Matthew Lukwiya
Encyclopedia
Dr. Matthew Lukwiya was a Uganda
n physician and the supervisor of St. Mary's Hospital Lacor
, outside of Gulu
. He was at the forefront of the 2000 ebola
outbreak and the first doctor to die of the disease.
. His father, a fishmonger, drowned when Lukwiya was 12. His mother was a petty trader who smuggled tea
across the border with Sudan
to trade for soap. Lukwiya was one of four sons. While his mother started teaching him how to smuggle goods by bicycle, Lukwiya began to prove himself to be an extraordinary student. He came in at the top of his class in grade school, received the top school-leaving marks in the country, going on to attend university and medical school through a series of scholarships. He took a position as a medical intern at St. Mary's, a Catholic missionary hospital, in 1983.
After three months, the founders of the hospital, Dr. Piero Corti and his wife Lucille Teasdale-Corti
, had decided that he would be their successor. He soon came to be known to his colleagues and patients as "Dr. Matthew". Many patients were victims of attacks by the rebel Lord's Resistance Army
. On Good Friday
1989, the rebels came to St. Mary's to abduct several Italian nuns. Lukwiya managed to convince the rebels to take him instead and spent a week wandering through the brush in his doctor's gown until the rebels released him. He subsequently opened the gates of the hospital compound to people seeking a place to sleep that was safe from rebel attacks and abduction. Until the Ebola outbreak, 9000 people sought sanctuary on the hospital grounds nightly to sleep. In a later incident, Lukwiya, his wife Margaret and five children were lying in bed one evening listening to nearby fighting between the rebels and government forces when a mortar
shell crashed through the ceiling of their house, but failed to explode. He also played an unpublicized role in advocating for a peaceful solution to the war.
In 1990, Lukwiya earned a scholarship to earn a master's degree in tropical
pediatrics
in Liverpool School of Tropical Medicine
. Despite being offered a teaching position at the school, where he earned the best marks in the school's history, he appears to have never considered any other option than returning to St. Mary's. Under Lukwiya's administration the hospital tripled its capacity to 18,000 patients annually, included wounded from both sides of the conflict, and a further 500 out-patients daily. St. Mary's became easily the best hospital in northern Uganda, arguably the best in the country and one of the top hospitals in East Africa
. In December 1998, Lukwiya moved his family to the capital city, Kampala
, far from the violence of the northern war. There he sought a master's in public health at Makerere University
, leaving the running of the hospital to colleague Cyprian Opira. In 1999, Lukwiya, always a church-going Protestant
, took his born-again wife to a Pentecostal
church and declared that he too was born again.
(CDC) and the World Health Organization
(WHO) on infectious disease
s 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 recognized 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 hemorrhagic 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 doctors, five nurses and five nursing assistants, all volunteers. When a South Africa
n lab confirmed the Ebola outbreak on October 15, 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 minimization 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 rather than risk St. Mary's and that they would be responsible for the deaths that would result if the hospital closed. After hours of contentious discussion that extended into the afternoon, Lukwiya switched back to a conciliatory approach, stating that he would remain no matter if everyone left. The meeting ended with him and the nurses singing a song together; he had prevailed.
On the evening of Sunday, 26 November, two days after he had convinced the nurses to remain on the job, Margaret was startled to hear her husband's voice sound heavily congested. He told her that he had a "terrible flu". The next morning, he and Sister Maria agreed that he had malaria
. "We said malaria, but we thought Ebola," she later said. His fever grew worse through the day, a Monday, and by Wednesday was vomiting and Dr. Pierre Rollin of the CDC took blood samples for testing. A nurse who was administering an intravenous drip that evening at his home was surprised when he began speaking distinctly, though not to her: "Oh, God, I think I will die in my service. If I die, let me be the last." Then, in a clear voice, he sang "Onward, Christian Soldiers
". Rollin came back with the results the next morning; it was Ebola. Lukwiya immediately asked to be put into the isolation ward, stating "Since I am the boss, I should show an example."
Margaret was finally called on Thursday afternoon and she arrived the next morning. However, Lukwiya's colleagues were strict in the protocols. While she was forced to sit on a stool three feet away from his bed, she was eventually allowed to hold his foot through three layers of glove. On Sunday, his breathing had become so labored that he was put on a respirator. By early Monday evening the oxygen level of his blood was rising and his pulse was near normal. It appeared that he might pull through but later that evening Lukwiya's lungs began hemorrhaging, a worst-case scenario. Lukwiya died at 1:20 am on Tuesday, 5 December 2000. When Margaret was informed and came to the ward, the body had already been put into a polyethylene bag. When she asked if they could unzip it a little so she could have a last look, she was refused; the body was too infectious to take any risks.
