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 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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