When Ebola broke out in Uganda in September, 10 doctors immediately stepped forward to work on the isolation team at the Fort Portal Regional Referral Hospital, but now there are only three.
Workers are reluctant to work in the group for fear of contracting the deadly haemorrhagic fever, as well as fatigue and delayed payments, said one of the three, who asked not to be identified because he was not authorized to speak to the media.
Two doctors at a hospital in western Uganda have died of Ebola in the outbreak. Nationwide, 15 health workers have been tested and six have died.
The virus spreading in Uganda is the Sudanese strain of Ebola, for which there is no proven vaccine. The total number of recorded cases has reached 141, and 55 have died.
“In the beginning the number of health workers willing to work in the sector was good but now we are not getting better. “When we receive five cases, the work we do is a lot,” said the doctor.
“But if we all run away we will all get sick,” said the doctor, adding that the hospital sometimes runs out of water needed for treatment.
Uganda is one of the countries with the lowest number of doctors and patients, with one doctor for every 25,000 people, compared to the number of one to 1,000 people reported by the World Health Organization (WHO).
The WHO and aid groups are providing aid to Uganda to fight the Ebola epidemic, and the United States says it has sent $22m through its partners there.
But Uganda still faces a serious funding crisis – a WHO official said an initial $20m government grant was burned in the first month as cases soared.
The head of affairs of the Ministry of Health in Uganda, Dr Henry Kyobe Bosa, has denied that there is a shortage of staff or resources. Intensive care workers work eight-hour shifts and workers in Ebola-free areas are rotated, he said.
But the workforce was 40 percent spread of the epidemic, and Ebola is now “destroying the system in a different way,” said Dr Alone Nahabwe, head of the Uganda Medical Association.
Workers lack protective equipment including eye shields, gowns, gloves and gumboots, he added.
“There are places where doctors and medical workers are still handling patients without gloves because (gloves) are not available,” said Nahabwe.
‘We can handle it’
Officials say that when the chaos starts, things are going well. The numbers remain low compared to the 2013-2016 Ebola outbreak in West Africa that killed at least 11,300 people.
“The reality is that we don’t have a lot of cases to deal with,” Bosa said. “The biggest threat we have is that cases come to Kampala.
So far 20 cases have been confirmed in the capital, which is home to almost two million people.
At the isolation center in Mubende district, where it started, one doctor said that PPE and staffing risks have decreased as the numbers have dropped: in his unit, 12 out of 60 beds were occupied last week, from a risk of 48.
But experts worry about the proliferation of cases. On Sunday, the first case was reported in the east of the country.
“The number of staff you need under IPC (infection, prevention, and control), monitoring, surveillance, numbers are huge,” said Miriam Nanyunja, WHO consultant on emergency management in Uganda.
“Although the number of cases is not increasing, the geographical spread is increasing,” he said. “If it goes on for a long time you will need to gather more resources.”