News on Uganda’s Ebola outbreak

An outbreak of Ebola that started in Kibaale district, western Uganda, has spread to Kampala, say government officials (including the president). So far 14 people have died from the Ebola virus, and at least a dozen more have been infected. As more information becomes available, I will post it here.

Many of the cases so far are reported to have come from the same family, in addition to a health worker in Kibaale, Clare Muhumuza, who was transferred to Mulago Hospital, where she died.

According to the Centers for Disease Control (and common sense), a critical factor in stopping the epidemic is to recognize an outbreak and respond quickly. It appears as though this is the third week since the outbreak in Kibaale. Let us hope not too many people were infected before news of the outbreak and government response became public.

Some of the recent stories are below:

Museveni warns of Ebola threat, BBC news

Ebola in Uganda alert, World Health Organization

6 more patients admitted with possible Ebola, AP

Ebola kills Kampala doctor, Chimp Reports

Ugandans told to avoid handshaking, Reuters

Why has Besigye gone to Nairobi?

Dr. Kizza Besigye was finally allowed to fly to Nairobi to seek treatment for his battering yesterday at the hands of (flower-print shirted, h/t Rosebell) plainclothes state security operatives. NTV has footage of his departure:

I am very glad Dr. Besigye was ultimately allowed to fly (@AndrewMwenda suggests maybe he needs to invest in a boat now that walking, driving and flying are forbidden), but let’s remember why he needs to go to Nairobi in the first place (apart from his brutal treatment). There are no hospitals in Uganda that come close to rivaling the best of those of Kenya or South Africa. Those who get care in Mulago or IHK are the luckiest.

Beyond the overburdened national referral hospital and private hospitals (the latter of which are impossibly expensive for most), the health sector in Uganda is in a pathetic state. Health worker absenteeism, drug leakage, and even ghost clinics are rampant. A 2007 survey found that only 6% of Uganda’s hospitals had the basic infection control elements (soap, running water, latex gloves, etc.). 1 in 8 children will not live to see their first birthday, meaning that nearly 500 of the 4000+ born each day will have died within the next five years. Maternal mortality has not improved by any statistically significant amount from 1995 to 2006, when the last Demographic and Health study was completed (Uganda DHS 2006 pg.282).

The failures of the health sector are to a large extent, a failure of governance.

Yes, it is terrible that security forces attempted to stop Besigye from seeking the medical treatment he so desperately needs and deserves. It literally added insult to a horribly unjust injury. But even more terrible is that Besigye is only one of millions of Ugandans who desperately need quality health care. And most aren’t getting it.

When the beater is beaten, who wins?

This morning in Mulago hospital, a young man lay on a stretcher in the emergency ward, the side of his head split open over a lump that had swelled to the size of an apple. “Mob justice,” explained a nurse. “They were found beating a woman, and so they were beaten.” In the hall outside the room, two police officers waited for their suspects to be released. In the next room, patients waited to see the triage nurse, to register, to be whisked away to the appropriate ward, some of which remained too full to admit new patients.

I hoped the young man would make it, but I couldn’t help thinking that he was taking doctors and nurses away from so many other patients who hadn’t landed in the emergency room for beating someone (if in fact the story was correct, which it sometimes is not in the case of mob justice). I am sure the police saved the young man and his accomplice from the certain death they would have encountered at the hands of the mob.

According to Uganda’s 2008 Annual Crime Report, released last month, the incidence of mob justice is on the rise. The statement read by Inspector General of Police Maj. Gen. Kale Kayihura, “Last year registered a 100% increase in cases of mob action leading to death, from 184 cases in 2007, to 368 cases in 2008. Of these instances, 232 suspects were lynched on suspicion of theft and 59 on suspicion of murder. Suspected robbers, burglars and witchdoctors were other categories of persons murdered through mob action.”

He continued, “I am putting the public on notice that no one shall be allowed to take the law into their own hands, whatever the provocation or perceived justification. I have given strict instruction to the CID to apprehend and have all persons involved in mob action charged with murder.”

I am not sure what the apparent increase in prevalence of mob justice indicates. The obvious explanation for mob justice is that people feel that the legal justice system does not work for them and therefore must take matters into their own hands. But why more so now than before?