-Suspected Anthrax, As More Studies Underway
By Davis Buyondo
Kyotera
Residents in Kyamayembe and Nakatoogo villages in Bwamijja Parish, and others in Kidda village in Kyanika Parish, all in Kabira sub-county, Kyotera district, are living in fear after a strange illness, allegedly claiming the lives of, so far, 14 people and leaving over 30 others in its grip in five months.
The peculiar characteristic of this illness is its initial manifestation as an itchy bump on the hand, progressing to pain and swelling before extending to the chest. Ultimately, it obstructs the throat, leading to respiratory difficulties.
Therefore, in a span of 8 to 24 hours, the patient suffocates, and the heart ceases abruptly, resulting in death. Numbness, headache, fevers, elevated blood sugar levels, coma, and chest and spleen coagulopathies are also observed.
According to local leaders and affected families we interviewed, every village has lost some residents with the survivors bearing permanent scars and gangrenous deformities on the affected upper limbs.
Godfrey Kiganda Kajulu, the Secretary for Kyamayembe Local Council (LC1), said the unusual disease first claimed their 58-year-old chairperson – Aloysius Kibira in July. Fatalities continued to rise between August and September, with infections persisting up to now causing anxiety among the residents.
Other individuals (between 36 and 60 years) who succumbed to the ailment include John Kasagga, Naddi Midende, Kisekka Mayirima, Peter Ssemisa, and Bernardo Yuda Ssekirijja. Meanwhile, in Kidda village, the illness first killed Muwonge Francis and later, John Lubambula, Mugangazi, Namwanza, Nakaayi, Kasiita and others from Nakatoogo village.
Those currently battling the sickness include Matia Mbaziira, Magdaline Nasaasi, David Mukasa (the councilor for Bwemijja parish), Julius Kiweewa (the Kyamayembe LCI Youth representative), Gaudencia Naluboobi (the Kyamayembe Secretary for Woman affairs), Anamaria Namugga, Gorethi Nassango, Benardo Muwanga, and Gertrude Nakafuuma and others totalling over 30 individuals.
According to Kiganda, the residents are gripped by fear, with some considering leaving their homes until the situation stabilises. “We informed the district authorities about the issue, and their response was to collect samples from the deceased chairperson and other residents experiencing the effects,” he recounted.
Nevertheless, he added, they later received information from the same authorities indicating that the medical tests had not yielded any conclusive results yet the illness was exacting a toll on the residents in the two villages.
Abdul Mugenyi, a 70-year-old elder in Kyamayembe village, expresses concern that the district authorities and the government have yet to set up an outreach centre in their community to address the needs of infected residents and further investigate the issue.
“Even though the cause remains unknown, we require an outreach initiative that can instil hope in the residents and demonstrate tangible efforts to resolve the problem because more people are falling ill almost every week,” he argued.
In the absence of such services, he added residents have been attempting to explore alternative solutions, resorting to the use of herbal medicines and prayers.
Mugenyi recognises that utilising herbal medicines and relying on prayers might not provide the ideal solutions for an unidentified disease, similar to the challenges encountered during the early stages of HIV/AIDS when some people erroneously attributed it to witchcraft before the virus’s nature was understood.
“We have not received guidance on what actions to take as there are currently no standard operating procedures in place. Despite this, survivors are not receiving psychosocial support services, and they are still engaging in social interactions with members from other communities,” he explained.
Yowana Batista Ssenkindu, the Chairperson of Kidda LCI, expressed that the residents are gripped by fear, with some already abandoning their homes due to concerns about the ongoing situation.
“Several have opted to leave the village until the illness is addressed. As local leaders, we find ourselves difficult because residents turn to us for solutions. They demand answers regarding the situation, but what can we tell them for sure?” he pondered.
Ssenkindu further shared that they resorted to traditional methods in the absence of a medical explanation for the problem. Traditional healers were enlisted to identify the alleged spiritual entities disrupting the communities, but the initiative faced obstacles due to insufficient funds.
He urged John Paul Mpalanyi, the Kyotera County Member of Parliament, and Fortunate Rose Nantongo, the District Woman MP, to intervene and bring the matter to the attention of the parliament as a national concern deserving special attention.
