Doctors and nurses did not at first know what they were facing, and failed to protect themselves, according to a lawmaker representing the western area at the centre of the outbreak. Experts say the Ebola subtype that sparked the outbreak is new, and the classic Ebola symptoms were not always present, slowing diagnosis.

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"We are facing a crisis in health care here," said Jane Alisemera, the lawmaker representing Bundibugyo, the district 200 km from Kampala where the outbreak has claimed at least 18 lives.

"These health workers have already lost three of their colleagues and six more have contracted the disease. They are scared and morale is low."

"There is a very big shortage of nursing staff now at the hospital," she said.

According to the Ministry of Health's latest figures, Bundibugyo has 75 suspected cases of Ebola. The outbreak began August 20, 2008 but the disease was not confirmed as Ebola until November 29, 2008.

"The staff at the hospital didn't know they were dealing with a highly contagious outbreak so they took inadequate precautions," Alisemera said. The hospital had no protective clothing at the time of the outbreak, she said, though aid agencies have since donated supplies.

Two teams, including infection control doctors from the World Health Organization (WHO) and the United States' Centres for Disease Control and Prevention, recently arrived in Uganda to help contain the outbreak. In previous Ebola outbreaks, the virus has often spread in health care centres where doctors and nurses are not properly protected.

International health experts recommend that, when caring for Ebola patients, doctors and nurses wear full protective equipment - gowns, gloves, masks and boots.

Local newspapers reported that nursing staff in the isolation unit at Bundibugyo hospital were working without gloves and masks, and that the door of the ward was not locked.

"The staff are moving in a state of fear," said Samuel Kazinga, a local government official and head of the district Ebola task force.

"They have lost many of their colleagues and have put themselves at great risk in the line of duty. It is only fair that they should get some extra money, unfortunately we did not have the funds available immediately."

At one point, a strike was threatened.

Kazinga said negotiations with hospital staff had resolved their complaints and that medical personnel were attending patients normally.

Doctors would be paid a daily risk allowance of Uganda shillings 40 000 (about R180), nurses and auxiliary staff 30 000 (about R130) and 20 000 (about R90) respectively, he said.

Since the strike threat, the United Nations children's agency UNICEF has offered to contribute money toward risk payment for health workers.

"Health workers are taking a great risk in supporting their communities and they need to be supported in that," said UNICEF's country representative, Keith McKenzie.

Ebola typically kills most of those it strikes through massive blood loss, and has no cure or treatment. It is spread through direct contact with the blood or secretions of an infected person, or objects that have been contaminated with infected secretions. - (Katy Pownall/Sapa)

Read more:
New ebola strain kills 16 in Uganda

April 2008
 

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