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Using Community Based Surveillance to improve early detection of Ebola

Friday, 18 January 2019 10:40 Written by

Using Community Based Surveillance to improve early detection of Ebola outbreak in western Uganda

There is no one who understands a community better than its own members. Community challenges are best known to its people and solutions are always with the same people. Uganda Red Cross employs the ‘community based volunteer approach’ which allows volunteers picked and trained from the communities to deal with their own people and present their community’s needs. With support from USAID Uganda through the International Federation of the Red Cross, Uganda Red Cross is implementing a community based preparedness program that focuses on epidemics and pandemics dubbed #CP3 Project The introduce Community is trained to be able to detect potential disease outbreaks and also respond through reporting the signs and eventually participate in the response to save lives.

Today, Uganda is one of the countries at risk for Ebola following the confirmed outbreak in neighboring DR-Congo.As the Ebola threat continues to loom around the Uganda-Congoboarder, Uganda Red Cross has trained over 300 Volunteers in communities closes to DR-Congo in districts like Bundibugyo, Kasese, Ntoroko, Bunyangabu, Kisoro, Kabale, Kanungu among others to carry out surveillance and risk communication activities, including screening for all people entering the country. In some busy communities, a special data collection App called “Kobo-Collect” was introduced and about 50 Volunteers have been trained to use it.

This is to enable the reporting of any epidemic alerts in real time at low costs and resources for early response. “We trained our volunteers to use this real time mobile system to help us detect any epidemic alerts in the community. These communities are near the border and are at high risk. We have a lot of movement across the border,especially on market days and the risk of an Ebola outbreak is imminent. This is why we have relied on our community based volunteers to use this technology as a surveillance tool to further keep Ebola out of Uganda but also sensitize the people about Ebola .” Said Dr.Joseph Kasumba, the Community Epidemic and Pandemic Preparedness Program officer in Bundibugyo district.

Majority of the trained volunteers have already started working in communities where they hold sessions with community members and sensitize them about Ebola. Others like Adam Mugenyi have already sent out alerts to their supervisor and highly commend the system. “I have so far sent two alerts to my supervisor. I am proud that the community trusts me and in case of any suspicions, I am the first one they call. After my door to door movements, a lady called and told me her grand-daughter was sick with what she described as Ebola symptoms. I checked on the child ,indeed she was bleeding and had bloody diarrhea. She also had blood in her urine. I then called my supervisor and informed him about it.

I was amazed to see a response in just 25 minutes. They checked on the girl, took her to hospital and fortunately she tested negative for Ebola. I kept checking on the family to ensure that they were doing the right hygiene practices. I am so proud of my work. , I believe I saved her life” Adam said In Bundibugyo district which is in South Western Uganda, community based surveillance system is at preparedness phase where surveillance, monitoring and reporting is a great effort in partnership with stakeholders like WHO, UNICEF Uganda, Ministry of Health, World Food Programme. Volunteers submit reports by short message service (SMS) or forms which upload to a computer system for automated data processing. Reports can be designed for very basic analogue phones or modern touch phones and used by people with no experience, and minimal literacy with a well-designed training approach.

This is done through the Red Cross Community Epidemic and Pandemic Preparedness Program (CP3) which collaborates closely with Ministry of Health, health care workers, sectors for animal health, agriculture and environment, development partners, civil society, and the communities themselves.“We have been trained in this approach by the RedCross and we have worked closely with them to tackle community epidemics in this region. Given that Ebola is the major threat at the moment, all efforts have been focused on prevention and preparedness because of our proximity to neighboring Congo where Ebola has already killed many people.

The future of this project is very bright and the government always welcomes such support and collaborations.” Said Dr.Samson Ndyanabaisi, the District Veterinary Officer, Bundibugyo district. In August 2018 World Health Organization declared an Ebola outbreak in Congo where over 250 people have died from the epidemic. Uganda has been on high alert and Uganda Red Cross with support in partnership with other partners and government structures that include the Ministry of Health, Unicef Uganda, W.H.O, USAID and IFRC, has been at the center of Ebola prevention and preparedness especially around the Uganda-Congo border.

