Kampala—At a health clinic in Arua, a border town in northern Uganda, staff are on high alert after unsuspectingly attending to a patient who was later diagnosed with Ebola disease caused by the Bundibugyo virus. It was 8 May 2026, before the outbreak was declared in neighbouring Democratic Republic of Congo, and the staff’s index of suspicion was low. After the patient asked to be discharged, she travelled to Kampala, Uganda’s capital city, where she tested positive for the virus.
“Two weeks after treating the patient, we got a call from the district surveillance team,” says Dr Seth Ejuu, the medical officer who treated the patient for fever and abdominal pain. “We were concerned and anxious.” The district surveillance team advised the nine staff who had contact with the patient to self-isolate for a further six days to complete the 21-day incubation period in which signs and symptoms could develop. Thankfully, they experienced none and are now back at work. “It was our standard operating procedures, for example, the use of gloves and hand sanitizer when we treat our patients, that helped us mostly,” says Ejuu.
During this brief period of isolation, the clinic deployed staff from their other branch and repurposed staff from within the clinic itself to ensure that health services were uninterrupted. “It was business as usual,” says Dr Alex Kigera, medical officer in charge of the clinic.
Maintaining access to essential health services is an important part of any disease outbreak response. Experience from previous disease outbreaks, especially viral haemorrhagic fever outbreaks, has shown that disruptions to routine healthcare can lead to indirect health consequences, including decreased health-seeking behaviour, missed immunizations, interruptions to maternal and child health services, delayed treatment for chronic diseases and reduced access to emergency care.
To ensure that preparedness was stepped up and health services continued, the clinic strengthened infection prevention and control measures. “We also provided people with the right information about the disease and how they can protect themselves,” says Kigera.
At national level, health authorities, with support from World Health Organization (WHO), developed a continuity of essential health services plan and supported regional and district authorities to adapt the plan to local needs.
Health facilities received standard operating procedures for continuity of essential services and virtual training sessions. These covered triage, infection prevention and control, patient flow and isolation procedures, as well as the clinical management of illnesses caused by fever (including the difference between malaria and Ebola disease), continuity of care for noncommunicable diseases and mental health conditions, and the provision of reproductive, maternal and child health services. More than 3000 healthcare providers from public and private health facilities participated in these sessions.
To support preparedness, a standardized tool was developed to guide assessments of health facility readiness. These assessments examine whether facilities can continue providing essential services while safely managing patients with suspected Ebola disease.
Between 27 May and 17 June 2026, health authorities, with support from WHO and partners, conducted health facility readiness assessments and support activities in 819 health facilities across 20 high-risk districts.
The main gaps identified in the assessments were a shortage of personal protective equipment (PPE) in 55% of facilities, while almost one in five facilities reported stockouts of essential medicines and around 10% had gaps in waste management and disposal systems. Additionally, only 35% of the 819 assessed health facilities had received outbreak-specific training, highlighting the need to expand training and mentorship activities as preparedness and response efforts continue.
The findings provided health authorities with key actions to advance the readiness of health facilities and plan for the continuity of essential health service delivery. "District teams through support from our partners have been able to do a lot of supportive supervision, mentorship, case detection and active case search in health facilities,” says Patrick Ongeyowun, Vurra health sub-district surveillance focal person. “The knowledge of health workers has been boosted through mentorship and implementation of standard operating procedures especially in facilities that have had contact with cases.”
Health facilities in Arua City have experienced around 8% decrease in outpatient department attendance between March‒April and May‒June 2026, before and after outbreak declaration. Despite having attended to an Ebola patient, essential health services at the clinic in Arua have not been significantly disrupted. Staff report that there has been a drop in the number of health clients from nearby Democratic Republic of the Congo due to restricted border movements. Communities in the Democratic Republic of the Congo living along this porous border rely heavily on essential health services in Uganda, underscoring the need to ensure uninterrupted access to care on both sides of the border.
“By strengthening routine health services alongside emergency response measures, Uganda is protecting both the health of communities affected by the outbreak and the delivery of the everyday services on which millions of people depend,” says Dr Kasonde Mwinga, WHO Representative in Uganda.
Now that Uganda has started the 42-day countdown towards declaring the outbreak over, staff in Arua are calm yet vigilant. “Our team on the ground is strong and we are not in panic mode,” says Sarah Aguti, director of the clinic. “Our index of suspicion is very high and every case we look at with a keen eye. We are ready to move through this outbreak and continue to serve our clients.”
