7. Pillars of the Health System

In October 2000, an outbreak of Ebola hemorrhagic fever was identified in Gulu district in northern Uganda. Rapid reporting and recognition of the problem and the subsequent response led to successful containment of the epidemic. Public health surveillance was difficult because Gulu was a politically unstable area and because people reacted to infection by seeking traditional healers or fleeing, which spread the epidemic further. Hospitals were also desperately short of supplies to control the spread of infection from so many patients simultaneously affected. The Ugandan government mobilized the military to help with locating cases and invited WHO, the U.S. Centers for Disease Control and Prevention, and other international teams to assist. Ugandan health workers cared for the sick at great risk to themselves. With 425 cases identified, it was the largest Ebola outbreak ever recorded. Only 53 percent of the patients died, a proportion far less than the 88 percent reported in previous epidemics.

The successful containment of the epidemic testifies to the Ugandan Ministry of Health's investment in developing competent, motivated health workers through its Public Health School Without Walls, an active partnership with Makerere University, the Rockefeller Foundation, the U.S. Centers for Disease Control and Prevention, and WHO, along with the successful implementation of an integrated strategy for disease surveillance strategy.

Source: Adapted from DCP2, chapter 53.