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Published in: Globalization and Health 1/2012

Open Access 01-12-2012 | Research

“A time of fear”: local, national, and international responses to a large Ebola outbreak in Uganda

Author: John Kinsman

Published in: Globalization and Health | Issue 1/2012

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Abstract

Background

This paper documents and analyses some of the responses to the largest Ebola outbreak on record, which took place in Uganda between September 2000 and February 2001. Four hundred and twenty five people developed clinical symptoms in three geographically distinct parts of the country (Gulu, Masindi, and Mbarara), of whom 224 (53%) died. Given the focus of previous social scientific Ebola research on experiences in communities that have been directly affected, this article expands the lens to include responses to the outbreak in local, national, and international contexts over the course of the outbreak.

Methods

Responses to the outbreak were gauged through the articles, editorials, cartoons, and letters that were published in the country’s two main English language daily national newspapers: the New Vision and the Monitor (now the Daily Monitor). All the relevant pieces from these two sources over the course of the epidemic were cut out, entered onto a computer, and the originals filed. The three a priori codes, based on the local, national, and international levels, were expanded into six, to include issues that emerged inductively during analysis. The data within each code were subsequently worked into coherent, chronological narratives.

Results

A total of 639 cuttings were included in the analysis. Strong and varied responses to the outbreak were identified from across the globe. These included, among others: confusion, anger, and serious stigma in affected communities; medical staff working themselves to exhaustion, with some quitting their posts; patients fleeing from hospitals; calls on spiritual forces for protection against infection; a well-coordinated national control strategy; and the imposition of some international travel restrictions. Responses varied both quantitatively and qualitatively according to the level (i.e. local, national, or international) at which they were manifested.

