Supporting Tanzania’s Marburg survivors

“God gave me another chance at life and helped me survive up to this moment because what I experienced was out of this world,” says Dr Mahona Ndulu, a doctor at Maruku Health Centre in Kagera, the north-western Tanzanian region where the outbreak was detected. As the seventh recorded case of Marburg Virus Disease in the country, he suffered life-threatening health complications.
In March 2023, during one of his routine daily rounds, he attended to a patient who presented with high fever, severe headache and malaise. After an examination, Dr Ndulu referred the man to the Kagera Regional Referral Hospital, but he died on the way.

When one of the man’s contacts was tested, it was determined that he had likely contracted Marburg.

Three days after their encounter, the 36-year-old doctor was himself fighting Marburg infection and on life support with multiple organ failure.

“This was a difficult case to treat. I have never experienced this before. Because this was an infectious disease, we couldn’t use the normal laboratory procedures,” says Dr Said Omary Kanenda, a renal health specialist who treated Dr Ndulu.

“Dr Ndulu experienced a range of different health issues, from anaemia to kidney and renal failure. Thanks to the additional specialist equipment donated by the Ministry of Health, we were able to manage the case successfully.”

After nearly three weeks in treatment, Dr Ndulu was discharged after testing negative for the virus and transferred for renal complications treatment. He was the last person to recover from the virus, kicking off the mandatory 42-day countdown to declare the outbreak over.

The Ministry of Health provided a dialysis machine to the health centre where Dr Ndulu was cared for, proving crucial for his recovery. Hospitals that were used as isolation and treatment centres during the outbreak were decontaminated so that routine health services can resume.

His recovery was met with jubilation in his community. “My family and community members viewed my illness as a spiritual battle between good and evil,” he says. “As a doctor and a survivor, I keep correcting and educating them, so we are all safe and protected.”

The father of one is grateful for the care he received that ensured his recovery. “I could see how the health workers worked relentlessly to save me. To say I am thankful is not enough,” he says.

In the aftermath of the outbreak, the Ministry of Health, with support from WHO and partners, has established a national Marburg Survivors’ Programme. Its purpose is to support the survivors as they continue their journey towards mental and physical health, while addressing fear and stigma in communities affected by the outbreak.

“Indeed, Marburg is over, but we are not completely out of the woods, as it left some impacts that we are managing currently,” says Dr Issessanda Kaniki, Kagera’s Regional Medical Officer. “Thanks to the support of WHO, we are providing psychosocial and mental health support for the survivors and their families in order to ensure complete recovery.”

With financial support from the United Kingdom’s Foreign, Commonwealth and Development Office, and the United States Agency for International Development, WHO is working with the Tanzanian government to raise public awareness through a door-to-door campaigns, educating people on the risks associated with Marburg and how to stay protected.

“Moving forward, building a health system and community that is more resilient against outbreaks is critical,” says Dr William Mwengee, WHO’s surveillance officer and field coordinator for the Marburg response in Tanzania. “It is a goal we all must strive to achieve, considering the increasing threats posed by emerging and re-emerging diseases. This will require sustained investment in health systems for health security.”

As a member of the survivors’ programme, Dr Ndulu is currently receiving daily medical and weekly psychosocial support. He has returned to work and has successfully reintegrated into the community, engaging in his usual social activities with friends.

“During my treatment, I suffered from high blood pressure, so the specialist visits my home every morning and evening to take my temperature and other vitals,” says Dr Ndulu. “Thankfully, I never experienced any stigma. The specialist has been so helpful in educating my community members. Truly, this has been a good recovery path for me.”