, contracted after she performed surgery on an HIV
-positive patient. Among the hundreds of mourners who were warned to stay back until the burial was complete were Lukwiya's children and numerous government officials, including the Minister of Health, who had rushed from Kampala after receiving word that morning.
Over the course of the epidemic, Lukwiya had been quoted almost daily in the national media. The New York Times described his image: "the fearless field commander at the center of a biological war that threatened everyone in the country". His death shocked the country. Even though the outbreak was in steep decline by the time of Lukwiya's death, it sent shockwaves through the health sector. St. Mary's stopped accepting Ebola patients, a number of disillusioned health workers across Gulu District quit, while some suspected Ebola patients refused to go to a hospital, reasoning that if the top doctor couldn't be saved there was no point in them seeking treatment.
On 6 February, the WHO declared that Uganda was Ebola-free, with no new cases in the previous 21 days. 173 people had died. While the survivability rate in previous Ebola outbreaks was as low at 10%, the Ugandan outbreak had a survivability of nearly 50%, an increase partially attributable to better health care. Lukwiya was the last health worker at St. Mary's to die from Ebola. Foreign epidemiologists credit Lukwiya with accelerating the government's public education campaign to stop the spread of the disease with his phone call to Kampala on the 8th of October. The number of lives possibly saved by this quick action is variously numbered in the hundreds to the thousands.
In February 2001, the American Medical Association
named Lukwiya a role model. An annual Dr. Matthew Lukwiya Memorial Lecture began the year after his death. The lectures are sponsored by the World Health Organization and organized by the Uganda National Association of Community and Occupational Health.
Uganda
Uganda , officially the Republic of Uganda, is a landlocked country in East Africa. Uganda is also known as the "Pearl of Africa". It is bordered on the east by Kenya, on the north by South Sudan, on the west by the Democratic Republic of the Congo, on the southwest by Rwanda, and on the south by...
n physician and the supervisor of St. Mary's Hospital Lacor
St. Mary's Hospital Lacor
St. Mary's Hospital Lacor, often referred to as Lacor Hospital, is a hospital in Gulu District, northern Uganda. It was founded by Comboni missionaries and is run by the Roman Catholic Archdiocese of Gulu. The hospital is located , by road, west of the central business district of Gulu town, in...
, outside of Gulu
Gulu
Gulu is a city in Northern Uganda. It is the commercial and administrative centre of Gulu District. The city is located at 2˚46'48N 32˚18'00E, on the metre gauge railway from Tororo to Pakwach. Gulu is located approximately , by road, north of Kampala, Uganda's capital and largest city...
. He was at the forefront of the 2000 ebola
Ebola
Ebola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...
outbreak and the first doctor to die of the disease.
Biography
Lukwiya, an ethnic Acholi, grew up in the town of KitgumKitgum
Kitgum is a municipality in Kitgum District, in Northern Uganda. The town is administered by Kitgum Town Council, an Urban Local Government within Kitgum District Administration...
. His father, a fishmonger, drowned when Lukwiya was 12. His mother was a petty trader who smuggled tea
Tea
Tea is an aromatic beverage prepared by adding cured leaves of the Camellia sinensis plant to hot water. The term also refers to the plant itself. After water, tea is the most widely consumed beverage in the world...
across the border with Sudan
Sudan
Sudan , officially the Republic of the Sudan , is a country in North Africa, sometimes considered part of the Middle East politically. It is bordered by Egypt to the north, the Red Sea to the northeast, Eritrea and Ethiopia to the east, South Sudan to the south, the Central African Republic to the...
to trade for soap. Lukwiya was one of four sons. While his mother started teaching him how to smuggle goods by bicycle, Lukwiya began to prove himself to be an extraordinary student. He came in at the top of his class in grade school, received the top school-leaving marks in the country, going on to attend university and medical school through a series of scholarships. He took a position as a medical intern at St. Mary's, a Catholic missionary hospital, in 1983.
After three months, the founders of the hospital, Dr. Piero Corti and his wife Lucille Teasdale-Corti
Lucille Teasdale-Corti
Lucille Teasdale-Corti, was a Canadian physician, surgeon and international aid worker, who worked in Uganda and contributed to the development of medical services in the country.-Early life in Canada:...
