Archive for ‘Bundibugyo’

February 22, 2008

Lest We Forget

On Wednesday, Uganda was declared Ebola free. 

When I visited Bundibugyo at the height of the epidemic two months ago, it was noticeable that it wasn’t always the wealthiest, the most educated, the most vocal who were at the forefront of the fight to contain the deadly virus.  Those with money packed up their bags and abandoned the district, leaving a few dedicated medical workers, clerics and volunteers to manage the disease. 

This post is a tribute to those unsung heroes … lest we forget. 

Hero Number One 

In December I asked Tom Ndyanabo, the Bundibugyo Red Cross Field Coordinator, if he could name a hero of the Ebola fight. Without hesitation he said, “Julius Mande.” 

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Julius Mande, the Senior Clinical Officer of Kikyo Health Center, is one of those rare truly humble people. Unlike many civil servants in Uganda, he opted not to work in his home district of Kasese, but to serve the poor in Kikyo sub-county in Bundibugyo.   When a strange disease started claiming lives in Kikyo in August last year, he worked around the clock to find a cure for the ailment, consistently disputing the assumptions of his seniors who dismissed it as chronic intestinal worms or Marburg.  He worked with no protective gear, watching his nurses succumb to the disease, receiving real relief only three months later.  It is a miracle that Mande did not contract Ebola. 

The disease hit the people of Kikyo hard and Mande was right there on top of things, laboring in the midst of personnel and drug shortages, to calm his patients and their families.  But he will not take any of the praise for himself.  He says he was only a spoke in a wheel.   

The national celebrations to mark the end of Ebola were scheduled to be held in Kikyo this week.  They were postponed because there is no money to renovate Kikyo Health Center.  For Mande, this is the least of his worries.  He takes everything in stride, going about his job of saving lives with a smile on his face.   He’s a real hero. 

Hero Number Two 

I should have said heroes because that’s what the 100-plus volunteers of the Uganda Red Cross Society are.  Volunteering is not something Ugandans are strong on.  Ours is a world of nothing for nothing and something for something.  The Bundibugyo volunteers showed us that we can do better; that we can be better. 

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Bundibugyo is situated at the northern end of the Rwenzori Mountain Range.  It is rough terrain and in the middle of the December and January rainy seasons, trekking for miles up the mountains was no easy feat.  Yet for the love of their people, the Red Cross Volunteers walked many miles to educate them about Ebola and its spread.  They met with people in their homes, allayed fears and consoled those who lost their loved ones.  They were not paid a coin, only receiving a basic lunch allowance, boots and a uniform to do their work.   They are real heroes. 

Hero Number Three 

When the Ebola epidemic broke out in Gulu district in 2000 and 2001, Dr. Zebulon Yoti, was a young epidemiologist at St. Mary’s Hospital Lacor.  He was by the side of the hospital supervisor, Dr. Matthew Lukwiya, when he lost the battle against the disease and he watched more than 10 of his colleagues die a painful death.  Despite this, he wasn’t deterred in his mission to make the world a better place and when Ebola was reported in Bundibugyo he was one of the first people on the scene. 

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Dr. Yoti is one of a handful of experts on Ebola and he could be anywhere around the world giving lectures on the disease, wining and dining with the cream of the crop in the medical field.  Instead he went to Bundibugyo to coordinate the Ebola case management in Bundibugyo and the work of a team of specialists from the Ministry of Health, the World Health Organization, International Rescue Committee, the Red Cross and Medicine Sans Frontiers.  

Hero Number Four 

Thik of TV’s Dr. Gregory House when you think of Dr. Stephen Ssesanga.  Think of Dr. House without the melancholy, rudeness or poor bedside manner.  Think of Dr. House the Medical Maverick. He doesn’t look like it, but Dr. Ssesanga, the Medical Superintendent of Bundibugyo Hospital is one of the most unconventional, inspiring people I have ever met.  He’s a hero. 

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Battling an epidemic like Ebola with limited equipment, resources and staff is an uphill task for the most experienced doctors. But this doesn’t compare with the challenge of fighting the disease, contracting the disease and losing five vital members of your medical team to the disease. This is the challenge facing Dr. Ssesanga, who himself survived a four-week battle against Ebola. The Medical Superintendent says his recovery is still a mystery and he can only attribute it to prayer and to the fact that he has never lost the will to live.

