Dear Editor

To: Tedros Adhanom Ghebreyesus
@DrTedros
Director General and Team,
The World Health Organization,
Geneva, Switzerland,

Dear Dr. Tedros and Team,

We the undersigned have noted with concern the recent personal and institutional attacks against you and WHO. We want to let you know that the world and humanity needs the institution of the World Health Organization (WHO) now more than ever. In the wake of the COVID -19 pandemic the technical guidance and leadership of the WHO that you and the leadership team in Geneva, Regional and Country Offices round the world is valued and appreciated.

A number of us were members of the Commission that released the report “The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises” in 2016. Having reviewed a wide range of options for a coordinated global response to infectious diseases, we concluded that the WHO is best placed to play the leadership and coordinating role and that if there was no WHO, we would have to invent one.

This is why we are writing to you to let you know that at this critical time in human history, it has fallen upon you and your WHO team to carry the singular responsibility of leading and coordinating the global charge to stop COVID -19 from killing more people and wreaking more collateral economic and social damage to the world.

We would like you to know that we have noted some of the attacks that have been leveled at WHO and to you personally. We know that some of these attacks are motivated by a number of factors that have nothing to do with your leadership of the WHO.

We are delighted and encouraged that despite these attacks you and WHO are committed to continue to focus on saving lives and controlling the pandemic with statements such as “No time to waste. Let’s focus on saving lives. Collaboration across party lines important to ensure national unity to fight the virus more effectively. National unity is a foundation for global solidarity. When we do this, we quarantine political covid. Stop politicizing #COVID19”.

Civil Society Organizations (CSOs) in Uganda are calling on the government to ensure that critical care and other emergencies get as much attention during the fight against the COVID19 pandemic.
Under the umbrella “Coalition to Stop Maternal Mortality in Uganda” the CSOs have written an open letter to the Prime Minister Rt. Hon. Ruhakana Rugunda, urging his office to prioritise maternal health and rights in the fight against COVID19.
They commend efforts by the government to stop the spread of the pandemic through measures such as home isolation and social distancing.
However, with the country currently on lockdown, the CSOs express concern that the most vulnerable Ugandans are struggling to get their urgent health services and needs addressed.
This especially follows media reports that showed a number of mothers dying in labour due to lack of a means to travel to hospital; and that many others are giving birth from the roadside.
“While we all want to have the pandemic suppressed and not spread further, other health need need to be provided and thatfundamental health rights are not violated during this period,” the letter reads in part.
It should be noted that the maternal mortality ratio in Uganda is high at 336/100,000 live births, according to the 2016 Demographic and Health Survey. The deaths are often due to preventable causes such as excessive bleeding, sepsis and lack of skilled care during childbirth.
The CSOs thus make several recommendations as follows:
1. Ensure continuity of blood donation services by giving exemptions to the Uganda Blood Transfusion Services to collect blood. Also, make provisions for people who would like to donate blood to do so.
2. Designate emergency vehicles for each Sub-County that are solely to be used for responding to non-elective, urgent and emergency health issues including antenatal care visits, accidents, dialysis, pressure, ART refills, immunizations, etc... The contact information for this driver shall be made available to all residents, and published locally and nationally to ensure transparency and accountability. Health facilities shall be made aware of this service and must share this information with their patients to enable responsiveness to bona fide urgent health needs.
3. The national toll-free call centre shall be upgraded to include a designated number only for Ugandans who have urgent non-COVID-19 health queries, for example, that need to know the contact details for their sub-county ambulance, or need to know how they are expected to travel to the clinic during this lockdown period. This line will be staffed by trained people who understand how the Government is managing urgent health issues during this period and can communicate that effectively.
4. Recommend to Cabinet a revision to the supplementary budget request to give further prioritization to health sector expenditures beyond the currently allocated UGX82.5 Billion.
5. Immediately direct NGO partners implementing maternal health care programmes in the health sector to work during this period under a waiver that authorises their movement, so that they are able to support women visit clinics safely.
6. Supply three months of family planning commodities to clients; rapidly develop and implement new protocols for community based family planning outreach and service provision so that gains in sexual and reproductive health and rights are not lost due to concerns regarding infection control.
Compiled by Carol Natukunda, Communications Specialist, ACHEST

