Risk Communication and Community Engagement

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Module 1: RCCE Foundations, Urban Context & One Health

COMPONENT 4: INTERACTIVE READING – ONE HEALTH PDF (5 pages, 20 minutes)

ONE HEALTH AND RCCE IN KAMPALA

What is One Health?

One Health is an integrated approach recognizing that human health, animal health, and environmental health are interconnected.

You cannot protect human health by focusing only on humans. Diseases don’t respect species boundaries.

Why One Health Matters: The Numbers

75% of emerging infectious diseases are zoonotic—they jump from animals to humans.

Examples:

  • Ebola: Fruit bats → humans
  • Mpox: Rodents → humans
  • Rabies: Dogs → humans
  • Avian influenza: Poultry → humans
  • Anthrax: Livestock → humans
  • COVID-19: Animal origin (likely bats) → humans

60% of existing human pathogens are zoonotic.

In Uganda specifically:

  • Ebola: 6 outbreaks since 2000
  • Mpox: Ongoing clusters in Kampala
  • Rabies: 200+ deaths annually
  • Anthrax: Periodic livestock outbreaks
  • Rift Valley Fever: Cross-border transmission
  • Marburg: Related to bat exposure

All require One Health approaches.

The Human-Animal-Environment Interface in Kampala

Kampala’s rapid urbanization creates unique One Health risks:

1. Backyard Poultry

  • 40% of Kampala households keep chickens
  • Close contact with humans (inside homes)
  • Avian influenza risk
  • No veterinary oversight

2. Live Animal Markets

  • Nakasero Market, Kalerwe Market, Wandegeya Market
  • Multiple species (chickens, goats, rabbits, rodents)
  • High-risk mixing environment
  • Poor sanitation
  • Zoonotic disease transmission hotspot

3. Urban Wildlife

  • Fruit bats in Makerere University, Mulago Hospital trees
  • Monkeys in urban forests
  • Rodents in markets and settlements
  • Contact with humans and domestic animals

4. Pet Ownership

  • Growing middle class with dogs, cats
  • Limited rabies vaccination coverage
  • Dog bites common
  • No dog population control

5. Informal Settlements

  • Humans, chickens, goats, pigs in close quarters
  • Poor waste management attracts rodents
  • Standing water (mosquitoes → dengue, Rift Valley fever)
  • No veterinary services

6. Slaughterhouses and Butcheries

  • Often informal, unregulated
  • Butchers handle diseased animals
  • No protective equipment
  • Anthrax, brucellosis risk

7. Cross-Border Livestock Trade

  • Cattle from DRC, South Sudan, Tanzania
  • Not inspected for disease
  • Spread Rift Valley fever, foot-and-mouth disease
  • Markets in Kampala receive these animals

One Health Sectors

Effective One Health requires collaboration across:

1. HUMAN HEALTH

  • Ministry of Health
  • KCCA Public Health Department
  • Hospitals and health centers
  • Community health workers (VHTs)

2. ANIMAL HEALTH

  • Ministry of Agriculture (Veterinary Services)
  • MAAIF District Veterinary Officers
  • Private veterinarians
  • Animal welfare organizations

3. ENVIRONMENT

  • National Environment Management Authority (NEMA)
  • KCCA Environment Department
  • Uganda Wildlife Authority

4. WILDLIFE

  • Uganda Wildlife Authority
  • Conservation organizations
  • National parks near Kampala

5. AGRICULTURE

  • Ministry of Agriculture
  • Farmer cooperatives

One Health in Practice: Case Study – Ebola Preparedness in Kampala

The Challenge:
Ebola outbreaks in DRC regularly threaten Uganda. Kampala is entry point (airport, trucking routes). Fruit bats (Ebola reservoir) live in urban trees.

Human health approach (insufficient):

  • Hospital isolation units
  • Contact tracing
  • Vaccination campaigns
  • Surveillance of suspect cases

One Health approach (effective):

HUMAN HEALTH:

  • Hospital preparedness + community surveillance (VHTs)
  • Cross-border screening at Entebbe Airport
  • Educate taxi drivers, hotel workers, market vendors about symptoms

ANIMAL HEALTH:

  • Wildlife monitoring (fruit bat populations, deaths)
  • Veterinarians report unusual animal deaths
  • Ban on bushmeat hunting and trade
  • Market inspections for illegal wildlife products

ENVIRONMENT:

  • Mapping human-bat interfaces (where do people encounter bats?)
  • Removing fruit trees near schools and hospitals (reduce bat-human contact)
  • Wetland restoration (healthier ecosystems = healthier humans)

COMMUNICATION (RCCE):

  • Engage hunters and bushmeat consumers (not just general public)
  • Work with market vendors selling wildlife
  • Educate farmers about protecting livestock from bat contact
  • Teach children not to touch bats or dead animals

COORDINATION:

  • One Health Task Force (health + veterinary + environment + security)
  • Joint outbreak investigations
  • Shared surveillance data
  • Unified communication strategy

Result: Uganda has successfully contained multiple Ebola outbreaks because of One Health coordination—unlike DRC, which initially focused only on human health.

