page_title: Matthew Lukwiya
section_title: Ebola outbreak
hierarchical_section_title: Matthew Lukwiya / Ebola outbreak
caption_attribution_description: Original caption states, "Outbreak of Ebola hemorrhagic fever, Uganda, 2000. The isolation ward of Gulu Municipal Hospital, Gulu, Uganda, during an outbreak of Ebola hemorrhagic fever in October 2000. There is no known drug treatment or vaccine for this disease, which is transmitted person-to-person through contact with infected bodily fluids and has a case-fatality ratio of 50–90%. At the invitation of the Ugandan Ministry of Health, CDC sent several teams of scientists to Gulu to participate in a multinational WHO-coordinated response team. The response team helped bring the epidemic under control by providing assistance and consultation to help rapidly identify cases, provide safe care, and interrupt the spread of the virus. "
context_page_description: Matthew Lukwiya was a Ugandan physician and the supervisor of St. Mary's Hospital Lacor, outside of Gulu. He was at the forefront of the 2000 Ebola virus disease outbreak in Uganda.
context_section_description: On the morning of 7 October 2000, Lukwiya received a phone call from Opira informing him that a mysterious illness had killed two of the hospital's student nurses, all of whom had begun bleeding or vomiting blood.  Opira asked Lukwiya for help and he arrived that evening, in time to witness the death of a third nursing student, Daniel Ayella.   He had head nurse Sister Maria Di Santo bring him the charts of all unusual deaths in the past two weeks and identified 17 cases with similar symptoms.  Lukwiya and Sr. Maria spent most of that night reading reports from the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) on infectious diseases that caused bleeding.  By the end of their review, they suspected Ebola.  The literature on Ebola, largely based on a 1995 outbreak in Kikwit, Congo that had killed four (4) out of five (5) patients, stated that the sicker a patient, the more infectious they became.  Dead bodies themselves were highly contagious. Lukwiya immediately recognised this as a particular problem in Acholiland, where the traditional practice was for the bereaved family to wash the body of the deceased before burial.
  On the morning of 8 October, Lukwiya informed staff of his suspicion that the illness was a viral haemorrhagic fever.  That afternoon, a group of local community leaders came to the hospital reporting that entire families were dying in their villages.  He ignored the usual bureaucratic protocols and placed a direct call to Dr. Sam Okware, Uganda's Commissioner of Community Health Services, who dispatched a team from the Uganda Virus Research Institute to take blood samples.  By the time the team arrived, Lukwiya had already set up an isolation ward for suspected Ebola cases, in line with the WHO guidelines.  The special ward was staffed by three physicians, five nurses and five nursing assistants, all volunteers. When a South African lab confirmed the Ebola outbreak on 15 October, and a WHO delegation arrived in Gulu, they were astonished at the efficiency of the operation.  Dr. Simon Mardel, a member of the WHO team, stated,
  Finding that their assistance was not required at St. Mary's, the WHO and Médecins Sans Frontières rapid response teams offered their assistance at Gulu Regional Referral Hospital, where they found corpses abandoned in their hospital beds.
  The crisis continued to worsen.  By the third week of October, the number of Ebola patients had increased to almost 60, overwhelming the volunteers in the isolation ward.  Lukwiya ordered other nurses to assist the patients and tried to lead by example, working with Ebola patients from 7 am to 8 pm.  However, despite instituting risk minimisation procedures, including wearing of robes, multiple gloves, surgical masks and goggles, hospital workers continued to fall ill.  Twelve more died.  At the funeral of an Italian nun on 7 November, he attempted to rally the morale of his workers: "It is our vocation to save life.  It involves risk, but when we serve with love, that is when the risk does not matter so much. When we believe our mission is to save lives, we have got to do our work."
  Matters reached a breaking point in late November.  While the national epidemic had already peaked, St. Mary's endured a terrible day.  In the 24-hour period ending at the dawn of 24 November, seven patients died, three of which were health workers.  Two of these were nurses who did not work in the isolation ward.  The thought of infections being passed to health workers who did not directly care for Ebola patients panicked many and the nurses mutinied.  The day-shift did not go to work; instead 400 health workers, nearly the entire staff of St. Mary's, gathered in the assembly hall of the nursing school.  When Lukwiya rushed down to ask what they wanted, at least one nurse yelled that the hospital should be closed.  Lukwiya silenced the nurses, most of whom he had trained himself, by stating that if the hospital closed he would leave Gulu and never return.  He then spoke on how he had let himself be abducted by the rebels 
caption: The isolation ward of nearby Gulu Regional Referral Hospital in October 2000.
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