URCS has trained and deployed over 360 volunteers who are doing risk communication, social mobilization and Ebola screening at the border. Other interventions like edutainment through use of music and drama, community engagement through mobile cinema have also been employed to ensure that people access messages on Ebola and communities are prepared to cope despite the high risk.

Road users sensitized about road safety

Friday, 18 January 2019 09:51 Written by
Road users sensitized about road safety ahead of the festive season.

Road users sensitized about road safety ahead of the festive season.

This is a very dangerous season on the road and the perfect time for this road safety campaign. This is the 3rd year we are doing this and the second edition of the caravan.  This year’s caravan has been brought along this Jinja-Kampala road highway. Last year we year we took it to Kampala – Masaka highway. We focus on educating and engaging road users along the busy highways on road safety.” said Gilbert Assi, the Managing Director Vivo Energy Uganda.

Every December, as we approach the festive season, a number of fatal accidents claim lives pf people.This is because of over speeding, among other factors since motorists usually drive upcountry to enjoy festive seasons with their extended families and friends. Away from Kampala,  some drivers want to make more trips and maximize profits, while others want to come to town to sell  merchandise. The heavy traffic makes the roads busier than usual.

According to the Annual Traffic and Road safety report for Uganda, there were 13,244 road accidents in 2017 and most of these happened towards the end of the year. The same report reveals that 3,000 people died during these accidents while 10,000 were injured. 

Vivo energy in partnership with Uganda Red Cross society, Ministry Of Works And Transport, NTV Uganda Television in 2016came up with a road safety campaign to sensitize road users on major highways about road usage and safety. This was dubbed “Tweddeko” meaning “let’s re-think our ways”.  Most of these accidents can be avoided if road users became a little more careful.

“The campaign started in February in 2016 with an initial focus on television messages on road safety until  last year when the caravan edition was introduced. This includes a mobile cinema with testimonials and other road safety messages. This is accompanied by a fleet of vehicles and patrol that make stop overs at major towns along the highway. The caravan made its maiden convoy on Masaka road last year and thousands of road users were engaged.  This year’s caravan  has been broughton Jinja road which has the biggest traffic flow in Uganda, given its  connection to Kenya border and beyond. 

The road is also considered one of the deadliest in Africa. Let us not forget that road safety is shared responsibility. Jinja road is our gateway to the sea and is the route that carries 90% of the goods that are imported to Uganda. It has more traffic than any other road in Uganda and this increases the risk of road accidents” said Mr. BenonKajuna, the Director  Transport, Ministry Of Works And Transport. The road crosses to Kenya through Malaba, then to Nairobi and up to Mombasa. He added.

There were tworoad safety caravans, one started off at Namanve towards Jinja and the other one moved  from Jinja town towardsKampala. The two teams then met at Mabira forest for the closing ceremony. The convoy was joined by the minister for works and transport Eng. Monica AzubaNtege who applauded  the initiative and pledged the ministry’s continued support.“The ministry would like to pledge continued collaboration with all likeminded partners in the fight against road carnage. We have set up a multisectoral team to prepare a paper detailing measures for reducing road carnage and this work is about to be completed and the paper will be presented to cabinet in January 2019.” said  the Hon. Minister before flagging off the caravan.

During this exercise, Uganda Red Cross equipped the different road users with knowledge and tips on how to respond or handle someone who has been involved in an accident. They also learnt the basics of first aid. This was done through demonstration of live simulations and accident skits. Road safety messages and testimonies were also played for the participants on the mobile cinema. They also received the Highway Code manual book, road signs posters and stickers. A few participants walked away with reflector jackets as well. At the major towns, the caravan targeted taxi drivers, boda-boda cyclists, pedestrians and their leaders in those areas.

Road safety is a collective responsibility. We can avoid most of the accidents.

