After surviving an Ebola scare, Kagadi District is more than ready to respond to any emergency
“The Ebola outbreak was our first major simulation exercise because it tested several aspects of the contingency plan and caused us to reflect on our approach,,” Deogratious Tibende, District Planner.
On 12 August 2022, Kagadi District in western Uganda started the daunting journey to develop a district contingency plan to boost their emergency preparedness and disaster mitigation.
The journey supported by the Office of the Prime Minister, World Vision Uganda and UNICEF with funding from the Government of Sweden, the Kingdom of Netherlands and the Spanish Committee for UNICEF went on smoothly until October 2022, when the Ebola Virus Disease (EVD) was confirmed in the district.
According to the District Planner, Deogratious Tibende, the contingency plan had passed the first two hurdles save for the simulation exercise when the virus struck. These included the validation exercise and ensuring stakeholder involvement.
“I think the Ebola outbreak was our first major simulation exercise because it tested several aspects of the contingency plan and caused us to reflect on our approach,” he said.
Due to its proximity to Lake Albert, Kagadi often experiences floods which cause hygiene-related diseases such as cholera. In 2020, the district also registered a rare case of a zoonotic tick-borne illness, the Crimean Congo hemorrhagic fever.
With this background and the most recent Ebola scare, it was no surprise that the simulation exercise designed to test the appreciation roles in the district contingency plan focused on preventing and managing a disease outbreak.
Guided by scenarios curated by the World Vision Uganda team, the simulation exercise took place on 14 February 2023 at the Kagadi District Headquarters.
With the sun overhead and temperatures at 31°c, the select leaders mimicked the steps they would take in the event of a disease outbreak in one of the 35 sub-counties in the district.
An Oscar-award contender
The actors’ roles did not have to coincide with their official positions, so Raymond Kirungi, a Disaster Preparedness Officer in the Office of the Prime Minister, grouped the senior district, town council and sub-county leaders by their roles in the simulation.
Then the movie director, Gabriel Oriokot, the Project Officer with World Vision Uganda, signalled his cast to action under the guidance of Susan Birungi Nyakoojo, Programme Officer Emergencies, UNICEF Mbarara Field Office.
The simulation started in a particular village in Ndaiga Sub-County where the local council one (LC.1) chairperson, a role played by Samuel Tumwesigire, the Town Clerk of Kagadi Town Council, alerted the Village Health Team (VHT) to a suspect who presented with signs of cholera.
The suspect had been to a traditional healer, a common practice in the district. Despite asking for an arm and a leg, his ‘ancestral powers’ did not bring any relief, prompting the suspect to try a local pastor instead. By this time, however, he needed much more than prayer.
Armed with information from VHT, the health surveillance team swung into action and moved the patient to a nearby health centre, from where he was further referred to the main district hospital. Upon examination, the doctor confirmed the suspect as a cholera case and quickly moved him into the isolation centre – a makeshift outpost under a jackfruit tree.
While that went on, the health in-charge and the LC.1 chairperson gathered more facts from the affected village. They alerted the Sub-County Disaster Management Committee (SDMC) of a possible cholera outbreak. The message was cascaded to the District Disaster Management Committee (DDMC) for administrative and technical support to boost contact tracing and referrals.
With an outstretched budget, the District Health Officer (DHO) reported to the Ministry of Health the potential cholera outbreak in the district while the other committee members engaged partners such as UNICEF, Uganda Red Cross, World Vision Uganda and the OPM for assistance.
Lessons learned
Despite the exercise being a resounding success, some participants noted a communication breakdown at different levels, while other key stakeholders were not engaged.
“I noticed that after the patient was brought to the hospital, there was no follow-up to see if he made it or if the hospital or health workers needed some critical supplies,” noted Kefa Madira, the Senior Medical Clinical Officer at Kagadi Hospital.
Additionally, the Deputy Chief Administrative Officer, Edward Bisangabasaija, admitted that it was an oversight not to involve the media, who he said were critical partners in disseminating key health messages to local communities.
“During the Ebola outbreak, the media played a critical role in informing their listeners on the best prevention and reporting mechanisms. We must find room for the media to be involved in our planning activities, especially during emergencies,” Bisangabasaija added.
Kagadi now turns to the political leadership of the district to swiftly pass and adopt the district contingency plan as a working document – a step the Chairman LC.5, Peter Mugisa Sebugwawo, promised to see through.
“I pledge that when the district contingency plan is presented in the district council, it will quickly be passed so it can begin to work for our people,” Sebugwawo said at the climax of the simulation.