Witchcraft Allegations
Affected communities maintain that a resident bought deadly charms in the pursuit of wealth, but these entities veered off course, causing harm and death. Consequently, residents assert that their only recourse is to seek spiritual healing through both traditional and religious means.
Still, the residents are persistently avoiding health centres, arguing that those who sought medical help from modern healthcare facilities have died yet those seeking spiritual healing traditionally and religiously have survived. This unfounded perception has led them to believe that there may be witchcraft involved in these deaths.
Upon discovering that the samples did not confirm the cause of death, the residents reported the matter to the head of Traditional Healers in Masaka Region- Justine Nansamba who requested Sh5.5 million to capture the harmful/malicious entities or charms plaguing the two communities.
However, the residents could only gather Sh2.5 million, but despite the partial payment, Nansamba declined to remove the alleged charms, citing the incomplete amount she initially requested as the reason.
Affected residents
Matia Mbaziira, a resident whose upper limbs have been affected at various times, shares that he has been relying on traditional methods. His right hand initially experienced itching and swelling, leading to intense pain, paralysis, and the eventual development of wounds and scabs.
Unfortunately, in September, Mbaziira’s left hand suffered a similar fate, rendering him unable to engage in any manual work to support his family.
“I am apprehensive about going to a clinic or hospital for a checkup, especially considering that our acquaintances who were admitted to health centres did not survive. Those who opted for traditional remedies are still alive, so I feel compelled to follow the same path,” he stated.
Gaudencia Naluboobi’s ordeal began when her left hand became afflicted with the same illness, commencing with persistent itching that escalated to swelling the following day, accompanied by severe pain.
The complication extended to her chest, making breathing and swallowing a difficult task. Concerned for her well-being, Naluboobi’s family sought assistance from the prayer warriors at Kyanika Catholic Parish – Mpambire.
“Through their interventions, I found some relief. The affliction, initially suspected to be witchcraft, led me to participate in prayer sessions every Tuesday,” she said. Recently, she shared a testimony of gradual healing, saying her hand and chest are showing signs of great improvement.
Religious Perspective
While some residents have opted for traditional healing methods, a significant number seek solace at Kyanika sub-parish (church) under Mpambire Parish, gathering every Tuesday for communal prayers for healing.
Insight Post Uganda observed a group of affected residents who seek solution from church. At least eight went to pray alongside other believers for deliverance.
Ssonko Anatooli, a catechist at the church, shared that they have passionately prayed for more than 20 people, witnessing some experiencing healing while others are in the process of recovery.
“In cases where health experts struggle to identify the source of the problem, a spiritual battle ensues to protect the people. That’s our mission, and thankfully, we have seen significant positive changes,” recounted Ssonko.
Mawulisio Kabanda, Outreach Coordinator-Masaka Diocese, made an earnest plea to residents to avoid seeking healing from traditional shrines and instead encouraged them to seek deliverance from the mysterious disease through prayer to God.
He pointed out that some residents who chose the shrine route have experienced repeated attacks. “Our God is powerful and capable of bringing healing to the affected villages. If people turn to the Lord for a solution, they will find healing,” he asserted.
Sub-county Intervention
Silvester Mukasa, Deputy Speaker of Kabira Sub-County, confirmed the ongoing issue and affirmed that they deployed sub-county health officers, collaborating with the district health team, to collect samples to identify the precise cause of the disturbing illness.
Mukasa, who also serves as the Youth Councilor for Kabira, further stated that both the district and government have committed to conducting additional visits for further investigations. “We have sadly lost 12 people to the same illness, with several others still grappling with it,” he confirmed,
Despite the unknown cause, he added, some residents are seeking treatment in hospitals, while others are turning to traditional healers, and some are seeking solace in churches,” he elaborated.
He additionally urged individuals not to desert their residences, stating that the Ministry of Health, in collaboration with Kyotera District, Kabira sub-county, the World Health Organisation (WHO), and the traditional healers are actively pursuing the situation, with ongoing investigations.
“Anyone who becomes infected should promptly report to the authorities for a swift response. As far as I am aware, investigations are still in progress,” he stated.
Suspected Anthrax
According to Dr. Edward Muwanga, the District Health Officer, they have identified several cases and they suspect anthrax. Anthrax is a dangerous zoonotic illness caused by bacteria found in soil.
