Uganda was recently ranked among the top 10 countries world-wide in suppressing the Covid-19 pandemic by the Lancet Medical Journal, a leading global publisher of health research. This is a great honour for a country, so poor and so further removed from the global technological and medical modernity that the world expected would drive the fight against the pandemic when it was first reported at the end of 2019. To many, Uganda seems to be succeeding where many richer nations have failed. While this accolade is important for energising the country’s efforts towards recovery, one key area that has been ignored in these efforts is the communities— the places and ordinary Ugandans whom the prevention efforts target.
Given that the world is yet to find a vaccine for Covid-19, preventing the spread of the pathogen provides a more proven option for stemming the pandemic than first-rate medical care for those who acquire the infection. In fact, even if the vaccine had been available, the number of Ugandans who have the capacity to pay for it is lot less compared to those who can protect themselves through the available preventive methods.
This means that no matter how good the health infrastructure, no matter how prepared our medical staff may be, unless prevention is prioritised, medical efforts cannot yield the desired results. To halt the spread of the pandemic, Uganda has relied on strict and, and in many ways, restrictive measures, including a complete lockdown, closures of schools, enforced curfew, strict border entry and a mass awareness campaign spearheaded at the top by President Museveni and the Ministry of Health. No doubt, some people heed these measures. However, the recent spike in infections and later deaths due to the pandemic is clear indication that overwhelmingly most Ugandans, either through ignorance or simply rejection, do not adhere to Covid-19 guidelines. At the same time, there are still many Ugandans who believe that the pandemic does not exist, and that it is a hoax effected by the media and politicians. Unless people in places where they live, work and spend their time can in some way participate actively in efforts to prevent further spread of the virus, our country’s response plan may not yield any more benefit. Indeed, for the strict, instructional and informational measures to impel public response, they must be accompanied by people in their communities actively taking part in bringing the infection down.
When local groups of women and men, youth and children work together to prevent health emergencies and diseases, health problems become everyone’s business and responsibility. Involving local people in championing the response to Covid-19 will help to reduce public doubt about the pandemic. People in their village working together to ensure that members desist from unnecessary movement during Covid-19 lockdown, teach one another about hygiene, devise ways to locate contact cases, fighting stigma and spreading messages to prevent infection can bring benefits not just to themselves but to the wider population. On outlook, this suggestion might seem a wild hyperbole. However, community efforts are what have partly led to the overall reduction in malaria cases in the country through local communities volunteering in the distribution of mosquito nets and the management of simple malaria cases using the village health teams at the village level. What the Ministry of Health needs to do now, is to build on the experiences and lessons learned from engaging village health teams in managing other diseases, such as malaria, to formulate guidelines on how to engage communities in Covid-19 recovery. This is important because it will help to put Covid-19 prevention high on the priority list of people in their communities. In addition to using the state-of-the-art instructional mode, let us take Covid-19 prevention efforts to the people in their communities through a collaborative mode. The closer Covid-19 efforts will move to people in communities, the more opportunity there will be for the public to dispel any doubts, and to understand the seriousness of Covid-19, let alone the need for them to respond positively to prevention guidelines.
By Dr. Nakiwala Aisha Sembatya