“Every year in the world, 17th November is marked as the World Day of Remembrance for Road Traffic Victims to remember those who died or were injured from road crashes and the plight of their loved ones who must cope with the consequences of their deaths or injuries.As such, we encourage the people of Uganda to keep safe, observe traffic rules and do everything possible within their means to avoid road accidents. Tweddeko, every life matters!” Said Mr. Miti Lwanga, lead first aid instructoron the caravan.

Meet Kennedy and Stella, a love story that has stood a test

Friday, 18 January 2019 09:20 Written by
Kennedy and Stella playing with their youngest child at their home in imvepi refugee settlement,
northern Uganda

Being a refugee might be one of life’s biggestchallenges. It comes with a lot of deprivations, trauma and other limitations. Thousands of refugees in the world go hungry, others just fall sick and die, any are killed by the stress and circumstances while stress and boredom linger on majority. Everyone cherishes being in their home country, peaceful, working studying and have a happy family life.

For many years, South Sudan has been raging with war and this has pushed over a million refugees into Uganda. Despite Uganda’s friendly refugee policy, these still stay in settlements, with a small chunk of land, only a few household items, and still get food rations. Life is generally not a bed of roses. The situation however, is quite differentfor this young, enthusiastic and visibly happy family of four in village 6,Imvepi refugee settlement, in Nnorthern Uganda. KennedyMetaloro 27, lives with his wife StellaOnesta, 24 years old and their two daughters; Patricia- 3years and Gloria, (2 years), in their grass thatched house in the settlement. On seeing us approach their home, the two beamed with smiles and excitement as they welcomed us into their home with open hands.

They love visitors. They are a happy couple who despite all odds have chosen to smile and let life move on. The couple has lived in Uganda as refugees for two years. However before becoming refugees, Kennedy and Stella had been in Uganda as students in 2008. They met at Arua Progressive Secondary school. Kennedy was classes ahead of Stella. A beautiful and brilliant young girl in her senior three, Stellawas always the target of many eyes. Kennedy won her heart! “Kennedy was a young energetic man, very brilliant! Since he was ahead of me, I was sure I would rely on him for protection and academic assistance while we were at school. Life at school was so good and easy with him,and we were lucky to have come from the same tribe and village back in South Sudan.

I loved him since our school time and I knew he would become my future husband.” said Stella as she reminisced with nostalgia about the olden days. After high school, the two moved back to South Sudan and Kennedy started working at the airport. Unfortunately, against her will,Stella couldn’t proceed to university as there was no money for university tuition, she just kept waiting and praying for the day she would said Stella as she reminisced with nostalgia about the olden days. After high school, the two moved back to South Sudan and Kennedy started working at the airport.

Kennedy and Stella started dating way back in secondary school when they were both
students in Uganda

Unfortunately, against her will,Stella couldn’t proceed to university as there was no money for university tuition, she just kept waiting and praying for the day she would I was still working to raise money for the cows when the war broke out and we fled the country.” said Kennedy The war in South Sudan intensified in 2016 and by this time, Kennedy and Stella already had one child ;Patricia. Stella lived in Yei with her Kennedy’s mother since she was already accepted to live with Kennedy’s family. Kennedy was working at the airport, some good distance away from his family.When the war broke out, Stella was very pregnant. She ran to Uganda with Kennedy’s mother and their daughter Patricia. Kennedy was at work and they couldn’t communicate with him. “We were forced to leave him behind. The situation was getting out of hand, we were all scared.

They slaughtered our neighbors the night before we ran and this compelled us to take off. We run with nothing. On the road, we suffered a lot, there was no food or water, I had a young baby, I was pregnant for our second child and then I had to help Kennedy’s mother, who is old now. Some people died on the road and others fell sick. We were so happy and relieved when we reached Uganda” Stella narrated the ordeal. When Stella reached in Uganda, she gave birth to their second child. This was in the refugee settlement in Uganda.