, had decided that he would be their successor. He soon came to be known to his colleagues and patients as "Dr. Matthew". Many patients were victims of attacks by the rebel Lord's Resistance Army
Lord's Resistance Army
The Lord's Resistance Army insurgency is an ongoing guerrilla campaign waged since 1987 by the Lord's Resistance Army rebel group, operating mainly in northern Uganda, but also in South Sudan and eastern Democratic Republic of the Congo...
. On Good Friday
Good Friday
Good Friday , is a religious holiday observed primarily by Christians commemorating the crucifixion of Jesus Christ and his death at Calvary. The holiday is observed during Holy Week as part of the Paschal Triduum on the Friday preceding Easter Sunday, and may coincide with the Jewish observance of...
1989, the rebels came to St. Mary's to abduct several Italian nuns. Lukwiya managed to convince the rebels to take him instead and spent a week wandering through the brush in his doctor's gown until the rebels released him. He subsequently opened the gates of the hospital compound to people seeking a place to sleep that was safe from rebel attacks and abduction. Until the Ebola outbreak, 9000 people sought sanctuary on the hospital grounds nightly to sleep. In a later incident, Lukwiya, his wife Margaret and five children were lying in bed one evening listening to nearby fighting between the rebels and government forces when a mortar
Mortar (weapon)
A mortar is an indirect fire weapon that fires explosive projectiles known as bombs at low velocities, short ranges, and high-arcing ballistic trajectories. It is typically muzzle-loading and has a barrel length less than 15 times its caliber....
shell crashed through the ceiling of their house, but failed to explode. He also played an unpublicized role in advocating for a peaceful solution to the war.
In 1990, Lukwiya earned a scholarship to earn a master's degree in tropical
Tropical medicine
Tropical medicine is the branch of medicine that deals with health problems that occur uniquely, are more widespread, or prove more difficult to control in tropical and subtropical regions....
pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
in Liverpool School of Tropical Medicine
Liverpool School of Tropical Medicine
The Liverpool School of Tropical Medicine is a research and teaching institution focused on neglected tropical diseases and the control of diseases caused by poverty. It is a registered charity affiliated to the University of Liverpool...
. Despite being offered a teaching position at the school, where he earned the best marks in the school's history, he appears to have never considered any other option than returning to St. Mary's. Under Lukwiya's administration the hospital tripled its capacity to 18,000 patients annually, included wounded from both sides of the conflict, and a further 500 out-patients daily. St. Mary's became easily the best hospital in northern Uganda, arguably the best in the country and one of the top hospitals in East Africa
East Africa
East Africa or Eastern Africa is the easterly region of the African continent, variably defined by geography or geopolitics. In the UN scheme of geographic regions, 19 territories constitute Eastern Africa:...
. In December 1998, Lukwiya moved his family to the capital city, Kampala
Kampala
Kampala is the largest city and capital of Uganda. The city is divided into five boroughs that oversee local planning: Kampala Central Division, Kawempe Division, Makindye Division, Nakawa Division and Lubaga Division. The city is coterminous with Kampala District.-History: of Buganda, had chosen...
, far from the violence of the northern war. There he sought a master's in public health at Makerere University
Makerere University
Makerere University , Uganda's largest and second-oldest higher institution of learning, , was first established as a technical school in 1922. In 1963 it became the University of East Africa, offering courses leading to general degrees from the University of London...
, leaving the running of the hospital to colleague Cyprian Opira. In 1999, Lukwiya, always a church-going Protestant
Protestantism
Protestantism is one of the three major groupings within Christianity. It is a movement that began in Germany in the early 16th century as a reaction against medieval Roman Catholic doctrines and practices, especially in regards to salvation, justification, and ecclesiology.The doctrines of the...
, took his born-again wife to a Pentecostal
Pentecostalism
Pentecostalism is a diverse and complex movement within Christianity that places special emphasis on a direct personal experience of God through the baptism in the Holy Spirit, has an eschatological focus, and is an experiential religion. The term Pentecostal is derived from Pentecost, the Greek...
church and declared that he too was born again.
Ebola outbreak
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 U.S. Centers for Disease Control and PreventionCenters for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
(CDC) and the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) on infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
s that caused bleeding. By the end of their review, they suspected Ebola
Ebola
Ebola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...
. The literature on Ebola, largely based on a 1995 outbreak in Kikwit
Kikwit
Kikwit is the largest city of Kwilu District, lying on the Kwilu River in the southwestern part of the Democratic Republic of Congo. Kikwit is also known in the region under the nickname "The Mother". The population is approximately 294,210...
, Congo
Democratic Republic of the Congo
The Democratic Republic of the Congo is a state located in Central Africa. It is the second largest country in Africa by area and the eleventh largest in the world...
