Kween District, 27th October 2017:  In the ongoing Marburg Virus Disease (MVD) outbreak in Kween district eastern Uganda, community engagement responders are faced with several rumours, misinformation and strong negative beliefs that seem to underpin outbreak.

Most prominent is witchcraft which many believe is responsible for the deaths that have lately occurred in their community. For instance, family members of the probable and confirmed cases are convinced that their people were bewitched by their step mother who comes from a neighbouring tribe and with whom they have had a longstanding land feud. So firm is their belief that they planned to attack and kill her and her children had it not been for the timely intervention by members of the district health team.

The witchcraft belief runs so deep to the extent that John (not real name), a brother to the probable and confirmed cases has hidden from MVD responders for over a week reportedly looking for medicine men in the community to cure his ailment. It has been a futile attempt for on 24th of October, he surrendered, weak, sickly and with signs and symptoms of MVD. Last night, 26th October 2017, after only one night in the isolation unit at Kaproron Health Centre IV, John was pronounced dead. Laboratory tests have come out positive for MVD.

Unfortunately, John’s attempt to get a local “cure” for his ailment is proving a nightmare for surveillance and contact tracing teams. This is in regard to tracing and monitoring the people he came in contact with during his travels. He has stayed long in the community, travelled distances on Boda Boda and closely interacted with family and friends before he come out. In fact, the contact tracers found John helpless surrounded by family and friends in this closely knit community.

Confidence in the health care system is also declining especially in Joseph’s village mainly because people believe health workers are deliberately killing them to save others from the mysterious diseases that has no known cure. Instances of the probable and confirmed MVD cases and a couple of children who died albeit due to other causes are cited as examples. Therefore, convincing people to go to hospital is proving a daunting task for community engagement responders.

Indeed the scene at John’s home as the response teams picked him for isolation were heart wrecking. Family members pleaded with the team to a least spare him as he was the last able-bodied member left after the “mysterious death” of two family members.

John’s father   courageously stopped the ambulance and begged to see and talk to his son “for the last time” for according to him, he will never see him again. As it is, his prediction has come to pass further compounding the work of mobilizers to convince people to seek care in health facilities.

Community belief that bat droppings are good manure for crops is also keeping many people in the caves that harbour bats, the known reservoir for the virus.  A sack of bat droppings, about 50kgs, reportedly fetches 40,000 UGX (12USD) which many find too tempting to abandon. Perhaps the death of John if well explained will help dispel some of these rumours and misinformation.