WHO mobilizes urban-based Congolese refugees in Uganda for Ebola action

Life as a refugee is never easy. This is especially true if one lives in settlements where access to social services such as health, education or economic opportunities to earn a living may not be readily available.

The natural tendency is to move to where conditions might be better. For the over 1.5 million refugees currently in Uganda, the government’s policy permits them to integrate into the host communities and to and access social and economic services just like the locals.

Free movement of refugees from places where their lives and property are threatened is a human right guaranteed by international agreements and covenants. As such, thousands of Congolese refugees have integrated into host communities near the settlements and many have moved to urban centres including Kampala city where social services are much better including economic activities.

However, the current outbreak of Ebola Virus Disease (EVD) in part of the Democratic Republic of the Congo such as Beni, Butembo and Bunia, where majority of the refugees come from, presents serious public health challenges. This requires public health workers, especially on the Ugandan side of the border, to be extra vigilant – screening travellers for any EVD signs and symptoms and manage them appropriately.

Every week, at least 2000 people settle in Kampala city without necessarily going through official border entry points. Some are traders, others visit relatives, and several are students or patients looking for medical care. The majority are refugees seeking a more secure environment.

In order to reach these people, the World Health Organization engaged leaders of Congolese refugees resident in Kampala city.

According to the Office of the Prime Minister, there are over 300,000 Congolese refugees in Uganda, and the majority are settled under well-organized community structures in the various suburbs of Kampala city. This means mobilizing them for public health action is seamless especially if done through their leadership.

Abdulkarim Twaha, a truck driver is the leader of refugees in Kampala city and also doubles as the chairman of the Refugees Drivers' Association. The middle-aged and highly respected Abdulkarim has lived in Kampala as a refugee for eight years. He is articulate in Kiswahili, fluent in French, understands English and commands respectable Luganda – Uganda’s widely spoken language.

Therefore, it was easy for Abdulkarim to mobilize close to 50 Congolese refugee leaders from across the city who congregated at the appropriately named Antonio Guterres Community Center in Lubaga Division of Kampala city. The centre, funded by UNHCR and Interaid, is a meeting place for refugees from various countries where they learn English and Luganda, tailoring and crafts, and also perform drama and dances from their countries, among other activities.

This time, it was to learn about Ebola. The interest and excitement were palpable as soon as the WHO team arrived. Right from the outset, it was clear that many wanted to be updated on the current EVD situation in DRC. This was promptly done followed by a number of questions, clarifications and rumour busting.

There were concerns about the safety of family and friends left in Beni, Butembo and Bunia. “My children and sister will come to visit me next week. Can I hug them when they come?” asked Mimi Ngamitha, one of the active participants at the meeting. They were then taken through the EVD screening process at the border entry point, and reasons why compliance with the process is so important.

This indeed seemed to resonate with many judging from the question that followed. It was also a signal to the facilitators to switch to facts about Ebola, signs and symptoms, spread and personal protection. This topic generated a lot of interest given its focus on the personal.

“This disease seems to be more serious than HIV/AIDS and you can see the interest it has generated,” noted Isma Muhindo, the Programme Officer for the Refugees Drivers' Association. The seriousness with which the participants accorded the topic was pronounced in the action plan they agreed.

For instance, they will embark on immediate sensitization of all refugees under their jurisdiction with emphasis on signs and symptoms and personal protection. For this, they equally shared the 1,000 EVD poster and 6,000 leaflets available at the meeting to assist them with this task.

In addition, they agreed to monitor all new arrivals from DRC for any sign and symptoms, especially visitors from Beni, Butembo and Bunia. They will let health authorities know if anyone seems sick using telephone contacts that were duly shared. Equally important, they will explain to family and friends who may want to cross into Uganda the reasons to use official entry points where they will be screened and given appropriate medical support if needed.

The refugee leaders agreed to do all these and more activities on a voluntary basis. “We want to share this important information with others who are not here,” said Abdulkarim on behalf of the group. For this, they requested another session with more participants from other refugee communities.

The interest shown by Abdulkarim and his colleagues is an important part of preparedness activities, which will help protect Ugandans and people from DRC alike.