Fighting Ebola: Voices from the Frontline Documenting the experiences of East African deployed experts who volunteered to fight Ebola in West Africa Implemented by: Fighting Ebola: Voices from the Frontline Documenting the experiences of East African deployed experts who volunteered to fight Ebola in West Africa Contents Introduction . 6 Foreword from the Hon . Jesca Eriyo . 9 Foreword from Dr Zabulon Yoti . .. 10 Foreword from Dr Jackson Amone . 12 Foreword from Dr Irene Lukassowitz . 13 George Acire . 14 Rebecca Racheal Apolot . 17 Sarah Awilo . 22 Dr Mwaniki Collins . 24 Charles Draleku . 26 Emmanuel Ejoku .. 28 Dr Madina Hussein . 31 Loveness Daniel Isojick . 34 Dr Abdulrahman Said Kassim . 36 Teddy Kusemererwa . .. 40 Liliane Luwaga . 43 Dr Appolinaire Manirafasha . 46 Dr Landry Mayigane . 48 James Mugume . 50 Dr Monica Musenero . 52 Doreen Nabawanuka . 55 Dr Bella Nihorimbere . 56 Teresia Wairimu Thuku . 57 Tony Walter Onena . 59 Acknowledgements . 61 4 Fighting Ebola: Voices from the Frontline 5 Introduction ccording to the World Health Organization (WHO), Others, seeing scenes of death and devastation on their The East African Community Secretariat, in collaboration the Ebola epidemic that occurred in West Africa television screens, just felt compelled to do whatever they with the Federal Government of Germany through the Abetween 2014 and 2016 killed over 11,000 people could to help . Given that so many West African health GIZ-coordinated Support to Pandemic Preparedness in out of the almost 30,000 that were infected . From one initial workers, initially unaware of what they were facing and the EAC Region project, hosted a conference in the Kenyan case believed to have originated in Guinea, the Ebola Virus how to react, had already died in the epidemic, all of the capital Nairobi from 6th to 8th November 2017 so that these Disease (EVD) spread like a bushfire through the country volunteers from East Africa knew that they were taking first-hand experiences could be discussed, documented and and then to neighbouring Sierra Leone, Liberia and other huge personal risks and there was a real possibility that they developed and so that we can all learn from this invaluable countries in the region . There were real fears that the too could get infected and die too . Their immense courage experience and be better prepared for future outbreaks epidemic could rapidly escalate into a global pandemic, and self-sacrifice cannot be valued highly enough . of infectious diseases . The conference was also held in of origin and where they worked in West Africa) and gender fueled by the speed of ground and air transportation cooperation with GIZ’s Epidemic Preparedness Team of the experts attending . and free movement of people – indeed a few cases were (Schnell einsetzbare Expertengruppe Gesundheit, SEEG) and the reported, mostly amongst returning health workers, in German Development Bank (Kreditanstalt für Wiederaufbau, These first-hand accounts should be read in conjunction Europe and the USA . KfW)-supported EAC Regional Network of Reference with the conference report ‘Lessons for the Future - What Laboratories for Communicable Diseases . East African experts learned from fighting the Ebola Although no cases of Ebola were registered in East Africa epidemic in West Africa’ , which gives a much more during this epidemic, the East African Community (EAC) Ninety two participants attended the conference which detailed account of the discussions and deliberations, Partner States of Burundi, Kenya, Rwanda, South Sudan, was held at the International Centre of Insect Physiology as well as a summary of the agreed lessons learned and Tanzania and Uganda and their neighbouring countries and Ecology (icipe) in Nairobi . The participants included recommendations for the future . have experienced several fatal outbreaks of the Ebola virus over 50 of the 500 or so East African doctors, nurses, disease in the past, including the first recorded outbreaks epidemiologists, laboratory technicians and many other The five key messages for future preparedness that emerged in 1976 in what is now South Sudan and in the Democratic health specialists who were deployed to West Africa to from the participants’ discussions about lessons learned Republic of Congo near the Ebola River, from which the fight the Ebola epidemic between 2014 and 2016 . The from their experiences in West Africa are: disease takes its name . Such outbreaks are a stark reminder remaining participants were representatives of regional of the crucial importance of pandemic preparedness and and international (UN) organisations and institutions and n Political will is very important for timely declaration the need for early warning mechanisms and trained experts experts from the ECOWAS region and many of them were and management of epidemics . Regional and who can respond rapidly to them . During the months - and sometimes even years - they spent also involved in the fight against Ebola . national contingency plans need to be developed and on the Ebola frontline in West Africa, these East African implemented, with adequate