Kampala, 30 October 2020: - Lawrence Ahumuza (26), his pregnant wife Magdalene Kembabazi 24 (not real names) and their five-year-old son Prosper are a typical young Ugandan rural family.
They are tea-pickers at Kayonza Tea Producers in Kanungu district Southwestern Uganda. They grow their food around their home, their child attends the nearby local primary school, they get along very well with extended family and neighbours, they are prayerful, and they obey the law.
Theirs was a blissful existence until COVID-19 struck in the family and disorganized everything. On 13 September 2020, Magdalene tested positive for COVID-19 and was admitted to Kabale COVID-19 Treatment Unit (CTU). Lawrence together with Prosper were put in isolation for 14 days as contacts to a confirmed case.
After treatment, Magdalene recovered and was discharged. Lawrence and Prosper completed the isolation without developing symptoms and they tested negative before going back home. And that is when the strange life began for this young family.
For the time Magdalene was in the CTU and even upon her return home no one, not even the extended family members or neighbours visited them. This never happens in rural Uganda.
Under normal circumstances, a return from the hospital would bring multitudes of visitors complete with drink and food to welcome her back. It was strange but most importantly it was worrying and stressful for Lawrence and Magdalene.
Added to this was the dire financial situation for the family occasioned by the COVID-19 situation they had endured. With Magdalene in CTU and Lawrence in isolation, there was no income from Kayonza Tea Producers where they worked as casual labourers. Life lost meaning for this young family.
Upon learning about their fate, the World Health Organization (WHO) field team visited them to offer counselling and psychosocial support. There was a sombre mood when the team arrived with Lawrence, Magdalene and their son visibly shocked to see people turn into their compound.
"What brings you here at this time? We were properly discharged after completing the treatment at the hospital. We are okay", Lawrence said, trying to justify their presence in his own home. He looked tense and one could understand the stress he was going through and the so many worries that were going through his mind because of the team's presence.
After the usual pleasantries and having been assured about the purpose of the WHO visit, Lawrence and his wife opened up wondering why family and neighbours had abandoned them at their greatest hour of need. "No one is associating with us anymore; we don't know what to do for now and for the future. The doctors say we are healed but no one in the village believes us," Lawrence explained visibly worried.
Added jeopardy for the family was the uncertainty about daily upkeep as they were running low on finances. "We used the money we hand and the remaining balance of 45,000 Uganda Shilling on boda boda (motorcycle taxi) to bring us back home," he explained. By village standards, this is a hefty amount not easy to justify the expenditure on boda boda let alone part with.
"We thought they were going to take us back home by ambulance, but they said the ambulance had to go somewhere else. We could do nothing but get a boda boda to take us home because we could not continue staying there," says Lawrence.
The WHO team then discussed with the family issues and challenges about COVID-19 assuring them about their safety and together they identified practical behavioural measures they should observe to stay safe in the community. They also agreed on continuous counselling and communication via mobile telephone.
It was all fine but as the WHO team prepared to leave, Lawrence and Magdalene raised a fundamental concern on which they needed urgent assistance. "How do we get people to accept us as before in the community and how do we get back to work at the tea factory? Can you please help us?" Lawrence pleaded.
This then led to the next part of the WHO mission - a visit to the community to assure them about the safety of Lawrence and Magdalene. A few meters from their house at the foot of the hill is the home of Stephen Byamugisha 50 (not real name), Magdalene's father-in-law.
Stephen was a man at crossroads: his wife was in Kabale CTU having tested positive for COVID-19 certainly contracted from Magdalene with whom she had been in contact. His son's family was having challenges of getting accepted back in the community. Although asymptomatic, he was not sure about his status either.
"I am worried about my son and his family but also for myself after seeing what they are going through. The abandonment, isolation, stigmatization and distancing from the community is not understandable," he said. He was consoled and assisted to identify survival measures he had to undertake immediately.
At the residence of the Local Council I Chairman, a few people had gathered eager to listen to the WHO team. They were taken through the basics of COVID-19 assuring them about the safety of Lawrence's family. They also got insights into post-CTU-Counselling and adherence to the Standard Operating Procedures. The Village Health Team members were specially instructed to follow-up Lawrence's family and to continuously respond to any rumours and misinformation on COVID-19 in the community.
"I wish the medical authorities had brought back the sick lady because she was pregnant and they could have talked to the community and explained to them what COVID-19 is; we need to be educated but now our work is very difficult," said Asaph Byaruhanga the LCI Chairman of the village. Indeed, from that comment, the Ministry of Health and WHO psychosocial teams have their work cut out. It will require a lot of financial and human resources which are currently inadequate.
As COVID-19 continues to escalate in Kanungu district and Uganda in general, its effect on the social set up and interactions in rural communities remains hard for the locals to fathom. For Lawrence, his wife and son, the question is: Where has everybody gone? The answer is strange and scary.
NOTE: The visit to the family, the village and the compilation of this story were facilitated with financial support from Irish Aid, DANIDA, DFID and GAVI to WHO's COVID-19 response