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Richard Kilonzo, a PATA Technical Assistant in Uganda, offers insight from the frontline during COVID-19

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Uganda’s first case of coronavirus was announced by Jane Aceng, Uganda’s Minister of Health, on March 21, 2020. This led Yoweri Museveni, the country’s president, to issue a nationwide order to close all schools and places of worship for 30 days, and to stop all travel in and out of the country with the hope that such measures will slow the spread of disease.

These preventive measures are certainly a good start, but they may not be enough, especially given the systemic and deep-rooted challenges facing Uganda’s public healthcare system. Uganda has 55 intensive care beds for its more than 42 million people. Of these, 20 have no ventilatory capacity and only one-third are part of the public health system. Furthermore, these beds can be found only in the regional and national referral hospitals, located in major urban hubs.

Frontline health providers are deeply affected by coronavirus COVID-19, with safety an ongoing issue in responding to the outbreak. Because of their close proximity to the most severe cases, health providers face a dire risk of contracting the disease. Most health facilities do not have COVID-19 protective gears such a face masks, gloves and other protective materials. The COVID-19 testing kits are not yet available to the health facilities and, at the moment, all of the tests are done in one lab hub in Entebbe referral hospital*.  The Ministry of Health (MOH) has announced massive trainings for frontline health providers at both government and private health facilities, however, this has not been implemented as of yet.

The importance of frontline health providers, both in the community and the health facility, is greater now than ever. Health providers needs to be equipped with information, resources, and protection. 

Many Ugandans live in remote and rural regions of Uganda, and in sub-Saharan African more generally, frontline health providers will be the first and possibly only line of defence against the coronavirus. Uganda does not seem prepared enough to curb this pandemic. With current healthcare system challenges and the increase of the confirmed cases daily, the disease curve seems to be getting worse. 

The country lockdown also means that public services, such as transport, are no longer in operation – a service that many health providers and clients use in order to access and travel to health facilities. The shutdown of transport has meant that many clients have missed drug refills and clinic appointments. The people who will suffer most are those living with pre-existing health conditions, who need drug refills and clinic follow-up visits. The MOH has expressed the need to provide guidelines to the public on how these clients should be able to access vital medicines or medical follow-ups during this partial lock down.

Prevention during COVID-19 will be key to protecting the lives of people across low-income countries, where health systems are weak. Over the past fortnight, community health workers have been constructing hand-washing stations, known locally as “tippy-taps,” at important communal locations and in people’s homes. Tippy-taps, which are made out of locally-sourced materials such as tree branches, rope, and recycled jerry cans filled with liquid soap, are just one example of the resourcefulness on the ground. 

Increasing ownership of low-cost smartphones and cellular coverage has also enabled community health workers to connect with each other remotely to share best practices, up-to-date policy changes, and messages of encouragement — something which is especially important at this time. By accessing the World Health Organization’s WhatsApp group, community health workers have also been able to access timely and accurate information, which they have relayed to local community members in order to dispel unfounded rumours or misinformation that is being spread at a time of heightened anxiety.  

Source of Richard´s information: State and MOH press conference/releases, Ugandan newspapers (Daily Monitor and New Vision)

*Richard´s story from the frontline reflects his experiences as of 29/03/2020.