ministry of Health to support medical care in the country.

Since the start of the outbreak and as of October 23, 90 patients were confirmed with Ebola and 28 people were reported to have died from the disease. Another 32 people have recovered and been discharged from treatment centres.

Given the challenges posed by the lack of a currently licensed vaccine or treatment for the Sudan strain of Ebola, and based on experience from previous outbreaks, MSF is focusing its response in three areas. Teams of doctors, nurses, logisticians, infection prevention and control (IPC) specialists, and health promoters are currently working to limit the spread of the epidemic, reduce mortality, and facilitate epidemiological monitoring, research, and innovation.

"One of the most important goals in controlling the spread of the epidemic is to reduce the time between the first symptoms of the disease and its management. We know that the earlier patients are treated, the greater their chances of survival and the less risk there is of the disease spreading within the community," explains Denis K. Mbae, outreach project coordinator.

In Mubende District, the epicentre of the epidemic, several MSF teams are currently deployed close to the patients. For example, some of them are visiting health centres or schools where Ebola patients have passed through to support prevention and infection control or to provide health promotion advice. 

They also provide medical and social support to people who have been forced to isolate themselves for 21 days after coming into contact with an Ebola patient through the distribution of basic necessities such as hygiene products, food donations, and communication equipment. This support is intended to compensate for the loss of income-generating activities and allow the person to isolate themselves in acceptable conditions.

MSF health promoters are also involved in identifying and monitoring contacts in order to quickly identify those at risk of carrying the disease and to raise awareness about how to prevent it and what to do if they develop symptoms. Finally, MSF is preparing to support the affected health centres to help them provide free primary health care to the population in the areas affected by the epidemic.

In parallel, MSF continues to support the Ugandan Ministry of Health in the medical treatment of sick people in Mubende district, which remains the epicentre of the epidemic. One 40-bed Ebola treatment centre has been completed, and another 40-bed facility, which will have the capacity to provide intensive care, is under construction in Mubende town for confirmed patients. An 8-bed treatment unit in Madudu for those in the early stages of the disease is now up and running.

"In addition to the construction of the units, we have donated medicines and protective equipment, and provided training to medical staff working in the health facilities, particularly on how to care for patients but also on hygiene measures to be implemented, which is crucial to avoid nosocomial transmission. We have also provided the Ministry with MSF staff experienced in managing cases of hemorrhagic fever, such as doctors and nurses," said Denis Basdevant, MSF project coordinator in Mubende.

In Kampala, the country's capital, MSF will develop similar measures: health promotion activities, social support for contacts, support to health facilities in terms of prevention and infection control, and support for non-Ebola related health care. MSF is also expected to become involved in patients’ care in the near future.

Finally, on the epidemiological side, Epicentre is collaborating with the Ministry of Health, in support of epidemiological activities, including surveillance and infection control and prevention.

MSF also expressed interest and availability to participate in research that will begin in the coming weeks on vaccines and treatments for the Sudan strain of Ebola virus. "The approval of effective vaccines and treatments for the Zaire strain of Ebola in 2018-2019 in the Democratic Republic of Congo and the management of subsequent outbreaks have been crucial tools in controlling the spread of the virus. Yet we know that these can be developed and tested in advance to determine their safety, but their effectiveness can only be tested during an outbreak. As such, and as was the case with the clinical trials conducted for the Zaire strain vaccines and treatments in the DRC in 2019, MSF is prepared to invest heavily in this research," said John Johnson, MSF's vaccine and epidemic response expert.