According to the latest figures, more than 1,400 confirmed cases of Ebola Bundibugyo virus disease, including 350 deaths, have been reported in the two countries. More than 90 percent of the infections are concentrated in Ituri province in the DRC, a major cross-border trade hub with Uganda – ravaged by years of armed conflict.
Calling Kampala
On a Sunday morning in Kampala, Dr. Chris Opesen, an anthropologist at the World Health Organization (WHO), a call from local authorities shortly after 05.30.
A woman suspected of having Ebola is preparing to return home and he has been asked to help ensure her reintegration into society is safe.
Three days earlier, Lilian* had presented with symptoms consistent with Ebola and was transferred to the Ebola Isolation Unit at Mulago Hospital for diagnosis and care.
Although the move was planned, it was nonetheless an unsettling experience for her, her family and neighbors. Since then, everyone has been anxiously waiting for the final confirmatory test to determine whether she can safely return home.
During the last 36 hours, Dr. Opesen has been in regular contact with Lilian and her family, offering reassurance and guidance as anxiety in the community has grown.
“The anthropologist is the midfielder of the outbreak response,” he says, drawing on a football analogy. “I connect response teams with communities and provide feedback, from communities to response teams citing concerns, fears and complaints.”
Dealing with fear and misinformation
Together with colleagues from the Kampala Capital City Authority, Dr. Opesen to a community meeting with Lilian’s family and friends to address concerns before she returns.
What begins as a tense and emotional exchange gradually changes when Dr. Opesen suggests a more structured dialogue. The group agrees and elects a chairman, a neighbor and a secretary: Lilian’s sister, Angela*.
Students participate in an Ebola awareness session at a primary school in Kasese District, Uganda.
As each person is given space to speak, the atmosphere slowly calms down. “We appreciate you because without you there would still be fear,” Angela says afterwards.
Later accompanying Dr. Opesen and his colleague Henry Bwire, a surveillance contact point at the Kampala Capital City Authority, a neighbor of a local shop.
Lilian had asked them to speak to the shop owner, who had allegedly stigmatized her mother the day before.
“Ebola is a disease that everyone fears,” explains Mr Bwire. “Sigma can come through miscommunication and fear, both of which were present in this case. It was our role to bring Lilian back and clean up that miscommunication and reduce that fear in the community.”
After the discussion, the shop owner thanks the team and assures them that Lilian will be treated with respect when she returns.
Waiting for everything to be ready
All that remains is the laboratory confirmation.
Both decide to wait on neutral ground instead of returning home, positioning themselves between the hospital and Lilian’s quarters. They remain in contact with the lab and the family throughout the afternoon.
Around 18.30 the call comes: the result is negative for Ebola. Lilian had been treated for a bacterial infection and is well enough to return home.
Relief supplies for the Ebola outbreak are unloaded from a plane in Entebbe, Uganda.
A worthy return
Back in the house, family and neighbors gather in anticipation. Dr. The butler brings a cake and bottles of water.
When Lilian finally arrives, escorted by a member of Uganda’s National Emergency Medical Team, she seems tired but relieved. The group listens as she talks about her experience and what recovery will mean for her.
“As a family, we appreciate you coming to the ground and the community to talk to us, because the stigma can be too much,” she says. “Thank you for listening and addressing our concerns. I hope this can be a learning experience.”
Lilian then cuts the cake and shares it with everyone gathered.
“For me, reintegration should be a celebration, especially when the evacuation didn’t go as planned,” says Chris. “I wanted to do something special for Lilian and for her to serve the slices to people and for them to eat what she has given them, to demonstrate her acceptance back into society.”
A long day, a common result
At 9 p.m., more than 15 hours after his day began, Dr. Opesen finally on his way home. Despite the long hours, he describes the day as rewarding.
“My role in the answer gives me satisfaction,” he says. “If I do my job well, I can make a difference and support WHO’s leadership on the front lines of a safe and dignified response.”
*Names have been changed to protect patient privacy
