Volume 9, Number 10—October 2003
Research
Cultural Contexts of Ebola in Northern Uganda
Barry S. Hewlett*
and Richard P. Amola†
and Richard P. Amola†Table 5
Beliefs and practices of the national and international healthcare professionals that enhanced and lowered health of some persons during Gulu Ebola hemorrhagic fever (EHF) outbreak
| Health-enhancing beliefs and practices | Health-lowering beliefs and practices |
|---|---|
| Most national government health workers and decision makers spoke local language and had an understanding of local cultures |
Unintended consequences of WHOa health education video: burning of houses of survivors |
| Establishment of isolation unit and use of barrier nursing |
Taking bodies to burial ground before family members could verify the death. This practice led to sick persons hiding from family and health workers; family members being afraid to take sick persons to hospital; persons running away from the ambulance; and stories of Europeans selling body parts |
| Providing gloves and bleach to local communities |
Omitting traditional healers from control efforts; they were ready and willing as a group to help mobilize the community |
| Medical care of Ebola victims including rehydration, control of vomiting, other
drugs/medications |
Early stages only: 1) nurses and healthcare nurses lacked training about barrier nursing, protective gear, and education about the transmission and nature of the disease; 2) lack of transport for sick patients; 3) international health workers not familiar with naming, kinship system, household organization of local communities |
| Multidimensional health education |
Taking blood samples for research only or blood taken without reporting results back to persons or communities’ increased distrust of healthcare workers |
| Suspension of the following activities: handshaking upon greeting, cutting by traditional healers, schools, discos, public funerals, traditional beer drinking |
International team members conducting EHF studies for research only. This diverted time and energy from control efforts |
| Diagnostic laboratories for Ebola |
|
| Ambulances to transport patients to hospital to isolate |
|
| Reallocation of tasks of health workers to focus on EHF |
|
| Use of mobile teams to follow all contacts and provide health education, support for survivors and impacted families |
aWHO, World Health Organization; EHF, Ebola hemorrhagic fever.
