Kampala, Uganda – A month after the Ebola outbreak hit Uganda in September 2022, Edward Kaiwa began to feel sick: headaches, fever, muscle pain. He knew something was wrong and he had two options. He either goes to the hospital or believes he is at home believing rumors circulating in his community.
“I knew I was infected, but the fear was overwhelming,” the 32-year-old truck driver told Al Jazeera about the epidemic that lasted for four months and killed 55 people.
His fear came from a conspiracy theory that patients treated in the community, which promptly injected with substances that were killed. It took him two days to realize that no one had been killed, and some had recovered. He then says, “I personally called the ambulance to pick me up,” he says.
The 2022 health crisis was the seventh outbreak of Ebola in Uganda, a highly infectious hemorrhagic disease, and the fifth outbreak of Sudan virus (SVD) strains with a fatality rate of over 40%.
One confirmed case of Kayiwa-142 was fortunate to survive, but many others were not.
Now, just two years later, on January 30, 2025, Uganda announced its latest Sudan Ebola outbreak. The Ministry of Health has identified a 32-year-old male nurse who died as the first documented case. He was an employee of Murago National Referral Hospital, the country’s top medical facility.
The nurse first developed fever-like symptoms and sought treatment at two health facilities in the Kampala region near the Kenya border and another health facility in eastern Uganda.
There is no approved vaccine for the Sudan Ebola strain, but the Zaire Ebola strain vaccine (the 2013-2016 West Africa epidemic killed over 11,000 people) was developed and approved in 2022. Discovered in 1976 in the Democratic Republic of the Congo (known at the time as Zaire), it is the most deadly of the four Ebola viruses that exist.
“In the absence of approved vaccines and treatments for the prevention and treatment of SVD, there is a high risk of potential serious public health impacts,” the World Health Organization (WHO) said of the current outbreak in Uganda. Ta.
According to the WHO, symptoms of Ebola appear 2-21 days after infection and include fever, severe headache, muscle pain, fatigue, abdominal pain, diarrhea, vomiting, bleeding from the nose, gums, ears and eyes.
It is highly infectious and requires patients to be isolated and treated. Healthcare workers dealing with Ebola patients should wear full personal protective equipment, comply with strict hygiene protocols, and handle the body safely to avoid infection.
The disease itself is a major challenge for the continent, but experts say it has been exacerbated by other stumbling blocks.
In Uganda, the Ministry of Health said that a nurse who passed away last month visited a traditional healer. His relatives also reportedly tried to excavate his body to revive it according to the Muslim faith. However, this poses a serious risk as the body may be infectious for a certain period of time after death.
When Kayiwa’s friends signed Ebola in 2022, before he did, they believed he was fascinated, their first choice was to take him to a traditional healer. did. They also thought he was suffering from a disease known locally as “Etaro”, which caused pain of unknown cause and attempted local herbal medicine to cure it.
Deeper conspiracy theory also prevailed during the 2022 outbreak that began in the Mbende district, about 160 km (100 miles) from Kampala, famous for its artisan gold mining.
“When we first heard about the outbreak, it was linked to the gold mine at Kassanda Mbende,” says Kaiwa. “A lot of people, including myself, thought it was a conspiracy by officials to drive out artisan miners and take over the mining area.”
Lack of communication
However, the current outbreak presents new challenges.
The key among them appears to be a lack of clear communication from government authorities regarding the outbreak. Pushing back from businesses, especially in the tourism sector, claims that the methods announced will hurt the industry. And hesitant among some people exposed to the virus to accept the new vaccines offered for testing.
At the event officially launching a vaccine trial last Monday, Dr. Daniel Kavainze, director of public health at Uganda’s Ministry of Health, and other officials, including representatives from the WHO, have not provided details regarding the Ebola outbreak. That was it.
Kyabayinze said the authorities will “release outbreak status in a different format than the vaccination process.” He argued that discussing Ebola status updates along with vaccine trials would lead to “confusion.” [of] “The message he deemed inappropriate.”