RCCE for One Health: What’s Different?

Traditional RCCE targets:

  • Patients
  • Health workers
  • General public

One Health RCCE must ALSO target:

  • Farmers (livestock owners, poultry farmers)
  • Veterinarians (private practitioners, government)
  • Butchers and slaughterhouse workers
  • Market vendors (selling live animals or meat)
  • Hunters (bushmeat, wildlife trade)
  • Waste collectors (contact with rodents, environment)
  • Pet owners
  • Children (interacting with animals)
  • Environmental workers (NEMA, forestry, wetlands)

Messages must be tailored for each audience.

Example:

General public message:
“If you develop fever, headache, and bleeding, seek medical care immediately.”

Farmer message:
“If your chickens die suddenly, report to the District Veterinary Officer before touching them. Avian influenza can spread to humans.”

Butcher message:
“Always wear gloves when slaughtering animals. If an animal looks sick (swollen, bleeding, unusual), report to veterinarian—do not butcher. Anthrax can kill you.”

Hunter message:
“Do not hunt or eat fruit bats, monkeys, or chimpanzees. These animals can carry Ebola, which is deadly to humans.”

Child message:
“If you see a bat on the ground, do not touch it. Tell an adult. Bats can make you very sick.”

Uganda’s One Health Strategic Plan Priorities

Uganda has a National One Health Strategic Plan 2018-2022 (extended to 2027), identifying priority zoonotic diseases:

Tier 1 (Highest priority):

  • Ebola
  • Marburg virus
  • Anthrax
  • Rabies
  • Brucellosis

Tier 2:

  • Rift Valley fever
  • Yellow fever
  • Mpox
  • Avian influenza
  • Crimean-Congo hemorrhagic fever (CCHF)

Tier 3:

  • Plague
  • Leptospirosis
  • Q fever

KCCA’s RCCE work must address Tier 1 and 2 diseases.

Building One Health into KCCA’s RCCE System

What KCCA should do:

  1. Include veterinary officers in PHEOC and task forces
    1. Currently: Human health dominates
    2. Needed: Veterinary expertise at the table
  2. Train VHTs in animal disease surveillance
    1. Report unusual animal deaths (chickens, dogs, livestock)
    2. Link to District Veterinary Officer
  3. Conduct joint human-animal outbreak investigations
    1. When human cases appear, investigate animal exposure
    2. Share data between health and veterinary sectors
  4. Develop One Health IEC materials
    1. Messages for farmers, butchers, hunters
    2. Visuals showing human-animal-environment connections
    3. Multilingual (including for refugee/migrant farmers)
  5. Engage livestock and pet markets
    1. Nakasero, Kalerwe as surveillance sites
    2. Market vendors as sentinels
    3. Install handwashing stations at markets
  6. Map human-animal interfaces in each division
    1. Where are backyard poultry concentrated?
    2. Where are slaughterhouses?
    3. Where are fruit bat roosts?
    4. Where do children interact with animals?
  7. Coordinate messaging across sectors
    1. Ministry of Health + MAAIF + NEMA speaking with one voice
    2. Avoid contradictory messages

Kampala One Health Simulation Findings

The 2025 KCCA simulation included One Health scenarios (Mpox from rodents, Ebola preparedness). Key findings:

Strengths:

  • DMOs understood zoonotic disease concepts
  • Task forces included veterinary representation (in 3 of 5 divisions)

Gaps:

  • VHTs not trained in animal surveillance
  • No systematic engagement with butchers, farmers, or markets
  • IEC materials focused only on human behavior (no animal handling guidance)
  • Veterinary officers not integrated into PHEOC
  • No linkage between human disease surveillance and animal disease surveillance

Recommendation: KCCA must operationalize One Health, not just conceptualize it. This requires:

One Health RCCE content in all modules

Joint training (human + animal health workers)

Shared data platforms

Unified command structure during outbreaks