Conclusions

The Ugandan experience of 2000/2001 demonstrates that responses to an Ebola outbreak can be very dramatic, but perhaps disproportionate to the actual danger presented. An important objective for any future outbreak control strategy must be to prevent excessive fear, which, it is expected, would reduce stigma and other negative outcomes. To this end, the value of openness in the provision of public information, and critically, of being seen to be open, cannot be overstated.
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Literature
2.
go back to reference Simpson D: Ebola haemorrhagic fever in Sudan, 1976. Bulletin of the World Health Organisation. 1978, 56 (2): 247-270. Simpson D: Ebola haemorrhagic fever in Sudan, 1976. Bulletin of the World Health Organisation. 1978, 56 (2): 247-270.
4.
go back to reference Feldmann H, Geisbert T: Ebola haemorrhagic fever – seminar. Lancet. 2010, 377 (9768): 849-862.CrossRef Feldmann H, Geisbert T: Ebola haemorrhagic fever – seminar. Lancet. 2010, 377 (9768): 849-862.CrossRef
5.
6.
go back to reference Johnson K, Breman J: Ebola haemorrhagic fever in Zaire, 1976. Bulletin of the World Health Organisation. 1978, 56 (2): 271-293. Johnson K, Breman J: Ebola haemorrhagic fever in Zaire, 1976. Bulletin of the World Health Organisation. 1978, 56 (2): 271-293.
7.
go back to reference Jezek Z, Szczeniowski M, Muyembe-Tamfum J, McCormick J, Heymann D: Ebola between outbreaks: intensified Ebola Haemorrhagic fever surveillance in the Democratic Republic of Congo, 1981–1985. J Infect Dis. 1999, 179 (suppl 1): S60-S64.CrossRefPubMed Jezek Z, Szczeniowski M, Muyembe-Tamfum J, McCormick J, Heymann D: Ebola between outbreaks: intensified Ebola Haemorrhagic fever surveillance in the Democratic Republic of Congo, 1981–1985. J Infect Dis. 1999, 179 (suppl 1): S60-S64.CrossRefPubMed
8.
go back to reference Khan A, Kweteminga Tshioko F, Heymann D, Le Guenno B, Nabeth P, et al: The reemergence of ebola haemorrhagic fever, democratic republic of congo, 1995. J Infect Dis. 1999, 179 (suppl 1): S76-S86.CrossRefPubMed Khan A, Kweteminga Tshioko F, Heymann D, Le Guenno B, Nabeth P, et al: The reemergence of ebola haemorrhagic fever, democratic republic of congo, 1995. J Infect Dis. 1999, 179 (suppl 1): S76-S86.CrossRefPubMed
9.
go back to reference Muyembe-Tamfum J, Kipasa M, Kiyungu C, Colebunders R: Ebola outbreak in kikwit, democratic republic of congo: discovery and control measures. J Infect Dis. 1999, 179 (suppl 1): S259-S262.CrossRefPubMed Muyembe-Tamfum J, Kipasa M, Kiyungu C, Colebunders R: Ebola outbreak in kikwit, democratic republic of congo: discovery and control measures. J Infect Dis. 1999, 179 (suppl 1): S259-S262.CrossRefPubMed
10.
go back to reference WHO: Outbreak of Ebola haemorrhagic fever, Uganda, August 2000 – January 2001. Weekly Epidemiological Record. 2001, 76: 41-46. WHO: Outbreak of Ebola haemorrhagic fever, Uganda, August 2000 – January 2001. Weekly Epidemiological Record. 2001, 76: 41-46.
11.
go back to reference Francesconi P, Yoti Z, Declich S, Onek P, Fabiani M, et al: Ebola hemorrhagic fever transmission and risk factors of contacts, uganda. Emerg Infect Dis. 2003, 9 (11): 1430-1437. 10.3201/eid0911.030339.CrossRefPubMedPubMedCentral Francesconi P, Yoti Z, Declich S, Onek P, Fabiani M, et al: Ebola hemorrhagic fever transmission and risk factors of contacts, uganda. Emerg Infect Dis. 2003, 9 (11): 1430-1437. 10.3201/eid0911.030339.CrossRefPubMedPubMedCentral
13.
go back to reference Okware S, Omaswa F, Zaramba S, Opio A, Lutwama J, et al: An outbreak of Ebola in Uganda. Trop Med Int Health. 2002, 7 (12): 1068-1075. 10.1046/j.1365-3156.2002.00944.x.CrossRefPubMed Okware S, Omaswa F, Zaramba S, Opio A, Lutwama J, et al: An outbreak of Ebola in Uganda. Trop Med Int Health. 2002, 7 (12): 1068-1075. 10.1046/j.1365-3156.2002.00944.x.CrossRefPubMed
14.
go back to reference de Roo A, Ado B, Rose B, Guimard Y, Fonck K, Colebunders R: Survey among survivors of the 1995 Ebola epidemic in Kikwit, Democratic Republic of Congo: their feelings and experiences. Trop Med Int Health. 1998, 3 (11): 883-885. 10.1046/j.1365-3156.1998.00322.x.CrossRefPubMed de Roo A, Ado B, Rose B, Guimard Y, Fonck K, Colebunders R: Survey among survivors of the 1995 Ebola epidemic in Kikwit, Democratic Republic of Congo: their feelings and experiences. Trop Med Int Health. 1998, 3 (11): 883-885. 10.1046/j.1365-3156.1998.00322.x.CrossRefPubMed
15.
go back to reference Hewlett BS, Hewlett BL: Ebola, Culture and Politics: The Anthropology of an Emerging Disease. 2006, Wadsworth, Belmont, California Hewlett BS, Hewlett BL: Ebola, Culture and Politics: The Anthropology of an Emerging Disease. 2006, Wadsworth, Belmont, California
16.
go back to reference Heymann D: Control of Communicable Diseases Manual. 2008, American Public Health Association, Washington DC Heymann D: Control of Communicable Diseases Manual. 2008, American Public Health Association, Washington DC
17.
go back to reference Guimard Y, Bwaka M, Colebunders R, Calain P, Massamba M, et al: Organisation of patient care during the ebola haemorrhagic fever epidemic in kikwit, democratic republic of congo, 1995. J Infect Dis. 1999, 179 (suppl 1): S268-S273.CrossRefPubMed Guimard Y, Bwaka M, Colebunders R, Calain P, Massamba M, et al: Organisation of patient care during the ebola haemorrhagic fever epidemic in kikwit, democratic republic of congo, 1995. J Infect Dis. 1999, 179 (suppl 1): S268-S273.CrossRefPubMed
18.
go back to reference Dox I, Melloni J: Melloni's Illustrated Medical Dictionary. 1998, Informa Healthcare, London, 3 Dox I, Melloni J: Melloni's Illustrated Medical Dictionary. 1998, Informa Healthcare, London, 3
19.
go back to reference Piliavin JA, Charng HW: Altruism: a review of recent theory and research. Annual Review of Sociology. 1990, 16: 27-65. 10.1146/annurev.so.16.080190.000331.CrossRef Piliavin JA, Charng HW: Altruism: a review of recent theory and research. Annual Review of Sociology. 1990, 16: 27-65. 10.1146/annurev.so.16.080190.000331.CrossRef
20.
go back to reference Goffman E: Stigma: Notes on the management of spoiled identity. 1963, Prentice-Hall, Englewood Cliffs, NJ Goffman E: Stigma: Notes on the management of spoiled identity. 1963, Prentice-Hall, Englewood Cliffs, NJ
21.
go back to reference Link BG, Phelan JC: Conceptualizing stigma. Annual Review of Sociology. 2001, 27: 363-385. 10.1146/annurev.soc.27.1.363.CrossRef Link BG, Phelan JC: Conceptualizing stigma. Annual Review of Sociology. 2001, 27: 363-385. 10.1146/annurev.soc.27.1.363.CrossRef
24.
go back to reference Lamunu M, Lutwama J, Kamugisha J, Opio A, Nambooze J, Ndayimirije N, Okware S: Containing a haemorrhagic fever epidemic: the Ebola experience in Uganda (October 2000 – January 2001). Int J Infect Dis. 2004, 8: 27-37. 10.1016/j.ijid.2003.04.001.CrossRefPubMed Lamunu M, Lutwama J, Kamugisha J, Opio A, Nambooze J, Ndayimirije N, Okware S: Containing a haemorrhagic fever epidemic: the Ebola experience in Uganda (October 2000 – January 2001). Int J Infect Dis. 2004, 8: 27-37. 10.1016/j.ijid.2003.04.001.CrossRefPubMed
25.
go back to reference Kinsman J: AIDS Policy in Uganda: Evidence, Ideology, and the Making of an African Success Story. 2010, Palgrave Macmillan, New YorkCrossRef Kinsman J: AIDS Policy in Uganda: Evidence, Ideology, and the Making of an African Success Story. 2010, Palgrave Macmillan, New YorkCrossRef
Metadata
Title
“A time of fear”: local, national, and international responses to a large Ebola outbreak in Uganda
Author
John Kinsman
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2012
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/1744-8603-8-15

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