In early October, ebola came to Uganda: the first major outbreak in any densely populated area. Scores died, but it might have been thousands if not for the work of Dr Matthew Lukwiya, who was in charge of St Mary’s Hospital Lacor. This is a doctor who made the ultimate sacrifice and paid with his life.
During Dr Matthew Lukwiya's funeral, the pallbearers wore face-masks, latex gloves and surgical gowns, and the restricted number of mourners pressed back from the tightly sealed coffin. Lukwiya would have approved of these safety measures - it was he who devised them. In early October, Lukwiya suspected that a mysterious sickness killing student nurses at his hospital in Gulu, northern Uganda, was ebola.
By the time a team of World Health Organisation (WHO) experts arrived, days later, there was little for them to do. Lukwiya had already got hold of their manual and begun isolating patients and setting up barrier nursing practices.
These are highly specialised techniques and ebola is not forgiving of mistakes. Even fleeting contact with infected body fluids pretty much guarantees infection. Within a week soaring fever marks the virus's onslaught on the vital organs. By the 10th day, often after heavy bleeding from every orifice, the patient is usually dead from shock.
Nothing can be done to fight ebola other than to contain its spread: there is no treatment, no cure. But Lukwiya saw what must be done immediately. This was the first time ebola had emerged in a densely populated area with good transport links to major cities. And he was not curious to see how the virus would fare in these new, improved infection conditions.
Dr Simon Mardel, one of the first to arrive with the WHO delegation, nursed Lukwiya. "A particularly cruel feature of this disease is that those who do the hands-on work, the hardest work, get exposed," he said. "It takes out your best people." In fact, in the last major ebola outbreak in 1995, in the Democratic Republic of Congo (then Zaire), 65 health workers died out of a total of 244 who were looking after the victims.
While Lukwiya was just one of thousands of heroic medical workers in Africa, he was far from typical. The majority - 70% - of newly qualified Ugandan doctors hotfoot it to lucrative practice in South Africa, Europe and the Middle East. Lukwiya was the brightest of young Ugandan doctors. He had scholarships and prizes to spare: the best school-leaving marks in Uganda; the best-ever student in tropical paediatrics at the school of tropical medicine in Liverpool. He could have chosen a career path that led towards riches. But he was never tempted. When he qualified in Kampala, he headed 300km north to St Mary's, in Lacor, an Italian missionary hospital outside Gulu, the main town in the region of his own Acholi people which was also being ravaged by a brutal conflict between the government of president Yoweri Museveni and the Lord’s Resistance Army (LRA).
Gulu is one crossroads, dotted about with several outsized churches bequeathed by competing Anglican and Roman Catholic missions. In the market, hawkers sell cassette tapes, nails and children's party dresses. In the streets, cyclists press radios to their ears to catch the news, muffling out the constant din of music. And every sun-baked inch is dusted with red earth. It is a thoroughly unremarkable African town. But it has suffered remarkably.
During Lukwiya's 15 years at Lacor, many of them as medical superintendent, Gulu had been ravaged by years of conflict - with refugees swelling the town's population threefold to about 100,000 people - and by related epidemics of cholera, measles, malaria, meningitis and Aids. Some might think doctoring there would be a thankless task. But for Lukwiya, it was enough to turn down a lecturing post in Liverpool and other softer options.
"There was never a doubt that he would stay in Gulu - he would always say, 'My people need my service,' " says Dr Bruno Corrado, Lacor's then longtime administrator.”He felt that holding a position meant having responsibility."
Margaret Lukwiya, his widow, said at the time of his passing: "Matthew was not for wordly desires," she says. "He was just devoted to his patients. It was never business. It was just his patients. That was it." When rebels came for the hospital's nurses one Good Friday, Lukwiya persuaded them to take him hostage for a week instead.
"Many of the doctors took their families and ran away," says Margaret, "but because I was his wife, because I loved him, I could not leave him to the war. So I had to pick up his character and learn to live like him."
Lacor is the shadow of what it used to be then. Thanks to Lukwiya, the hospital tripled its capacity to nearly 18,000 patients a year during this time - including the wounded of both army and rebels, according to Corrado. For Gulu, having one of the best hospitals in east Africa at hand when ebola emerged was a rare piece of luck.
It started, said Sister Maria Disanto, Lacor's weary, grieving, then head of nursing, when three student nurses fell sick and died, one after the other. "We were thinking, how can this happen?" she says. "Then we started realising that they were all either bleeding or vomiting blood."
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