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 recognized 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 hemorrhagic fever
Viral hemorrhagic fever
The viral hemorrhagic fevers are a diverse group of animal and human illnesses that are caused by four distinct families of RNA viruses: the families Arenaviridae, Filoviridae, Bunyaviridae, and Flaviviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress...
. 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
Uganda Virus Research Institute
The Uganda Virus Research Institute , located in Entebbe, Uganda, was established in 1936 as the Yellow Fever Research Institute by the Rockefeller Foundation. In 1950, after gaining regional recognition it was renamed the East African Virus Research institute...
to take blood samples. By the time the team arrived, Lukwiya had already set up an isolation ward
Isolation ward (medicine)
In hospitals and other medical facilities, an isolation ward is a separate ward used to isolate patients suffering from infectious diseases. Several wards for individual patients are usually placed together in an isolation unit.-Design:...
for suspected Ebola
Ebola
Ebola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...
cases, in line with the WHO guidelines. The special ward was staffed by three doctors, five nurses and five nursing assistants, all volunteers. When a South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
n lab confirmed the Ebola outbreak on October 15, 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,
Médecins Sans Frontières
' , or Doctors Without Borders, is a secular humanitarian-aid non-governmental organization best known for its projects in war-torn regions and developing countries facing endemic diseases. Its headquarters are in Geneva, Switzerland...
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 minimization 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 rather than risk St. Mary's and that they would be responsible for the deaths that would result if the hospital closed. After hours of contentious discussion that extended into the afternoon, Lukwiya switched back to a conciliatory approach, stating that he would remain no matter if everyone left. The meeting ended with him and the nurses singing a song together; he had prevailed.
Death
After finishing his days in the isolation ward, Lukwiya would sit with members of the WHO, CDC and other medical teams that had set up in the hospital compound to offer assistance and take blood samples that allowed them to map the course of the disease. His main question for them was how to stop his staff members from becoming infected. The likely explanation in most cases are momentary lapses. Health workers at St. Mary's worked 14 hours shifts for weeks in a row while in layers of protective clothing that were stifling in the equatorial country. All that would be required for infection is for a health worker to lose focus for a moment and, after touching a patient, slip a gloved finger under their mask to scratch an itchy nose or rub an eye. One infected St. Mary's health worker who may have been infected in this way was nurse Simon Ajok. In the early morning of 20 November, Ajok was in the Ebola ward and critical, bleeding from both his nose and gums. Fighting to breathe, Ajok pulled off his oxygen mask and coughed violently, sending a fine spray of blood and mucus against the nearby wall. He then astonished and terrified the night-shift by rising to his feet and staggering into the hallway. The night nurse on duty called Dr. Lukwiya for help. Woken out of bed, Lukwiya put on protective clothing, mask, cap, gown, apron and two pairs of gloves, but not goggles or a face shield to protect the eyes. Explanations for this range from grogginess at being newly awoken or haste to reach a colleague that he had helped train. While it will never be known for certain, the care for Simon Ajok, who died one hour after the doctor arrived, is the most likely candidate for Lukwiya's infection.On the evening of Sunday, 26 November, two days after he had convinced the nurses to remain on the job, Margaret was startled to hear her husband's voice sound heavily congested. He told her that he had a "terrible flu". The next morning, he and Sister Maria agreed that he had malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
. "We said malaria, but we thought Ebola," she later said. His fever grew worse through the day, a Monday, and by Wednesday was vomiting and Dr. Pierre Rollin of the CDC took blood samples for testing. A nurse who was administering an intravenous drip that evening at his home was surprised when he began speaking distinctly, though not to her: "Oh, God, I think I will die in my service. If I die, let me be the last." Then, in a clear voice, he sang "Onward, Christian Soldiers
Onward, Christian Soldiers
"Onward, Christian Soldiers" is a 19th century English hymn. The words were written by Sabine Baring-Gould in 1865, and the music was composed by Arthur Sullivan in 1871. Sullivan named the tune "St. Gertrude," after the wife of his friend Ernest Clay Ker Seymer, at whose country home he composed...
". Rollin came back with the results the next morning; it was Ebola. Lukwiya immediately asked to be put into the isolation ward, stating "Since I am the boss, I should show an example."