Use Personal Protective Equipment (PPE) When
Caring for Patients with Confirmed or Suspected COVID-19

“Health Workers for All and All for Health Workers” Slogan of the First Global Forum on Human Resources for Health
“Our job is to ensure access to a skilled, supported and motivated health worker for every person in every village everywhere” Dr. J W Lee, former WHO Director General.
In these trying times of the COVID -19 pandemic, there are Health Workforce (HWF) issues that keep recurring in all countries. Yet HWF is one of the most critical inputs into the pandemic control response. This message needs to be appreciated by all intersetoral actors in governments and the general population. There are persistent complaints about lack of protective equipment, long working hours, hazards of travel to and from work in the face of lock down regulations and lack of support to undertake non COVID related medical work leading to collateral damage to public health.
“Health Workers for All and All for Health Workers” was the slogan of the First Global Forum on Human Resources for Health in 2008. Another related trending theme at that time and still relevant today is the quote from Dr. J W Lee that “Our job is to ensure access to a skilled, supported and motivated health worker for every person in every village everywhere”.
Let us take the discussion forward based on this quotation:
1. Skilled HWF need general knowledge, attitudes and skills for good and bad times and the required competencies for this are:
• Prepared to work where services are most needed: selection process, attitudes, socially accountable
• Able to respond to health needs of community: training in real life situations in community
• Able to deliver quality care with available (limited) resources. (Achieving the most with available resources.)
• Clinical excellence as foundation for teaching and research.
• Able to be leader, manager , teacher and change agent: mentors
• Continuous self-directed learners
• Effective communicators: team based learning, practice
The HWF also needs to be prepared and fit for purpose to handle the special skills for COVID-19 and the required competencies are:
• Full understanding of Infection control practices including correct use of PPEs
• Knowledge of Novel Corona virus behavior and its manifestations especially modes of transmission, symptoms, signs and complications
• Team work and empathy with ability to delegate skills through Task Shifting approach

2. Supported HWF should have:
• Enjoy the full support of political leadership with established structures for HWF planning and management embracing all relevant sectors
• Enjoy full support supervision of competent technical leaders with clear structures for dialogue and communication
• Enjoy the full support and understanding of the general population
• Have access to the tools that they require for their work such as PPEs, supplies,
• Organized and well led HWF with a critical mass of individuals professional associations and other institutions that work with their respective governments as both support and accountability agents, for sustaining highly performing health systems

I was a bit excited when my country announced home isolation as a key measure to stop the spread of Coronavirus (COVID-19) infection. It would be comforting to just stay home, or so I thought.
I was wrong! Barely a week into home confinement, I was doubly stressed. I missed being free to move to wherever and whenever I wanted. I suddenly missed travelling by bodaboda and commuter taxi, or running my otherwise hectic daily errands. There were days I woke up angry for no reason at all. It was frustrating.
While I have had to devise ways to cope by including exercises and games amidst my schedule – office work, parenting and house chores – I still involuntarily get nervous. I worry about how much longer we are likely to be stuck in our homes; and how we will be able to put the next meal on the table – if the COVID-19 infection persists. I worry about the economic crisis in the aftermath of COVID19. It is frightening.
From the conversations with friends over the telephone or social media platforms, it is easy to tell that isolation is taking a toll on many people. Families whose loved ones are being quarantined or have tested positive have to bear untold distress. It must be worse for those who are in quarantine centers, receiving treatment. Households that live hand-to-mouth particularly spend sleepless nights with untold fear of what the next day holds. Health workers who are at the front-line have to endure fatigue, irritability, and a sense of helplessness especially as people continue to be infected or succumb to the infections.
What’s worse? The statistics are disturbing. The number of deaths has more than doubled in the past week. As of April 1, 2020, the World Health Organization indicated that the coronavirus has infected more than 900,000 and left more than 45,000 dead. WHO predicted that in next few days, the statistics would reach 1 million confirmed COVID-19 case, and 50, 000 deaths.

Somber as the picture looks, it is important to focus on the positive side, by focusing on what is within our control. Recently, the WHO Mental Health Department issued self-help tips for the general population, health workers, and families  It cautioned every individual to minimize watching, reading or listening to news about COVID-19 that causes anxiety ; but seek information only from trusted sources to get facts not rumours and misinformation.