According to the Centre for Disease Control (CDC), it can affect animals and, in rare cases, humans who come into contact with infected animals or contaminated products.
Muwanga clarified that the residents may have been exposed to sick animals or consumed the carcass of a cow, leading to their illness. Samples have been taken from the affected individuals, but the cause of the sickness is still under investigation.
“Having leant about the signs and symptoms of the strange disease and the history of the dead animals in the area, we contacted the Emergency Operation Masaka Regional Referral Hospital, MoH, and samples were taken to Kampala for further investigation,” he explained.
According to Joseph Giriman, the District Surveillance Focal Person, the index case, who fell ill on June 30, 2023, and died on July 2, 2023, triggered the alarming trend.
So far, the district interventions include enhanced surveillance, sample collection, autopsies, community meetings, and psychosocial support in addition to mobilising the Village Health Teams (VHTs), Local leaders and Health workers in private clinics to report any deaths and all cases of itching limbs to the District Health Office for possible investigations (Enhanced surveillance).
In addition, several samples of blood, urine and Biopsies were taken off from the ill, recovered and one dead person and these were delivered at UVRI for thorough investigation.
“We evacuated the body of the victim who died at Kalisizo Hospital to Masaka Regional Referral Hospital for advanced autopsy in addition to supervising two burials at Kyamayembe Village.
However, Giriman explained that challenges at hand include delays in sample processing, lack of fuel for surveillance, resistance from traditional healers, and hiding of patients by relatives. Also, the lack of funds for meetings and case investigation forms poses significant obstacles.
Emax Kintu, the District Health Educator, said that a team was dispatched to identify possible exposures and risk factors for the illness, engage the communities and traditional healers to understand what traditional remedies were used and be able to either associate or disassociate them with exposure.
Amidst the ongoing mystery surrounding the unidentified illness in Kabira sub-county, Kintu said it is important to have a proactive approach to address the social aspects of the problem. He further stressed that affected residents should maintain good sanitation practices and adopt a balanced diet to boost their immune systems.
“The belief is that these lifestyle measures can contribute to overall well-being while health officials continue their dedicated research efforts to unravel the complexities of the mysterious illness,” he said, urging the community to actively participate in promoting health and hygiene as a complementary strategy during this challenging period
Kintu mentioned that community gatherings were organised to prevent harm intended for certain individuals suspected of practising witchcraft, which is believed to be the root cause of the sudden deaths.
Additionally, they conducted visits to the families of the deceased to provide psychosocial support and continue tracing other affected individuals, a service they are actively ongoing.
Kijonjo outbreak
A similar disease claimed 10 lives in Kasasa sub-county from August 2021 to February 2022 leaving several in Kijonjo A, Kijonjo B, Nakatooke A, and Nakatooke B villages affected.
Despite efforts by the Ministry of Health, the WHO, Masaka Regional Referral Hospital, and the District Health Department, the illness remained unknown.
However, the affected communities turned to traditional remedies. Symptoms included severe fever, vomiting, chest pain, sore throat, abdominal pain, swelling, and diarrhoea, resulting in death within three to five days.
However, an isolation centre at Kakuuto Health Centre IV was shunned by patients for over two months. The Ministry of Health’s multi-disciplinary team’s investigation in February 2022 yielded no conclusive results, and the disease gradually disappeared, leaving the community in uncertainty.
Why Kyotera Is An Epicentre For Strange Outbreaks
Kyotera district has emerged as a focal point for severe health challenges. Notably, it recorded the first HIV/AIDS case in Uganda during the 1980s, identified at Kasensero landing site.
This marked the inception of a disease that has claimed numerous lives in the district, Greater Masaka region and the country at large for decades.
Moreover, when the COVID-19 pandemic unfolded in 2019, Kyotera faced a significant surge in infections during the initial stages. What complicates matters, the district shares borders with Tanzania, featuring various entry and exit points.
These include porous land borders and the expansive Lake Victoria making it easy for foreigners to enter the country. Since 2021, Kyotera has been grappling with a series of mysterious diseases that have led to the loss of several lives in Kasasa sub-counties and currently in Kabira sub-county affecting numerous residents.
Despite efforts by the Ministry of Health and World Health Organization (WHO) authorities, the exact cause of these strange illnesses remains unidentified.
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