Disaster relief emergency fund (DREF)
Uganda: Ebola epidemic
DREF operation n° MDRUG029
GLIDE n° EP-2012-000124-UGA
3 August 2012
The International Federation of Red Cross and Red Crescent (IFRC) Disaster Relief Emergency Fund
(DREF) is a source of un-earmarked money created by the Federation in 1985 to ensure that immediate
financial support is available for Red Cross and Red Crescent emergency response. The DREF is a vital
part of the International Federation’s disaster response system and increases the ability of National
Societies to respond to disasters.
CHF 197,205 has been allocated from the IFRC’s
Disaster Relief Emergency Fund (DREF) to support
the Uganda Red Cross Society (URCS) in
delivering immediate assistance to 900,000 people
in Kibale District and 4 surrounding districts (with
a media campaign),646,700 people in Kibale
District (with health promotion campaigns), 2,500
high risk people (with house-to-house contact
tracing and follow-up), 900 people at risk of
stigmatization (300 discharged from hospitals and
their 600 family members with psychosocial
support and NFI kits), 200 hospital staff (with
personal protective equipment), and 220
volunteers (with training in epidemic control and
psychosocial support) over 3 months. Unearmarked
funds to repay DREF are encouraged.
Personal protective equipment ready to be delivered
from URCS to Kibale Distict/ Photo URCS
Summary:
An outbreak of Ebola haemorrhagic fever was confirmed by the Ministry of Health (MoH) and World Health
Organization (WHO) on Friday, 27 July 2012 in Kibale district in Western Uganda. By Monday, 30 July 2012,
there were 36 suspected cases of Ebola, with 14 deaths. More cases have continued to be reported in the
affected area, with some being admitted in Kagadi hospital. There are fears that the disease has spread
beyond Kibale. One suspected case was referred by ambulance to Mulago Hospital in Kampala, and died on
22 July 2012. Hospital staff handling the case are being monitored according to protocol and have so far not
displayed any signs of the disease. The full extent of the outbreak is not yet established but is expected to be
clearer after the assessment that started on Saturday, 28 July by a team of MoH, WHO, United States
Centre for Disease Control (CDC) and URCS. The outbreak has been confirmed to be Ebola (Sudan type)
and more laboratory tests continue to be done to further establish the characteristics of this outbreak.
A Uganda Red Cross Society Task Force has been established that will work closely with the Ministry of
Health’s established Task Force consisting of a number of agencies including WHO, Medecin Sans Frontiers
(MSF), United Nations Children’s Fund (UNICEF), Africa Epidemic Network (AFINET) and other
development partners to coordinate local and international efforts to provide medical supplies and to assist
with transport and personnel.
A total of 220 URCS volunteers have been mobilized and are receiving a refresher training to support the
dissemination of information about the disease and its transmission in Kibale, as well as in Kampala and
other at-risk districts. These volunteers will provide support to the vulnerable communities in tracing and
follow-up of the contacts of the suspected/confirmed cases. Some of these volunteers will also be involved in
psychosocial support, rehabilitation and distribution of Non Food Item (NFI) kits to survivors.
This DREF operation will support Uganda Red Cross Society to reach communities and individuals in Kibale
and the surrounding districts as well as in Kampala as follows:
Table 2: Ebola situation as at 30
th July 2011:
No. Name of Sub County Cases Deaths
1 Matale 1
2 Mugarama 3 1
3 Nyamarunda* 18 12
4 Kibale T/C 5
5 Bwikara 4 1
6 Muhoro 2
7 Kyabsdima 1
8 Kagadi 2
Total 36 14
*One case referred from Nyamarunda died in Mulago Hospital in Kampala
Coordination and partnerships
In Kibale, a district task force has been set up to help coordinate the response efforts at district level.
Table 3: Members of Kibale District task force:
Sector Lead Agency
Coordination and resource mobilization District Health Officer (DHO)/Respective
stakeholder NGOs
Case management DHO/MSF/WHO
Logistics management DHO//Respective stakeholder NGOs
Community surveillance DHO/ District Education Officer (DEO), URCS
Social mobilization, Information and Education
Communications (IEC)
District Health Educator (DHE) and
URCS/Respective stakeholder NGOs
Burial team/Security and Safety DISO
A similar coordination mechanism at national level has been established at the Ministry of Health
headquarters where URCS is duly represented. The National task force will be meeting every day at 9:00
am at MoH to review and discuss progress of the implementation.
The Ministry of Health and the District Health Team (DHT) remain the main interveners, while humanitarian
agencies such as UNICEF, WHO, international and local NGOs as well as URCS, are being mobilized to act
in partnership to support the district in the response.
These coordination mechanisms help in drawing epidemic response plans, resource mobilization, and in
providing operational guidance that supports resource sharing and avoids duplication of efforts.
