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WCAA NEWS Vol. 17, November 2022 The Ebola outbreak in Uganda: What we know and what it portends Isaac K. Nyamongo and Khamati Shilabukha Ebola continues to make its oscillatory journey across Africa uninterrupted since it was discovered in 1976 in two parallel outbreaks in South Sudan and Congo. From the Democratic Rebuplic of Congo to Liberia back to DRC and now in Uganda. It is not the first time it is coming to Uganda. In 2000 the disease killed over 200 people in Uganda. In 2014-16 it was the turn of West Africa where it killed in excess of 11,000 people. According to the World Health Organization, in the past couple of weeks (going back to somewhere early October 2022) Uganda has reported a total of 130 cases, 43 of them fatal. That makes for a 33% case fatality rate from lab-confirmed cases which is an increase from a case fatality rate of 28% a week earlier. Before it was reported, it is suspected that the virus may have been circulating for as long as three weeks. The outbreak involves the rarer Sudan Ebola strain, for which there are no approved treatments or vaccines. Apart from deaths in the general population, health care workers have been affected too. At least 11 healthcare workers have been infected (of whom four have succumbed). Additionally, there are other individuals who died before any samples could be taken but were linked to confirmed cases. It is quite possible that these deaths were due to Ebola. But, there are also recoveries. Public health officials must move to put in place measures that prevent further spread of this highly fatal disease. It is worrying enough that cases have been reported in Kampala, Uganda’s capital and largest concentration of people in the country. This worry was captured in WHO’s Director General Tedros Ghebreyesus when he said: "Although these cases are linked to known clusters, the very fact that there are cases in a densely populated city underscores the very real risk of further transmission, and the very urgent need for increased readiness in districts and surrounding countries." (WHO Director General Tedros Ghebreyesus, Nov, 2022) Consider this. In Kampala (which is worrying due to a large concentration of a highly mobile population) 13 cases recently reported were linked to a man who previously died of the disease. This man’s wife died, his six children who attended three different schools died as were two health care workers who cared for the man. Consider this also, a 9-year old girl who died was a contact to a known ebola case. There are possibly many more similar cases. Could these deaths have been avoided had the authorities put in place proper quarantine procedures? Could these have been avoided had authorities put in place proper contact tracing procedures? Data available shows that across eight districts so far affected 1,777 contacts have been identified with 87% of them under monitoring. This could point to challenges in contact tracing efforts as well as in monitoring of confirmed cases. The spread of diseases like Ebola must be understood alongside other culturally-driven practices such as motherchild bonds, childcare practices, patient care and funerary rites pertaining to the departed. Anthropologists are best placed to deal with these and best placed to advice public health experts on how to respond. Prof. Isaac K. Nyamongo is a Medical Anthropologist, a Pelto International Award Recipient and Chair, WCAA Dr. Khamati Shilabukha² is Research Fellow at the Institute of Anthropology, Gender and African Studies, University of Nairobi. Citation: Nyamongo, I.K. and Khamati Shilabukha (2022). The Ebola outbreak in Uganda: What we know and what it portends WCAA News 17: 2, November 2022.