When Dr. Ssesanga first offered to go to Bundibugyo in 1997, the district was caught up in the bloody war waged by the Allied Democratic Force and he was cut off from any communication outside the district. By the time the war ended in 2001, decentralization was in place and he could not leave at will. He was informed that any recruitment of staff was in the hands of local governments and not the Ministry of Health and he no longer pick and choose where to go. 

Initially Dr. Ssesanga resigned to his fate to stay in Bundibugyo, but the beautiful lush land with its open people became his home.  He said it was not hard for him to dive head-first into the Ebola epidemic without protective gear or medication to save lives.  He suffered for it, but lived to tell the tale. 

Honoring the Rest

Drs. Scott & Jennifer Myhre, who stayed true to their calling to be missionaries to Bundibugyo, stepping in when Dr. Ssesanga fell ill and supporting the community when Dr. Jonah Kule passed away.  Jennifer’s moving blog Paradox Uganda gave the disease a human face and daily updates on the fight to combat the disease.

Staff of the World Health Organization, MSF, CDC, Ministry of Health who left the comfort of their homes for the dingy Bundibugyo hotels to offer advice and technical support to the team on the ground.

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Dr. William Sikyewunda, Bundibugyo’s long-suffering District Health Officer and his surveillance officer, Enoch Bahati, who followed patients to their homes, reported religiously on new Ebola contacts and transported the sick to the hospitals. In the midst of claims of foul play and a cover-up, Dr. Sikyewunda made a conscious decision to ignore the politics and to focus on saving lives.

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The fallen heroes – Dr. Jonah Kule, Rose Bulimpikya, Joshua Kule; all the nurses and clinical officers who worked around the clock to contain the disease.

The people of Bundibugyo.  Neglected.  Impoverished.  Hard pressed.  Beautiful.  Warm.  Open.  Strong.  Optimistic.  They have bounced back.  They are my heroes.

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I honor you.

December 13, 2007

Real Beauty, Real Heroes

((You know you’ve hit blog nirvana when you are called a ‘hater’.))

I’m on my way out of Bundibugyo.  The only reason I am returning to Krazy Kampala is that I ran out of money yesterday and my stupid pride won’t allow me to live on charity for more than one day.

I leave Bundibugyo at a loss for words on the Ebola epidemic.

What can I say about a people so poor and yet so brave; so frail and yet so strong?  What can I say about the medics, who despite their limited experience and the absence of equipment fought to contain a disease that baffled even the greatest among them?  What can I say about the more than 100 local volunteers, who receiving nothing but a small lunch allowance, traverse the mountains of this remote district to educate the population about Ebola, report new cases and struggle through the rough terrain to bring the sick to hospital?

What can I say about the Real Heroes … 

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… and the Real Beauty of the magnificent desolate Bundibugyo?  

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Sempaya Hot Springs

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Semliki River Valley (on the other side of the river is the DRC)

December 11, 2007

Ebola and CHOGM: Exaggeration, Cover Up or Lies?

From a ridiculously hot Bundibugyo, greetings! 

I thought a town nestled in the mountains would be cool with a fresh breeze blowing across the valley, but alas not.  It is hot and dusty and feels like I am in Kivuulu and not thousands of miles away from the Kampala madness.

But mad, this place is not.  The grass is being slashed and district offices are being given the once over because the mukubwa at the Ministry of Disease (or Ministry of Health for you) is visiting town.  Three weeks after Ebola epidemic was officially declared, three weeks after seven senior health officers died, three weeks of fear and isolation, Stephen Malinga has decided to ‘grace’ Bundibugyo town with his presence.

Aha.

Every once in a while you land on information that makes you say ‘aha’.  Like information that when the Ebola epidemic first broke out in Bundibugyo district in August this year, a Ministry of Health team diagnosed it as worms and ordered for a massive de-worming campaign to contain the disease.

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Here’s a brief rundown on the history of the epidemic as it was told to me by a highly-placed source in Bundibugyo.

