In September 2022, an Ebola outbreak across Uganda seemed certain. This particular strain of the highly infectious disease, a hemorrhagic virus that spreads through fluids like blood and sweat, was showing a 50 percent fatality rate.
“The bottom line is: this was very, very scary,” says Irene Atuhairwe Duhaga, country director for Seed Global Health, a nonprofit partnering with Project ECHO. Uganda had experienced Ebola outbreaks before, but they happened in the countryside. In 2022, the outbreak spread to Kampala, one of the country’s biggest cities.
“It’s a congested city,” Duhaga adds, “[and Ebola] is a deadline virus that spreads by contact. The potential for it to blow up was very high.”
The idea to use the ECHO Model came up after Duhaga and her team visited one of the emergency centers at the beginning of the outbreak, where they saw how chaotic things could get.
“What if people started to travel to Kampala instead of staying at their local emergency management center?,” Duhaga asked. “What if health workers were spreading the virus because they weren’t protected? This was our solution that could target all health workers across the country.”
Fortunately, resources were already in place to train health workers to stop the disease.
Seed Global Health and Jhpiego, two nonprofits with longstanding roots in Uganda, had already used the ECHO Model for infectious disease control and HIV treatment since 2016.
“We already had the ECHO network from working with HIV ECHO Programs and Emergency Medicine ECHO Programs,” explains Isaak Mukama, technology coordinator for Jhpiego. “For Ebola, we were able to work with the CDC to get ready for an emergency response ECHO.”
“It is not intuitive to treat Ebola or understand it,” Duhaga adds. “Ebola is [often] thought of as untreatable. But you can treat the symptoms to help people survive the viral course.”
Ebola is only briefly taught in medical training; it’s important that health workers know how it’s spread—through body fluids including sweat, blood, breast milk—and how to protect themselves while treating.
This combination of local partnerships and a trained understanding of the ECHO Model made a world of difference. An Ebola ECHO program was established within days.
“We covered everything from laboratory tests, to collection case management, to referrals,” Mukama explains. “Usually for our programs, we have an ECHO session once every two weeks, but because of the nature of the emergency, we were meeting every day.”
Up to 850 participants learned best practices from global infectious disease specialists, including World Health Organization physicians, Ugandan researchers and experts in emergency medicine.
Out of 164 confirmed cases, fatalities were held to 34 percent, and the outbreak was declared over within four months.
By applying the ECHO Model, a crisis was mitigated. “This was the platform that gave the right information to health care workers,” Mukama reiterates. “Because the frontline team had the information they needed, we contained the outbreak.”