It took Stella and Kennedy seven months to see each other again. There was no connection until through the Red Cross restoration of family links program,Stella got to know that Kennedy was nearby in Bidibidi settlement. Kennedy had also fled after his family left, but had no idea whether his family was safe or not. Through the Red Cross family tracing program, he got to know that his family was alive in a refugee settlement in Uganda. He however had no idea it was so close to his. “When I got to know where they lived, I couldn’t stop visiting. They were really suffering when I found them. There was no food, no land and life was hard. They clearly missed a I had to bribe security to allow me sneak in to check on my family every day. This is why I requested Uganda Red Cross and other authorities to let me join my family here in Imvepi refugee settlement.” The family recalls the joy and jubilations when they were reunited. “When I saw him again, I felt life come back. We were worried that he hadn’t made it out alive.

We really thank God for having kept him alive and brought him back to us” said Stella. After reuniting with his family, Kennedy got an opportunity to become a Red Cross volunteer in his community where he helps in translations during psychosocial, health and hygiene promotion activities carried out by Uganda Red Cross in the settlements. From his small facilitation, he has been able to look after his family. His wife Stella also volunteers at a nearby nursey school as a care taker for children. The two have never given up hopes of going back to school and have applied for a few scholarship opportunities within the settlement. Stella wants to study Public Health at the university and Kennedy wants to get more qualifications to get him a better paying job here in Uganda. When asked about going back to South Sudan, Stella had this to say; “I can’t, I can never go back to that place. I just want to go back to school and we comfortably live here.!”

Communication as Aid; Using music and drama to disseminate Ebola prevention messages in Kabarole district, South Western Uganda.

Friday, 14 December 2018 08:38 Written by
A scene from the play portryaing the safe and diginified bruial (SDB) process

As Ebola remains a major health threat Uganda, a number of preparedness interventions have been put in place to avert the epidemic.The Ebola outbreak broke out in neighboring DR-Congo in August 2018. Given the proximity of Uganda to North Kivu province, where a number of  people have died of the same disease, Uganda remains among the countries with the highest risk of getting Ebola.

Since December 2017, Uganda started receiving refugees from DR-Congo and with the confirmation of the  Ebola, Uganda has been on toes while guarding its porous borders from letting in people with  Ebola. 

The Ministry of Health in Uganda has marked 7 districts ranked at high risk due to their proximity to the high risk areas in DR-Congo with Ebola. Among those in Uganda include Kabarole, Kasese, Bundibugyo, Bunyangabu, Kanungu, Kisoro and Ntoroko.  A lot of trade goes on in these areas and this makes them stand higher chances of exposure with people from Congo whom are highly susceptible. 

Uganda Red Cross in close collaboration with the Ministry of Health, WHO, UNICEF Uganda, World Food program, the International Federation of the Red Cross / Crescent have come together to support the Ebola preparedness as a means of preventing Ebola but also managing it should there be any cases.

Grace Safari, the group leader taking part in the Ebola Drama process

Over 180 Red Cross volunteers have been trained and deployed to conduct risk communication and social mobilization in all the 7 high risk districts through  conducting home visits, engaging communities through community gatherings, sharing IEC materials on Ebola, screening all entrants at boarder points,  conducting hygiene promotion among other interventions

In Kabarole district, music and drama is an innovative health approach to passing on Ebola messages to the local communities. It is a faster, effective and easier way of engaging communities to understand Ebola, how it is spread, how to avoid it, until the cycle of burial is managed should one die.

Uganda Red Cross mobilized a group of community members, women and men to start up a drama group. These compose Ebola related songs and plays and perform in their communities. The group in Harugongo Sub County is led by Mrs. Grace Safari 51, a dedicated Red Cross community based volunteer.

“We started in September after a thorough training by the Red Cross. We then started recruiting members who had the various talents to help us put together songs and a drama which we would take to the communities. Our music and plays basically remind people that Ebola is real and encourage them to avoid it through the prevention messages we include.” Said Safari

Harugongo drama group has 25 members so far, two writers who are also the choir leaders, five instrumentalists, dancers and other group members. They have so far written 10 songs about Ebola and one play. In their songs, they emphasize how to prevent the spread of the Ebola virus, how to handle someone with Ebola symptoms (suspected case) and how to handle a dead-body and burial of the Ebola victim. According to the group these are some of the key messages that the communities need to learn about Ebola.

