Communities living along the porous borders of Uganda and the Democratic Republic of Congo (DRC) remain at high risk of the spread of Ebola. Thousands cross each day to sell and buy goods, tend to their farm and visit family and friends. With the epicentre of DRC’s largest Ebola outbreak only 100 kilometers away from the Ugandan border, it is crucial to contain and stop the virus from spreading.
Uganda Red Cross, with support from the International Federation of the Red Cross and Red Crescent Societies (IFRC) has been scaling up its response to help prepare communities and to prevent the spread of the virus. Volunteers are in high-risk areas, sensitizing communities about Ebola – providing information about the virus, what they can do to protect themselves, and screening the thousands of individuals who cross the border each day. Community engagement through music, drama, and mobile cinemas have also been employed to reach thousands of people.
“We would like to see communities that can easily detect diseases, potential epidemics and communities that can respond in case epidemics occur,” said Dr. Kasumba Joseph, Community Epidemic and Pandemic Preparedness Program Officer with the Uganda Red Cross.
“Most importantly we want communities that can actually prevent these epidemics. We are doing this through our volunteers.”
Karungi Shamillah is a Uganda Red Cross volunteer trained to educate families about Ebola and other health issues in her community. Photo: IFRC/Corrie Butler
Halting the virus before its spread through a real-time mobile system
Through Uganda Red Cross’ extensive network of community-based volunteers, a powerful surveillance system has been set up, in coordination with other actors and the Ministry of Health. This system helps stop the virus’ spread, detecting outbreaks before they happen.
Uganda Red Cross has trained community-based volunteers to recognize the signs of potential Ebola illness and to alert the authorities for follow up and care of people with such signs. With the help of the ‘Kobo Collect’ Mobile App, these cases are logged and are instantly shared with local health authorities for rapid action. If a case is detected the person can receive prompt treatment and the disease can be contained. This enables the reporting of any epidemic alerts in real time with low costs and resources.
“These communities being near the border are quite vulnerable. We have a lot of movement across the border, especially on market days, the risk of an Ebola outbreak is imminent,” says Kasumba, based in Bundibugyo.
“We have now trained 50 community-based volunteers who are using this technology as a surveillance tool to help prevent the threat of Ebola in Uganda.”
Only weeks after the training, volunteers have already started working in their communities where they hold sessions with community members and sensitize them about Ebola. Others, like Mugenyi Adam, have already sent out alerts to their supervisor.
“I have so far sent two alerts to my supervisor. I am proud that the community trusts me already and in case of any suspicions, I am the first one they call. This is what makes me proud – the response is so, so fast.”
He recalls one alert he submitted after conducting door to door community sensitization:
“A lady called me and told me her grand-daughter was sick, showing some of the symptoms of Ebola. I 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, I believe I saved her life.”
In Bundibugyo district, volunteers are conducting, what is called “passive” community-based surveillance. This means volunteers report alerts as they encounter them in the community while they conduct community health awareness activities. During large scale outbreaks, surveillance moves into an “active” phase where volunteers proactively reach out door-to-door ensuring alerts are quickly identified for a faster, more effective response.
Community-based surveillance, on its own, is not enough: coordination is key
Well before the community-based surveillance system was launched through the IFRC’s Community Epidemic and Pandemic Preparedness Program (CP3), significant coordination was done with stakeholders, including government ministries, 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 Red Cross 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,” said Dr. Samson Ndyanabaisi, the District Veterinary Officer in Bundibugyo district.
“The future of this project is very bright and the government always welcomes such support and collaborations.”
Communities remain at the heart of preparedness
With epidemics and pandemics continuing to take place around the world, it is increasingly important to ensure communities are prepared to respond in order to stop outbreaks early. Ebola is only one of the many health risks that IFRC’s CP3 is helping combat. The vision is that Uganda will use this as a model and continue to expand it to other epidemic and pandemic risks that are faced in the community, such as cholera or measles.
“As the Red Cross, we’re very strong at mobilizing to support communities when something happens. We’re one of the first who are there to take action. But we can do better than this,” explains Abbey Byrne, Community Based Surveillance Delegate with the IFRC.
“We’re also there before the epidemic. We can halt the spread instead of reacting once these diseases have already reached epidemic proportions.”
There is no one who understands a community more than its own. When challenges arise, they are the ones best suited to come up with the solutions. During epidemics, these community members are the first to respond and can, ultimately, save lives.
More about the CP3 programme
Launched in 2017 with funding from the U.S. Agency for International Development (USAID), IFRC’s Community Epidemic and Pandemic Preparedness Program (CP3) scales up efforts towards global health security. The program strengthens the ability of communities, National Societies and other partners in 8 target countries to prevent, detect and respond to disease threats and play a significant role in preparing for future risks.