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Legislations, lockdowns not effective measures for controlling epidemics: Experts

Prof David Serwadda. Courtesy photo

Kampala, Uganda | THE INDEPENDENT | Scientists have questioned the approach used by the government to control disease outbreaks and pandemics using coerce law enforcement.

Speaking at the launch of a report, “Finding Humanity in uncertainty: Pandemic Preparedness and Response in Uganda released by the Uganda National Academy of Sciences (UNAS) on Tuesday, David Serwadda, a Professor of Public Health at Makerere University said laws and lockdowns are not effective measures for controlling epidemics and pandemics.

Serwadda who was one of the scientists on the frontline in the early fight against HIV/AIDS says if using travel bans and arrests were helpful, the world wouldn’t still have Sexually Transmitted Diseases (STDs) since many countries adopted this approach in the early days of HIV but weren’t helpful. He says even in the United States, those that tested positive were banned from free movements and that even at the family level, many of them were secluded. But he says this didn’t help much in countering transmission.

His point resonates with findings presented in the report where a multi-disciplinary committee led by Harriet Mayanja Kizza, a professor of Internal Medicine at the College of Health Sciences found that justice, law, and order are limited in their ability to respond quickly when outbreaks hit.

The committee also found that law enforcers are often ill-prepared which hurts the response.

These findings come in just three days after President Museveni lifted the travel restrictions and curfew, measures instituted to halt transmission of Ebola in the districts of Kassanda and Mubende.

The districts have been under lockdown for more than a month but media reports from the area have often shown Uganda Police assaulting people and in some cases wrongly making arrests in areas of residence in their bid to enforce compliance.

In Madudu, Mubende district, a baby was burnt by boiling porridge when police officers enforcing curfew kicked a resident’s door hitting a stove on which the porridge was being boiled. Another incident was when police arrested volunteers attached to the Uganda Red Cross Society for playing loud music at their residence during curfew hours.

Such incidents coming just after Uganda experienced similar incidents during the COVID-19 restrictions enforcement show there is a need for a thorough briefing of these frontline workers about their role during a health crisis.

UNAS recommends that the police, UPDF, and the judiciary establish an independent forum with outside stakeholders for discussions on how to prepare their institutions and personnel to respond humanely, but fairly to societal anxieties and needs in a health crisis.

Prof. Seggane Musisi, a Professor of Psychiatry warns that it is the social-cultural aspects of the epidemic that exacerbates the mental health challenges that people battle both while the outbreak is still fresh and those which last long after.

He recommends a number of interventions including crisis counseling and debriefing law enforcers to be as humane as possible.

Since there is a wide range of social–cultural beliefs that healthcare managers have to battle with while responding to health crises, Musisi says it is important for the government to consider employing personnel versed in social anthropology when planning and implementing epidemic control measures.

However, as it is now, although there have generally been improvements in the way Uganda handles epidemics, trust in the healthcare system remains low because the improvement has not commensurately addressed people’s desire for respect and dignity, according to the UNAS report.

Dr. Joseph Okware who represented the Ministry of Health at the report launch acknowledged the fact that they are still challenged by the fact that when an outbreak hits, they first put 50 percent of the effort into things that should have been done before the pandemic, noting they encounter challenges including the inability to get funds in a timely manner.

The doctor urged academicians to build bridges that can help the government find ways of dealing with traditional healers by particularly studying ways in which they can possibly make them safer.

Over the previous pandemics including HIV and now Ebola, traditional healers have been seen to impede efforts geared towards control of disease transmission.

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