Dr Margaret writes…

This time last year, I was working as a medical officer at Bwindi Community Hospital, and we were watching with fear and anticipation as the epidemic of Ebola ebbed and flowed just over the border in Congo, and threatened at times to reach Uganda too. Never would I have imagined that only a year later, we would be facing a pandemic; one that threatens both of the places I cherish; the UK and Uganda too.

Whilst here in the UK my colleagues and I are concerned about the availability of PPE, and we worry about the effects of the disease on our families and loved ones and colleagues and patients, the same preoccupations affect our fellow team at BCH.

Although the number of confirmed cases of coronavirus in Uganda remains small, the impacts of the pandemic are being felt throughout the community. Uganda is experienced at dealing with outbreaks of infectious disease and has well-developed systems in place to respond. Uganda was quick to close its borders to prevent imported cases of coronavirus. It rapidly put in place stringent lockdown measures to curb the spread of infection. Schools were closed and churches and other social gatherings were suspended. There is now a ban on all but the most essential movement of vehicles, such as ambulances. There is a curfew at 7pm which is being strictly enforced.

Just as in the UK, such lockdown measures and restrictions affect the most vulnerable the first and the most. Because of the lack of transport, the price of staple goods in the markets has increased. In Bwindi/Buhoma, which relies heavily on tourist income, there has been a sharp rise in food insecurity and food poverty. Peoples can no longer travel to and from the health facilities to seek care. Patients who are already in hospital are stranded without transport to leave, and their relatives are unable to visit them and attend to them and bring them food. Those who find themselves outside after curfew are treated harshly by the authorities. Under the dark constraints of curfew, the likelihood of domestic violence is increased.

The impact on the hospital is also very significant. Bwindi Community Hospital relies heavily on donations to support its core services. Without tourist income, the funding is reduced. Students at the nursing school are not paying fees. Meanwhile, the costs to the hospital are increasing. The price of medication has increased, and the cost of PPE has risen by more than 100%. Services that are part of the hospital’s unique presence in the community are severely constrained – community outreach clinics can no longer operate and patients suffering from chronic diseases such as HIV, TB, diabetes and hypertension are having to receive medication dropped off at the roadside, and miss out on the support that would be provided by BCH’s specialist teams. Services to support the health needs of youth have also been suspended.

And all this is happening even before the pandemic reaches South Western Uganda.

As ever, the team remain courageous and proactive in their response to adversity. They do, however, urgently need our support to deal with the challenges they are currently experiencing, and as they prepare for the worst of the pandemic that we hope will never come.

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