Mid August 2007

The Senior Clinical Officer at Kikyo Health Center IV, about 14 kilometers from Bundibugyo town, reports that a number of patients turning up for treatment are displaying strange symptoms.  They have very high fevers, severe abdominal pain and diahorrea.  He says attempts to treat for malaria are futile and requests for urgent help.

September 2007

Patients referred from Kikyo to Bundibugyo Hospital.  A brief analysis by the Medical Superintendent, Dr. Stephen Ssesanga says the mysterious disease are intestinal worms and asks Kikyo to consider deworming and sensitization.  A team consisting of Luswa Lukwago, Godfre Bwire, Aidah Kaihindo, Julius Lutwama and Andrew Bakanga arrives in Bundibugyo to study to Kikyo situation.  After only one day at the Health Center, the team members conclude that indeed, the disease is caused by an infestation of askaris intestinal worms and recommend the mass de-worming of all adults in the area.

October 2007 

In the report dated October 5th, the team also made administrative recommendations for an appropriate system for admitting severe or highly infectious patients to be put in place and said the health center should be assisted to repair its ambulance.

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November 2007

Doubts persist regarding the diagnosis made and on November 6th the Bundibugyo Chief Administrative Officer sends a second team headed by the late Dr. Jonah Kule to investigate the disease.  Dr. Kule, who died of Ebola last week, ruled out worms and said some type of typhoid fever was suspected, but said it was important that a more skilled team should be brought in to assess the situation.

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November 10th a new group of Ministry of Health Staff led by Dr. Joseph Wamala and Dr. Atai Omurut arrived in Kikyo.  They take with them protective gear and draw blood samples from the patients.   Samples are sent to the U.S. Centers for Disease control laboratories in South Africa and Atlanta and for the next two weeks the team remains in Kikyo studying the patients and assisting in their treatment. 

November 28th it is confirmed that Ebola is the cause of death in Bundibugyo and an epidemic is declared.

I have seen the documentation.  I have talked to the medical staff.  This is my conclusion:  I don’t know what happened in the two weeks between the time when blood samples were taken and when Ebola was declared.  However, the CHOGM cover up story seems most unlikely. 

But what do I know for sure?  I am just a non-journalist who fled the boredom of Kampala for a maladventure in Bundibugyo.  Or maybe I am a spy with the KGB …

December 10, 2007

Ebola and the Unholy Weed

Don’t smooze or you’ll lose.

 That’s what we are told as journalists.  Don’t get too close to your source or your story will be biased and no one will really know the truth. That’s all well and good, but what do you do when the source (in this case the Bundibugyo Resident District Commissioner) is the only person with working internet in the whole district?  You forget those bu-journalism ideals and learn to live in the ‘real’ world. 

Plus I am not really a journalist … 

EBOLA UPDATE One man, Thembo Mutawumuka, died of Ebola this morning at about 4 a.m.  Mutawumuka was admitted in Kikyo Health Center IV about a week ago.  According to the Senior Clinical Officer in charge of Kikyo, Julius Mande, Mutawumuka was admitted after his disease had progressed.  Mande said the patient chose to stay at home looking for a solution in local herbal remedies.  By the time he was brought for treatment, it was too late. 

Local herbal remedies and the remedicians (too tired to remember their name) are a big hit in Bundibugyo town.  Mobile herbalists are selling 16 different herbal drugs purported to treat Ebola.  Many of these local remedies have been used traditionally for years to treat acne, dysentery and fevers and are being touted as a new miracle cure. For a population of largely illiterate people living in the inaccessible mountaneous region, these remedies are THE answer to Ebola.  The district health community and international NGOs who have set up base in Bundibygo are on the radios (the nearest are in Fort Portal about 64 kms away) every hour of every day trying to turn this situation around. 

Hopefully Mutawumuka is the last herbal remedy victim there will be, but there’s no telling how this story will end. 

Sorry, I couldn’t upload any pictures because Bwana RDC’s computer ‘doesn’t support your driver’.  Hopefully I will be able to do so early tomorrow to share with you the beauty and devastation of this wonderful place. 

As they say in Bwamba, the language of the Bundibygo low lands, until tomorrow Wesalo!

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