An isolation centre has been set up at Kagadi Hospital and by Monday, 30 July 2012, ten (10) suspected
cases had been admitted in the unit. MSF (Holland) is on board and helping in case management and
overall treatment at the established isolation unit. Through the National task force, a refined case definition
has been worked on and shared with stakeholders. The district task force meetings will also help in
developing guidelines on preventing further spread, managing public gatherings during such epidemics, and
burying corpses of the infected.
Red Cross and Red Crescent action
Kibale Branch conducted a joint assessment with the District Health Office, Ministry of Health and WHO that
highlighted the magnitude of the emergency and is guiding the disease control actions.
The branch also mobilized 220 volunteers, readying them for engaging communities with disease control
activities and psychosocial support. The society has also dispatched the available personal protective
equipment (PPEs) to Kibale District to support the case management team and volunteers with their work on
the ground. One senior staff and the regional manager have moved to Kibale to support training of URCS
volunteers by mid week so that the volunteers are ready for action in the community by Friday 3
rd August
2012. IEC materials for community education and sensitization are being reviewed and updated by the social
mobilization sub-committee of the National task force and will be ready for production by Wednesday, 1
August 2012, and also ready for distribution by the end of the first week of August.
URCS has played a central role in previous EHF outbreaks, with its network of trained volunteers
participating in the efforts aimed at controlling these outbreaks.
The needs
Selection of people to be reached:
This operation aims to support the Uganda Red Cross Society in
delivering immediate assistance to: 646,700 people in Kibale District (with health promotion campaigns),
900,000 people in Kibale district and 4 surrounding districts (with a media campaign), 2,500 high-risk people,
(with house-to-house contact tracing and follow-up), 900 people at risk of stigmatization (300 discharged
from hospitals and their 600 family members with psychosocial support and NFI kits), 200 hospital staff
(supported with personal protective equipment), and 220 volunteers (with training in Epidemic Control for
Volunteers-ECV and psychosocial support).
It is estimated that the intervention will need to follow-up over 500 possible cases before the end of the
outbreak and an estimated 2,500 contacts of these suspected cases that have to be monitored for 21 days
so that those that develop symptoms are adequately referred for isolation and treatment.
The people suspected to be infected will usually have any household property that may have come in
contact with their body fluids buried or destroyed, and this will certainly result in a need for essential
household items to be provided to these families for their daily livelihoods. The provision of non-food items
(NFIs) will therefore require approximately 300 NFI kits.
Because of the nature of the disease, there is bound to be stigma and discrimination attached to these
families and therefore the URCS intervention will from the onset target a psychosocial support system for
300 patients discharged from hospital and 600 of their family members.
URCS will build capacities of the volunteers and community members to recognize suspected cases and
report them to the authorities.
Needs assessments have revealed that there is a shortage of PPE in government health facilities for use by
health professionals and volunteers during community activities. On 1 August 2012, Ebola National Task
Force meeting held in Kampala, the need for PPE was identified as one of the key priorities for health
facilities around Kibale and surrounding districts. Ugandan health workers are treating patients with other
illnesses (cholera, malaria, etc.) without PPE. The only way to get the doctors and nurses to look after
patients is to avail them with PPE for reassurance.
The proposed operation
The operation will mainly focus on engaging community based volunteers to undertake intensified health
education and promotion campaigns at household level to improve on community knowledge of the
symptoms and signs of the disease and the procedure to follow while protecting household members and
ensure appropriate referral of suspected cases. The contacts of the suspected cases will be followed-up by
volunteers on a daily basis to monitor the development of symptoms so that those that develop symptoms
are immediately referred. The IFRC ECV toolkit shall be employed to facilitate effective EHF control
interventions where trained volunteers will be facilitated to conduct health promotion campaigns, active case
search, follow up of contacts and referral suspected cases.
In order to reduce risk of wide transmission of the epidemic, mass media and other forms of culturally
acceptable and context-specific IEC campaigns will be employed to promote a wide knowledge and
awareness about the disease, its risks of transmission, actions to take for suspected cases and preventive
measures. This will target the whole of Kibale District and surrounding areas since there is significant
population movement to and from the affected area. The total population of the district is 646,700 people that
will be targeted with the IEC and mass media messages.
URCS will deploy staff from the branch and regional offices as well as technical staff from headquarters to
train volunteers and provide technical support for the planned EHF interventions. The capacities of staff ,
including members of the Regional Disaster Response Team (RDRT) and the health specialist in ECV, as
well as local capacities in Kibale District departments of Health will be utilised to provide guidance and
support to the field activities.
The National Society Headquarters in Kampala, in line with the IFRC East Africa regional representation
office in Nairobi, will organize with the field teams to participate in the monitoring of the implementation of the
Ebola operation. The Red Cross regional board representatives and the local board members will also... http://reliefweb.int/sites/reliefweb.int/files/resources/MDRUG029.pdf
