Kampala—Daniel Dramile, a psychiatric nurse at Oli Health Centre in Arua City, Uganda, was part of a small team who staffed the facility’s Ebola isolation centre during the country’s recent Ebola outbreak in 2026.
Dramile emphasizes the importance of mental health during disease outbreak response, especially within the African context.
What does a mental health and psychosocial support professional do at an Ebola isolation centre?
We look at the psychosocial issues affecting our clients who are identified and referred by the [disease] surveillance teams. Ebola isolation centres receive, isolate, assess and manage suspected cases of Ebola or those that meet the case definition for Ebola. They are here until they either test positive and are moved to the treatment centre, or their negative result is confirmed by two consecutive tests and they are discharged.
So, when clients are picked up and brought here, they often ask, "Why should they pick me?" This subjects them to a lot of stress. You are separated from your family members. You are separated from your community. Your movements are restricted and you are kept idle in one place. That comes with a lot of mental health and psychosocial issues.
We listen to them. We talk to them so that they can accept the reality that they are now separated from their homes. We also help them stay connected to their family members through other means, such as phones. We may also provide radios so that they can remain in touch with the outside world.
We reach out to patients’ communities, allay their fears, communicate the process and the test results to them, and then reintegrate patients back into their communities at the appropriate moment.
What challenges do you face?
Mental health and psychosocial issues often manifest in physical conditions, but in most cases they do not receive adequate attention because there are too few psychosocial and mental health workers available to support those affected. Mental health is not prioritized.
Patients can arrive agitated, especially if many are brought in at the same time. Initially, I was the only person here. One person talking to five people at once is really challenging. The approach is difficult and you may not fully exhaust the discussion with them so that they completely understand and become comfortable.
At times, this forces you to do things in a hurry, without giving them adequate time or listening to them properly. That is the biggest challenge on our side as service providers.
In fact, psychosocial support is needed at all levels. In every activity that is performed, psychosocial support should be included. Even when health workers are going into treatment centres to provide medication or clinical care, psychosocial support should be part of that process.
Why is mental health and psychosocial support important in outbreak response?
Human nature is about relating to and interacting with other people. If the person I am supposed to interact with has an infectious disease, then there is a challenge.
In Africa, we do not simply wave; we greet by shaking hands Now, during an outbreak like this, you are deprived of that cultural practice. It means you cannot show care and affection in the way you normally would and that can be distressing. It feels unnatural because even a simple handshake can provide comfort.
In our culture, we sometimes eat together and share spaces. During an outbreak, we cannot do this. It is difficult because, traditionally, if people do not eat together, others may think there is a problem or that there is bad feeling between them. But during an outbreak, you are forced to do things differently. Going against your culture can really affect people psychologically.
However, when people are helped to understand that these measures are for their own health, to protect them, preserve their families and safeguard their communities, they begin to accept them. It becomes easier for them to understand why they need to be isolated and why they may need to eat separately or use separate containers.
Gradually, people gain a better understanding and life begins to feel a little more normal. That is how important mental health and psychosocial support are during outbreaks.
