In the frontlines of a safe and dignified Ebola outbreak response in Uganda

Kampala-It is Sunday, but Dr Chris Opesen's day started at 05:30. Chris, an anthropologist at WHO's country office in Uganda, is part of the rapid response team working on the ground to curb the Ebola outbreak in Uganda. He is up early because he has been called by local government authorities in Kampala to support the reintegration of Lilian* into her home and community today.

Three days earlier, Lilian presented with signs and symptoms consistent with Ebola and was transferred to Mulago hospital's Ebola isolation unit in Kampala for diagnosis and care. Although the transfer was planned, it was a disruptive experience and unsettled her, her family and their neighbours. Everyone is anxiously awaiting Lilian's final and conclusive negative test result so that she can come home today.

Chris has been on the phone with Lilian and her family multiple times over the past 36 hours, providing advice, support and reassurance.

"The anthropologist is the midfielder of the outbreak response," says Chris, using an analogy from his favourite sport. "I connect the response teams to the community and deliver feedback from community to response teams citing concerns, fears and grievances."

Chris and his colleague, Henry Bwire, a division surveillance focal person from Kampala Capital City Authority, have convened a meeting of Lilian's family and friends to address their concerns and facilitate Lilian's reintegration. The meeting starts with a lively discussion where emotions run high. Everyone is speaking over each other, and the discussion is escalating. Seeking a more constructive approach, Chris suggests a formal dialogue. The group agrees and elects a chairperson, a neighbour, and a secretary, Lilian's sister, Angela*.

The dialogue starts and everyone takes a turn to speak and listen to each other's version of events. This calms the atmosphere. The meeting is long-around three and a half hours-and the group moves with the shade as the sun gets hotter and higher in the midday sky.

"We appreciate you because without you there would still be fear," Angela says to Chris and Henry.

The meeting convenes and Chris, Henry and a neighbour walk to the nearby supermarket. Lilian has asked them to speak to the shopkeeper who she says was "pointing fingers" at her mother when she shopped yesterday.

"Ebola is a disease that everyone fears," says Henry. "If people hear that their neighbour may have Ebola, there will be stigma there. Sigma can come through miscommunication and fear, both of which were present in this case. It was our role to bring Lilian back and clear up that miscommunication and reduce that fear in the community.

After the discussion, the shopkeeper expresses his gratitude to the team for taking the time to visit and explain. He reassures them that Lilian will not be treated differently.

Now the only thing left to do is wait for the confirmatory test before Lilian is discharged from the isolation unit. Chris and Henry could go home to their families because the test results could take several hours.

Instead, they decide to wait at the local market, a midpoint between the hospital and Lilian's neighbourhood, so they can be close by when the all-clear is given. They while away the hours, chatting and having regular phone calls with the laboratory and family. At some point Chris buys a watermelon from a local vendor, a refreshing respite from the afternoon heat for the team. At around 18:30 Chris gets a call and breaks into a smile. The result has been received: negative for Ebola. Lilian is coming home. While in isolation, she was treated for a bacterial infection and is feeling better.

Chris and Henry return to the house, where the family and neighbours have gathered in the front yard. Chris presents a cake and bottles of water that he has bought earlier. After around an hour of waiting, headlights beam through the gate. Lilian is home, escorted by a member of Uganda's national emergency medical team who has cared for her for the last 36 hours. She looks tired and gaunt, but relieved to be back home. For the next hour, the group once again recount the details of Lilians's story, her time in the isolation unit and what returning to work will look like for her.

Lilian makes a speech, reading from a prepared note from her phone: she is still too emotional to speak spontaneously. "As a family, we appreciate you coming to the ground and community to talk to us, because stigma can be too much" she says. "Thank you for listening to and addressing our concerns. I hope this can be a learning experience."

Finally, it is time to celebrate. Lilian then cuts the cake and shares slices with everyone.

"For me reintegration is supposed to be a celebration, especially when the evacuation did not go as planned," says Chris. "I wanted to do something special for Lilian, and for her to serve people the slices and for them to eat what she has given them, to demonstrate her acceptance back into the community."

After some cake, it is time for Chris to go. It is 21:00, more than 15 hours since he set off from home. Despite the long hours, despite the time spent away from his family, it has been a good day. He and Henry are upbeat and talkative during the car ride home.

"My role in the response gives me satisfaction" he says. "If I do my job well, I can make a difference and support WHO's leadership at the frontline of a safe and dignified response."

*Names changed