Authorities said the Health Minister would hold a media event later that day to provide updates. But that didn’t happen.
Ministry of Health spokesman Emmanuel Ainbina said he had no updates on the status for him to share Al Jazeera with senior ministry officials. The staff did not answer repeated calls.
Since the outbreak was announced, the government has not provided any further communication. Health Minister Jane Ruth Assen told journalists Wednesday that updates will be made for two weeks rather than daily.
“Don’t ask for your case number every day. That’s not important. The key is to go to the community and tell them you need to protect yourself and pass on the information,” she said.
Without providing details, she added: They are undergoing treatment and improving. ”
Pushback from the tourism department
From the beginning, the way the current outbreak was conveyed drew sharp criticism from Uganda’s tourism industry.
Amos Wekesa, a well-known businessman in the tourism sector, criticised the government for being poor in strategic communication, and travel is being published to Uganda, with the story of the Ebola outbreak being widely covered by international media. I posted about X claiming it was leading to recommendations. Countries including the US, UK and Mauritius have urged their citizens to take precautions while traveling.
“Many countries may target Ugandans,” he said.
“There will never be an outbreak or attack of illness that kills more Ugandans than poverty,” he said in another post in X.
Uganda Tourism Minister Martin Mugala said on a local radio station last Saturday that he was “a bit shocked that they told them how they did it.”
Muhereza Kyamutetera, CEO of the Uganda Tourism Association, said in an interview that “coordinated conversation and communication” is necessary before announcing the outbreak of health.
“The next day, the moment the news of an outbreak is published, tour companies start receiving emails for cancellations and requests for refunds,” says Kyamutetera. He explained that the Ebola outbreak will affect the tourism sector all year round, and combined with previous incidents will affect the country’s reputation as a destination for the next few years.
“The reputation of a destination is the most important thing,” he said. He added that many international travelers may not be aware of their experience in dealing with the Ebola outbreak in Uganda.
Public Health Director Kyabayinze last week hesitated to wander around what he initially described as a controversial debate, but international health regulations said it would require all countries to report the outbreak of diseases that pose a global threat. Communities that meet WHO requirements.
“Uganda announces the outbreak is critical and important and I think we did the right thing,” he said. However, he quickly added, “I don’t want them to disrupt travel, trade or tourism.”
Hesitant about vaccines
The WHO praised the speed at which Uganda could launch randomized vaccine trials during last week’s emergency Ebola outbreak.
In a statement, the organization said the trial, which began in Uganda just four days after the outbreak was confirmed, was the first to assess the clinical efficacy of the vaccine against Ebola disease caused by the Sudan virus. .
Even though more than half of the initial Ebola fatality identified contacts were healthcare workers and patients at national referral hospitals, only one person received the trial vaccine last Monday. The trial itself was held at the same referral hospital.
Officials involved in the vaccination process told Al Jazeera that the contact of one person who first agreed to receive the trial vaccine later changed their minds. There was hope that individuals could still convince them to take the vaccine without the presence of media.
Dr. Bruskirenga, principal of Makerere University Health Sciences and executive director of Makerere University Lung Research Institute, who leads vaccine trials, acknowledged that vaccine hesitation remains a challenge.
“My job is to get rid of this hesitation. I did it for Covid, and I do it now,” he said.
“What causes hesitation is the lack of information. We will provide people with the information they need and understand the importance of participation,” he added.
What can you do?
Freddie Susengoba, a professor of public health at Makerere School of Public Health, says that while governments’ ability to handle the epidemics doesn’t matter, the public has more information, especially on measures and how they should act. He said it deserves it.
“There’s an information gap. We all want to know what’s going on.”
Meanwhile, survivors of the previous Ebola outbreak have urged people not to be cautious and believe rumors and conspiracy theories that could put lives and communities at risk.
While Kaiwa was in the hospital in 2022, he witnessed many deaths and says the trauma is with him.
“In the first room I was admitted, all patients died,” he says. “Ebola is no joke.”
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