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Volume 9, Number 10—October 2003

Research

Cultural Contexts of Ebola in Northern Uganda

Barry S. Hewlett*Comments to Author  and Richard P. Amola†
Author affiliations: *Washington State University, Vancouver, Washington, USA; †Ministry of Health, Adjumani, Uganda

Main Article

Table 1

Explanatory models for Ebola hemorrhagic fever (EHF) among the Acholia

Terms Yat Gemo Disease of contact; Ebola
Description
“Medicine” or substance that enters the body and causes illness
Bad spirit that comes suddenly and rapidly and effects many people
EHF, biomedical description
Signs and symptoms
Starts with pain inflammation but can have many other signs in later stages
Mental confusion, rapid death, high fever
High fever, vomiting, headache
Causes
Bad “medicine” (poison) goes into body
Lack of respect for jok, sometimes no reason
Filovirus, but host reservoir unknown
Transmission
Step on it, eat it, catching it, somebody sends, just looking at a person
Physical proximity, easy for gemo to catch you
Physical contact with bodily fluids of patients
Pathophysiology
Inflammation and pain in area touched by or location of yat
Attacks all of body
Damage to major organs
Treatment
Tak—techniques of healers who use their jok to identify and remove yat from body or environment
Talk to jok via traditional healer, give whatever wants, gifts of food to jok
None, hydrate (ORS), control vomiting
Prevention and control
Protective bracelets
See protocol in text, chani labolo, ryemo gemo
Do not touch patients, barrier nursing
Prognosis
Good if removed from body; otherwise death
Not good, no cure
Not good, no cure
Risk groups
Very smart, successful, salaried people; anybody
Caregivers close to patients (women), families that do not respect jok, families that do not follow protocol
Unprotected healthcare workers, caregivers of patients, people that wash or touch dead victims
Political Infected troops returning from DRC sent to Gulu Infected troops returning from DRC sent to Gulu Infected troops returning from DRC sent to Gulu

aORS, oral rehydration salts; DRC, Democratic Republic of Congo.

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