Safe return: Overcoming stigma on the Ebola frontline in Uganda

According to the latest figures, more than 1,400 cases have been confirmed Ebola Bundibugyo virus disease, including 350 deaths, has been reported in both countries. More than 90 percent of infections are concentrated in the DRC’s Ituri province, a major center for cross-border trade with Uganda – hit by years of armed conflict.

Calling Kampala

On Sunday morning in Kampala, Dr Chris Opensen, an anthropologist at the World Health Organization (WHO), received a call from local authorities shortly after 5.30am.

A woman suspected of having Ebola is preparing to return home, and her husband is asked to help ensure her safe reintegration into society.

Three days earlier, Lilian* showed symptoms similar to Ebola and was transferred to the Ebola isolation unit at Mulago Hospital for diagnosis and treatment.

Although the move was planned, it was a distressing experience for him, his family and neighbors. Since then, everyone has been anxiously awaiting the final confirmatory tests that will determine whether he can return home safely.

Over the past 36 hours, Dr Opensen has maintained regular contact with Lilian and her family, providing reassurance and guidance as anxiety in the community grows.

“Anthropologists are central figures in the response to this outbreak,” he said, using a football analogy. “I connect the response team with the community and provide feedback, from the community to the response team by citing concerns, fears and complaints.”

Managing fear and misinformation

Together with his colleagues from the Kampala Capital City Authority, Dr. Opesen held a community meeting with Lilian’s family and friends to address concerns ahead of her return.

What starts as a tense and emotional exchange, gradually changes when Dr. Opensen proposes a more structured dialogue. The group agreed and elected a chairman, neighbor, and secretary: Lilian’s sister, Angela*.

When everyone was given space to talk, the atmosphere slowly calmed down. “We appreciate you, because without you there is still fear,” Angela said afterward.

Later, Dr Opensen and his colleague Henry Bwire, a monitoring officer at the Kampala Capital City Authority, accompanied a neighbor to a local shop.

Lilian had asked them to speak to the shopkeeper, who had allegedly stigmatized her mother earlier in the day.

“Ebola is a disease that everyone is afraid of,” explained Mr. Bwire. “Sigma can arise through miscommunication and fear, both of which were present in this case. It was our role to bring Lilian back and clear up that miscommunication and reduce that fear in the community.”

After discussion, the shopkeeper thanked the team and assured them that Lilian would be treated with respect upon her return.

Waiting for everything to be done

All that remains is laboratory confirmation.

The two decided to wait in a neutral place instead of returning home, placing themselves between the hospital and Lilian’s neighborhood. They stayed in touch with the lab and family throughout the afternoon.

At around 6:30 p.m., the call came: the results were negative for Ebola. Lilian has been treated for a bacterial infection and is well enough to return home.

A dignified return

Back home, family and neighbors gather in anticipation. Dr Opensen arrived with cake and a water bottle.

When Lilian finally arrived, escorted by members of Uganda’s national Emergency Medical Team, she looked tired but relieved. The group listened as he shared his experience and what recovery meant to him.

“As a family, we appreciate you coming to the field and community to talk to us, because the stigma can be too much” he said. “Thank you for listening and addressing our concerns. I hope this can be a learning experience.”

Lilian then cut the cake and distributed it to everyone gathered.

“For me, reintegration should be a celebration, especially when the evacuation doesn’t go according to plan,” said Chris. “I wanted to do something special for Lilian, and for her to serve slices to people and for them to eat what she had given them, to show her acceptance back into society.”

Long day, shared results

At 9 p.m., more than 15 hours after his day began, Dr. Open finally on the way home. Despite the long hours, he described the day as rewarding.

“My role in this response gives me satisfaction,” he said. “If I do my job well, I can make a difference and support WHO’s leadership on the front lines in providing a safe and dignified response.”

*Names have been changed to protect patient privacy