Fear, stigma and Uncertainty: The short and long-term effects of Ebola on survivors, affected families, and community in Bundibugyo, Western Uganda
5 affiliations
- 1Makerere University, Kampala, Uganda
- 2Heidelberg Institute of Global Health, University of Heidelberg, Germany
- 3School of Nursing, University of Minnesota, United States of America
- 4Director, Health Sciences Institute, University of Hawaii, United States of America
- 5University of Tennessee College of Veterinary Medicine, Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, United States of America
Abstract
In 2014, Uganda was identified as a high-risk country for Ebola Virus Disease (EVD), with a series of outbreaks recorded since 2000. In 2007, the second outbreak in Bundibugyo district resulted in 149 reported cases and 37 confirmed Ebola deaths. Through the outbreak response, a new strain of the Ebola virus (Bundibugyo ebolavirus) was discovered. Although much is known about the nature of Ebola, including disease signs and symptoms, transmission and management, there is limited understanding of the short and long-term sociocultural impacts of the disease in communities. The study team conducted a focused ethnography in Bundibugyo District 10 years after the 2007 outbreak. Data collection included a review of archival data, participant observation, field notes and 19 in-depth interviews with survivors and affected families. Results underscored short and long term social, cultural and economic disruptions caused by the outbreak. We interpreted findings through an Eco-health framework with an emphasis on ways that underlying stigma accentuated detrimental long-term effects of the outbreak. Affected women, particularly widows, experienced social exclusion, and economic strain, and acknowledged loss of opportunity for a better life for their orphaned children. Deepening fear of the possible recurrence of Ebola resulted in ethnic tension driven by speculations on the 2007 outbreak source. Survivors reported varying persistent health effects including impaired vision and general body weakness. Community members reported positive changes in health seeking behaviors. Health care workers described high levels of alert for early clinical signs of Ebola, a critical factor for early outbreak detection at the community level. Our findings can inform future research, Ebola response, and recovery interventions, particularly those targeting community re-integration and mitigation of the fear and stigma associated with survivorship.
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BibTeX
@article{namusisi2026fear,
title = {{Fear, stigma and Uncertainty: The short and long-term effects of Ebola on survivors, affected families, and community in Bundibugyo, Western Uganda}},
author = {Shamilah Namusisi and Jacinta Mukulu Waila and Sarah J. Hoffman and Cheryl Roberston and Katey Pelican and Michael Mahero},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0355778},
url = {https://doi.org/10.1371/journal.pone.0355778},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Fear, stigma and Uncertainty: The short and long-term effects of Ebola on survivors, affected families, and community in Bundibugyo, Western Uganda
AU - Shamilah Namusisi
AU - Jacinta Mukulu Waila
AU - Sarah J. Hoffman
AU - Cheryl Roberston
AU - Katey Pelican
AU - Michael Mahero
PY - 2026
DA - 2026/09/08
JO - PLOS One
DO - 10.1371/journal.pone.0355778
UR - https://doi.org/10.1371/journal.pone.0355778
AB - In 2014, Uganda was identified as a high-risk country for Ebola Virus Disease (EVD), with a series of outbreaks recorded since 2000. In 2007, the second outbreak in Bundibugyo district resulted in 149 reported cases and 37 confirmed Ebola deaths. Through the outbreak response, a new strain of the Ebola virus (Bundibugyo ebolavirus) was discovered. Although much is known about the nature of Ebola, including disease signs and symptoms, transmission and management, there is limited understanding of the short and long-term sociocultural impacts of the disease in communities. The study team conducted a focused ethnography in Bundibugyo District 10 years after the 2007 outbreak. Data collection included a review of archival data, participant observation, field notes and 19 in-depth interviews with survivors and affected families. Results underscored short and long term social, cultural and economic disruptions caused by the outbreak. We interpreted findings through an Eco-health framework with an emphasis on ways that underlying stigma accentuated detrimental long-term effects of the outbreak. Affected women, particularly widows, experienced social exclusion, and economic strain, and acknowledged loss of opportunity for a better life for their orphaned children. Deepening fear of the possible recurrence of Ebola resulted in ethnic tension driven by speculations on the 2007 outbreak source. Survivors reported varying persistent health effects including impaired vision and general body weakness. Community members reported positive changes in health seeking behaviors. Health care workers described high levels of alert for early clinical signs of Ebola, a critical factor for early outbreak detection at the community level. Our findings can inform future research, Ebola response, and recovery interventions, particularly those targeting community re-integration and mitigation of the fear and stigma associated with survivorship.
SN - 1932-6203
ER -