resources to prevent and During the Ebola crisis in West Africa, some 500 courageous health professionals consolidated the skills they already had During the three-day conference, the author interviewed as react to future epidemics . There is a need to establish East African doctors, nurses, epidemiologists, laboratory and gained unique new experience and knowledge about many deployed delegates as time allowed . They spoke freely national and regional teams of experts that can be technicians and other health professionals risked their own preventing, combating and mitigating future outbreaks and frankly about their experiences . The views expressed rapidly deployed in an emergency . lives by volunteering to help their West African colleagues of infectious diseases . Indeed, many of these dedicated here are their own and do not necessarily represent the in the battle to contain and control the epidemic . These doctors, nurses, epidemiologists, disease contact tracers, views of the EAC Secretariat or GIZ . n Community engagement is crucial if disease outbreaks East African health experts were deployed by a variety of laboratory technicians and others involved must now are to be effectively contained . organisations, including the African Union (AU), the World surely be considered global experts in their fields . All the delegates were keen to share their experiences – and Health Organization (WHO) and other bodies . Some of all had inspirational stories of immense personal courage n Health systems need to be strengthened and work these experts already had experience of fighting smaller For this reason it is vitally important that their experiences and self-sacrifice in the face of enormous challenges . As it effectively with other sectors and areas of expertise to outbreaks of Ebola in their home countries, such as Uganda be documented so that lessons can be learned from them was not possible to interview everyone in the limited time ensure a holistic and effective response . or the Democratic Republic of Congo, and they felt that for the future . available, the author has selected interviewees with a view their knowledge and skills would be useful in West Africa . to reflecting a range of different professions, countries (both Ruth Evans, Editor 6 Fighting Ebola: Voices from the Frontline 7 A helping hand from East to West Africa Foreword from the Hon. Jesca Eriyo during the Ebola crisis Deputy Secretary General Finance and Administration, East African Community (EAC) Secretariat n October 2014, the East African Community’s Sectoral Council of Ministers of Health sent out a call for volunteers to join hands with our brethren in West Africa to fight the Ideadly scourge of Ebola, and some 500 experts responded from across our region . On behalf of the EAC Secretary General, Ambassador Liberat Mfumukeko, and on my own What is Ebola? behalf I would like to take this opportunity to thank wholeheartedly and warmly applaud these volunteers for their heroic self-sacrifice and courage, and the contributions they Ebola virus disease (EVD), formerly known made to containing and stopping the Ebola epidemic in West Africa . as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. The virus It is my belief and conviction that documenting these experiences will permanently is transmitted to people from bats and influence the way we plan for, implement and respond to epidemics in East Africa . spreads in the human population through human-to-human transmission. The The recommendations derived from these experiences and lessons learned will average EVD case fatality is around 50%, become the foundation for improved health polices, for guidelines, strategies and although fatality rates have varied from 25 frameworks . The documented experiences will be shared widely and will go a long to 90% in previous outbreaks. way towards shaping epidemic preparedness and response in our region, Africa and the world as a whole . Ebola spreads via direct contact (through broken skin or mucous membranes) with The EAC has adopted a One-Health contingency plan for epidemics which will be the blood, secretions, organs or other implemented in the region . We need to strengthen these efforts by listening to the bodily fluids of infected people, and with experiences of deployed East African experts who fought Ebola in West Africa and by surfaces and materials (e.g. bedding, clothing) contaminated by these fluids. implementing their recommendations for the future, including the setting up of a Burial ceremonies involving direct contact rapid deployment mechanism that the EAC Sectoral Council of Ministers of Health is seeking to put in place . with the body of the deceased can also contribute in the transmission of Ebola. As I conclude, I wish to call upon all Development and Implementing Partners to join the EAC in strengthening Health-care workers have frequently health systems at the regional level and in the Partner States in particular; because it is only strong Health systems been infected while treating patients with that can support and sustain a proper response to epidemics like Ebola .