Kween District, 4th November 2017 - As the Marburg Virus Disease (MVD) continues to unfold in Kween district, eastern Uganda, frontline health workers battling the outbreak have been urged to nurture local capacity to be able to respond to both the current and future outbreaks.
“Community engagement is the cornerstone of emergency response. Work with the communities to build their capacity for success and sustainability” said Dr Zabulon Yoti Technical Coordinator for Emergencies at the World Health Organization(WHO) Regional Office for Africa while addressing the Kween District Marburg Taskforce meeting. This way, he added, teams will be able to not only build local capacity but also better understand their cultures and traditions especially with regard to issues pertaining to safe and acceptable burials. “Response activities should be adapted in accordance with the local context”, Dr Yoti reiterated.
Currently, a total of 3 MVD cases (one probable and two confirmed) have been reported in Kween district. Unfortunately, all have died. However, a number of events such as the burial of the second confirmed case (CJ) in the evening of 27th October 2017 seem to have made the locals uneasy with some response activities. Safe burial meant that family and friends were not allowed to bathe or touch the body as they usually do in this community. This was strange and unacceptable to some.
Secondly, CJ died in the “Isolation room” of the health centre with only a few health workers fully dressed in Personal Protective Equipment (PPE) allowed to access him. To some of CJ’s relatives, this was not right and they could not understand why their kith and kin had to be isolated. The suggestion now from the community is to call the place “treatment room or unit” which is acceptable to the locals. This will reduce on the stigmatization associated with “isolation room” where some think, people are taken to be isolated and to die.
Some people are also still not clear as to why the current MVD is confined to members of one family yet many people attended the burial of the people who have so far died of the disease hence the strong association with witchcraft. However patient explanations that it is usually family and health workers who come into close contact with affected are at high risk to contracting the disease is slowly becoming clear to many.
Therefore, to assuage such fears and anxieties Dr Yoti advised responders to always work closely with the affected people for better results. “Be transparent and open to the community for them to appreciate what is going on especially in the treatment and burial areas of the response” he counselled.
Currently, elders and clan heads have been oriented on MVD and are featured regularly on FM radio stations explaining the Marburg phenomenon to their brethren. This is gradually putting many people at ease gauging from the comments and contribution they make during the phone-in time.
The “Treatment Center” has also been constructed by local people under the supervision of MSF France and WHO experts which has helped to demystify some myths and fears about the place. Besides, open air prayers were recently conducted at the place led by the local priest to dedicate it to God. Later, community members were taken on a guided tour of the facility with experts explaining what is done in each section of the facility. In addition, provision has been made for MVD patients who may be admitted at the treatment centre to be visited and to communicate with family and friends while admitted in the facility.
Later in the week, Dr Yoti, a few WHO staff and selected local leaders made an unobtrusive visit to the family of CJ and the “hostile” community and commiserated with them over the loss of their loved one. These and other community engagement measures are slowly mending relationships with the community, breaking down barriers and making it easier to work with the community to stop MVD in the shortest time possible.
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