Social Dynamics of Ebola Virus Disease: A Case of Bundibugyo District, Uganda

Abstract

Background: Ebola Virus Disease (EVD) presents with a high global mortality and is known to be a highly infectious disease with devastating and gendered effects on the social fabric, yet most of the science has focused on the disease’s biology. However, little has been documented with regard to the gender and social aspects of Ebola Virus Disease (EVD) in two sub counties (Kikyo and Bundibugyo Town Council) in Bundibugyo District in Western Uganda. The study was set to examine the gender differences in the level of knowledge, attitudes and perceptions about EVD. Methods: The study employed a cross-sectional design using both quantitative and qualitative data collection methods. A structured questionnaire was administered to 254 respondents, 50% of whom were women. Simple random sampling was used to select the participants. Questionnaire data were analysed using SPSS at univariate and bivariate levels. Qualitative methods such as key informant interviews (with 6 participants) and Focus Group Discussions (three, one with men alone, another with women alone and the last one with both men and women) were also used to collect additional information from participants. Results: The findings indicated that socio-demographically, the majority (35%) of the respondents were aged between 20 and 29 years, 53% of whom were females. More women (about 56%) compared to men (44%) attained secondary education while more men (about 51% versus 49% of the women) reported that they were married. In terms of religion, the majority of the survey participants were Catholics (59% females and 49% males). With regard to communities’ knowledge about EVD, there was no significant relationship between men and women in terms of prior knowledge about EVD, risk factors and control measures. However, slightly more males (about 51%) than females (49%) had heard about EVD and more males (about 52%) than females (48%) admitted that they were at risk of contracting the disease. On the control measures, slightly more females than males (about 53% vs. 47% respectively) proposed avoiding contact with infected persons. The results further revealed that more males (about 51%) than females (49%) were willing to relate with EVD survivors, and this was due to the latter’s fear of contracting the disease. The major devastating effects of EVD that were reported included loss of lives, disruption of peoples movements, isolation of people, disruption of children’s school activities, stigma and discrimination of survivors. More females (about 52%) than males (about 48%) reported that EVD survivors were discriminated during the EVD outbreak in Bundibugyo District. Conclusions: This study has shown that whereas both men and women demonstrate average knowledge about EVD, there is need for more training and sensitization targeting women who have delusions about the severity of the disease, its risk factors, stigma and the integration of survivors in the affected communities. Communities also need to be sensitized about the gender roles that increase both the burden of EVD and the risk of men and women contracting the disease. This will lead to more culturally sensitive responses to EVD outbreaks in future.