Wednesday, December 5, 2007

The Frontiers of Medicine

The year was 2000 when the first? epidemic of Ebola struck Uganda.

Place was Gulu, in the north of the country. War ravaged Gulu. And it had to be in the hospital. Lacor hospital.

Our hospitals. They are public hospitals. Under equipped, under funded, under staffed. The care is supposed to be free. But in the main it is not. And the medical workers- they work at the frontiers of medicine.

And when a disease like Ebola strikes, it is the staff in the hospitals that are most affected. Working at the frontiers, they are struck down like flies.

In that epidemic, a panic hit the north of the country. Understandable. And in the hospital, where the sick were taken, and at first attended without proper precautions, the medics contracted the disease and died.

One stood out in the mind of the country. Dr Matthew Lukwiya. Medical Superintendant of Lacor Hospital. When many others fled, he stood his ground. Nursed his staff. And paid the ultimate price. By the time the epidemic was contained, he was dead. Indeed a brave man, but the price as usual was too high. In leadership, in sheer strain to the services, in the ravages to the place.

Now, the ‘strange disease’ pre-chogm, had turned into a new strain of Ebola. In the middle of the year, it was deep in the rainforests of DR Congo. Uganda was on alert, but it seems to have passed without us being affected.

Late in August, it was new cases. Late November it was a ‘strange disease’, now it is identified a new, less lethal strain of Ebola. Less lethal, because it kills only 20% of the people it infects.

Sunday, the papers were reporting fleeing health workers from the border district of Bundibugyo. Monday, they reported at least one medic had been hospitalised in Mulago. Tuesday afternoon, the fm stations are reporting the deaths of at least 3 health workers. One was the medic who was in Mulago, another one was head of the health centre near the epicentre of the epidemic, and a third a Senior Nurse, with others hospitalised.

Swift, silent, deadly, the disease has struck again. And those at the frontlines of medicine are paying the usual price.

It is sad.

In the 1980s, it was HIV. Slim disease as it was locally named. Today it is the swifter, more deadly Ebola that strikes at the medics themselves. They have to be space suited zombies to treat patients without contracting the disease.

It will be controlled. The major control factor seems to be knowledge that the disease is, and avoiding contact with those that it strikes. It seems to spread most when it is not known that it is around; that the silent killer is loose. Once it is known, it is no longer deadly to those who do not have it. Unlike HIV.

Bundibugyo. I don’t think I have ever been to that district. But of a sudden, I am collecting news about it.

May those who rest, rest in peace. And those at the frontiers, have the courage to continue fighting.


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