Ibrahim baguma emotonally singing a song about a young a a man who was warned against
Ebola but did not heed.He in the end lost his life to the killer disease

“Through music and drama, people understand the message so fast and easily and this has helped a lot. We sing and act in our own local language which the communities appreciate very much. The children have found our messages very clear and interesting and they enjoy seeing us perform. It is always good to know that the children are well prepared for such an outbreak and have the knowledge to prevent it” she added.  

The group meets at a local church in the e sub county. The church helps them with some instruments and seats to use during their performances. Ibrahim Baguma 34, is one of the writers in the group. He is passionate about music and grew up dreaming of becoming a great artist who would sing to improve the lives of people in his society. Ibrahim never went to school all his life but found perfect joy in writing songs and serving in his local church. He believes through music and drama he is able to reach the educated people who he wouldn’t access 

"Otherwise. “I did not go to school. I cannot just go around telling educated people about Ebola. These are doctors, teachers and nurses, who am I to talk to them about these things? But through music and drama, I attract their attention and they appreciate me and the message. 

Ibrahim is 34, he never went to school but he uses his talent in music and drama to reach
even the most educated with Ebola prevention messages.

It gives me great joy to know that my songs help transform my community and help my people prepare for this killer endemic” said Baguma. According to the District Health Office in Kabarole district, this is one of the greatest ideas in place to fight and avoid the spread of Ebola because music is regarded as the biggest form of entertainment. It gathers big numbers of people at once. 

“Whenever drama is staged in a place, people will always come. It is a form of entertainment and the message is still carried home. Through this intervention, people can watch and listen at the same time which further drives the message. We have put a technical person in place to move with the drama to answer all questions that might arise from the audience about Ebola. This therefore allows easy and immediate feedback” said Brian Kisembo, a member of the district health task force in the District-Health-Officer’s office in Kabarole.

The role played by the drama team so far has been enormous and much appreciated by the communities and the authorities. From the plays and songs, people have been able to understand the symptoms of Ebola and become more precautions. No wonder it was after a drama show that the first suspected case in the district was identified in November, this year.

A scene from the Play portraying Mr. Wamatooke a hunter after hunting an animal
that spreads Ebola in his home and later on village

“We identified one of the suspected cases when someone, after watching the Ebola drama realized that he had a neighbor with most of the symptoms portrayed in the drama. He walked to us and asked our team to go and check it out. The suspect had indeed travelled from Congo a few weeks back and had not used the official boarder point where screening is done.” said Mr. Kisembo.

According to the Red Cross Ebola team in Kabarole district, it had increasingly become hard to find people in their homes during the door to door interventions and social mobilization. This had to be boosted by an addition of music and drama which can be taken to people at their places of work and in market places.

“We first concentrated on house to house interventions but then we later realized people are not always at home because they do a lot of businesses. we then resorted to using drama. In Uganda,  music is one of the key communication methods that spreads information faster and easily to communities through edutainment.” Said Geoffrey Buzaale, the URCS Ebola focal person Kabarole district.

In August 2018 the Ministry Of Health and W.H.O declared an Ebola outbreak in DR Congo which has so far claimed over 250 people, with 457 more confirmed cases. This has led to intensified preparedness activities around the border areas in Uganda.  The Uganda Red Cross with support from partners continues to scale up Ebola preparedness interventions at all the boarder points with DR-Congo and in communities that are at risk. Uganda has never had any confirmed Ebola case since the fresh outbreak in DR-Congo in August 2018.

 

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URCS Contacts

Plot 551/555 Rubaga Road.
P.O. Box 494, Kampala Uganda.
Tel:     (256) 414 258701
Tel:     (256) 414 258702
Email: sgurcs@redcrossug.org

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