Margaret was finally called on Thursday afternoon and she arrived the next morning. However, Lukwiya's colleagues were strict in the protocols. While she was forced to sit on a stool three feet away from his bed, she was eventually allowed to hold his foot through three layers of glove. On Sunday, his breathing had become so labored that he was put on a respirator. By early Monday evening the oxygen level of his blood was rising and his pulse was near normal. It appeared that he might pull through but later that evening Lukwiya's lungs began hemorrhaging, a worst-case scenario. Lukwiya died at 1:20 am on Tuesday, 5 December 2000. When Margaret was informed and came to the ward, the body had already been put into a polyethylene bag. When she asked if they could unzip it a little so she could have a last look, she was refused; the body was too infectious to take any risks.
Burial and legacy
Because of the risks, the burial was carried out at 4pm, as soon as it could be arranged. A team in full protective gear lowered the simple coffin, while one member continually sprayed the coffin and site with Jik bleach as a disinfectant. The location of the grave had been chosen by Lukwiya while he was in the isolation ward. It is next to the grave of Dr. Lucille Teasdale, the cofounder of hospital and a mentor and friend. Teasdale had died in 1996 from AIDSAIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
, contracted after she performed surgery on an HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
-positive patient. Among the hundreds of mourners who were warned to stay back until the burial was complete were Lukwiya's children and numerous government officials, including the Minister of Health, who had rushed from Kampala after receiving word that morning.
Over the course of the epidemic, Lukwiya had been quoted almost daily in the national media. The New York Times described his image: "the fearless field commander at the center of a biological war that threatened everyone in the country". His death shocked the country. Even though the outbreak was in steep decline by the time of Lukwiya's death, it sent shockwaves through the health sector. St. Mary's stopped accepting Ebola patients, a number of disillusioned health workers across Gulu District quit, while some suspected Ebola patients refused to go to a hospital, reasoning that if the top doctor couldn't be saved there was no point in them seeking treatment.
On 6 February, the WHO declared that Uganda was Ebola-free, with no new cases in the previous 21 days. 173 people had died. While the survivability rate in previous Ebola outbreaks was as low at 10%, the Ugandan outbreak had a survivability of nearly 50%, an increase partially attributable to better health care. Lukwiya was the last health worker at St. Mary's to die from Ebola. Foreign epidemiologists credit Lukwiya with accelerating the government's public education campaign to stop the spread of the disease with his phone call to Kampala on the 8th of October. The number of lives possibly saved by this quick action is variously numbered in the hundreds to the thousands.
In February 2001, the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
named Lukwiya a role model. An annual Dr. Matthew Lukwiya Memorial Lecture began the year after his death. The lectures are sponsored by the World Health Organization and organized by the Uganda National Association of Community and Occupational Health.
See also
- Viral hemorrhagic feverViral hemorrhagic feverThe viral hemorrhagic fevers are a diverse group of animal and human illnesses that are caused by four distinct families of RNA viruses: the families Arenaviridae, Filoviridae, Bunyaviridae, and Flaviviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress...
- EbolaEbolaEbola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...
- Universal precautionsUniversal precautionsUniversal precautions refers to the practice, in medicine, of avoiding contact with patients' bodily fluids, by means of the wearing of nonporous articles such as medical gloves, goggles, and face shields. The practice was introduced in 1985–88. In 1987, the practice of universal precautions was...
- Needle removerNeedle removerNeedle removers are devices that physically remove a needle from a syringe. In developing countries, there is still a need for improvements in needle safety in hospital settings as most of the needle removal processes are done manually and under severe risk of hazard from needles puncturing skin...
- Sharps wasteSharps wasteSharps waste is a form of medical waste composed of used sharps, which includes any device or object used to puncture or lacerate the skin. Sharps waste is classified as biohazardous waste and must be carefully handled...
- Body substance isolationBody substance isolationBody substance isolation is a practice of isolating all body substances of individuals undergoing medical treatment, particularly emergency medical treatment of those who might be infected with illnesses such as HIV, or hepatitis so as to reduce as much as possible the chances of transmitting...
- Biosafety level#Gabon (BSL4l)
- Biological hazardBiological hazardBiological hazards, refer to biological substances that pose a threat to the health of living organisms, primarily that of humans. This can include medical waste or samples of a microorganism, virus or toxin that can impact human health. It can also include substances harmful to animals...
- EpidemiologyEpidemiologyEpidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
- Dr. Ngoy MusholaNgoy MusholaNgoy Mushola is a DR Congolese medical doctor. Mushola, who is from Bumba, was the first person to record a description of the Ebola virus. It occurred Yambuku, DR Congo.-See also:*VHFs*Blood-borne pathogens *Universal precautions*Needle remover...
- Dr. Jonah Kule, (-Dec 4, 2007)