Dr. Gloria Seruwagi, the Principal Investigator-REFLECT study responds to questions at the event where preliminary findings were shared, 20th October 2020, CTF1, Makerere University, Kampala Uganda.
Uganda’s open-door policy on refugee-hosting has been internationally acclaimed as “the world’s most compassionate”. And while Uganda is among the world’s top three refugee-hosting nations, possibly the first in Africa, refugee communities continue to be disadvantaged on many fronts with poor socioeconomic and health outcomes.
Refugee settings are already besieged with a socially disrupted existence, and the COVID-19 experience could have catastrophic consequences in their context. Yet the extent to which refugee communities are aware of Covid-19, have complied, and are coping with the related preventive measures, remains largely unknown.
Moved mainly by three issues: 1) Uganda’s open-door policy on refugee hosting; 2) COVID-19; and 3) the knowledge gap on COVID-19 impact in refugee communities, Makerere University researchers in partnership with different institutions in academia, policy and practice have commenced on a study contributing to increased compliance with the Ministry of Health’s Covid-19 prevention guidelines under the project entitled “Refugee Lived Experiences, Compliance, and Thinking” (REFLECT) in Covid-19.
According to Dr. Gloria Seruwagi, the Principal Investigator, study findings will contribute to filling gaps in knowledge, policy by designing programmes to increase understanding and compliance levels around COVID-19 and refugee communities:
“Little is known about how refugee communities have complied with the Ministry’s guidelines like social distancing, wearing masks, sanitizing or frequent washing of hands with soap. Yet it is widely known that their living arrangements in crowded spaces with massive WASH (Water, Sanitation and Hygiene) challenges have been a long-standing challenge, even before the Covid-19 pandemic. To address this knowledge gap the Ministry of Health has partnered (as a Co-Investigator) with our study team which also comprises other Co-Investigators from Gulu University, ACORD and Lutheran World Federation which are implementing partners in refugee settlements.” explained Dr. Seruwagi
‘’This mixed methods research has a sample size of ~1,500 participants evenly distributed across three study sites in Central, West Nile and South Western refugee settlements. Similarly, there was fairly even distribution across nationalities with Congolese (30%), Somalis (33%) and South Sudanese (33%). Overall, the majority of participants were aged between 25-34 years (35%), of female gender (68%), of Moslem (30%) or Protestant (36%) religious denomination, uneducated (40%) and earned less than UGX 50,000 weekly (57%). In addition, the overwhelming majority neither smoked (97%) nor drunk alcohol (92%). Except for age and gender, there were variations in demographic and behavioral characteristics across the three study sites’’ she added.
Preliminary Findings
As part of preliminary findings from the study, Dr Seruwagi noted that there are very high levels of awareness about COVID-19 among the majority of the adult population. However, there are variations in this knowledge across refugee settings, with urban refugees being more knowledgeable on average than their rural counterparts. However, in reverse they [urban refugees] also displayed and reported higher risk behaviour in regards to Covid-19 than their rural-based counterparts who showed relatively more compliance. Despite being more knowledgeable than women with regard to symptoms, causes, risk factors, and treatment of COVID-19, men have poor compliance with Covid-19 preventive measures compared to women.
Children ages 5-12 were found to have very low levels of knowledge, explained by the assumption that adults at home will always pass on information and so, no targeted information is being given to children. “Due to school closure, teachers who are key change agents and transmit information were not in contact with the children. We believe this is a missed opportunity greatly contributing to these low knowledge levels among children” Dr. Gloria explained while sharing findings at Makerere University (CTF1 Building). In addition to disenfranchisement around access to Covid-related knowledge, school closure further heightened children’s vulnerability with a marked increase in neglect, exposure to different forms of violence and teenage pregnancy.
On attitudes, Dr. Seruwagi noted that previous adverse experiences like war, torture, rape or hunger have produced a “survivor” mentality with little or no fear among respondents in refugee communities. One refugee said “I have dodged bullets, been tortured and slept hungry for days, what more harm can Covid do to me?”
On adherence to preventive guidelines, Presidential directives and SOPs, handwashing was the most commonly adhered to guideline, again among the adults. Local leaders had come up with innovative mechanisms for ensuring compliance through supervision; and most households had washing points at the peak of COVID-19. ‘’Handwashing was even much higher in Muslim communities, mostly because it is in tandem with their religious and sociocultural practices’’ Dr. Seruwagi explained.
On masks, the researchers noted that there was not so much compliance in wearing masks, reportedly after restrictions were eased. There was a lot of “chin-masking” with those who had just wearing them on chins but without using them to cover up. Some other risky behaviours were observed such as borrowing masks at places where it was mandatory (health facilities, offices) or when they saw authorities and enforcers coming.
On social distancing: the researchers noted that local leaders have tried to enforce this at public meeting spaces; but it’s almost impossible at household level due to large family sizes. Also, sociocultural norms require them to sit together, eat together (including from the same utensils) which makes it almost impractical.
Despite the challenges, the researchers observed that there are also stories of resilience, innovation and improvisation among refugee communities. Local leaders made arrangements to help their people including translating prevention messages into local languages, having strict rules e.g. for social distancing at water collection points and enforcing handwashing facilities at household level. They also internally arranged some relief items. And new businesses (e.g. mask production) were birthed out of COVID-19. Key support systems during Covid-19 were reported to be health facilities, WASH, community leaders including religious leaders and the diaspora.
On the way forward, the research team highlighted the need for innovation and designing age-appropriate messages and interventions for children, incorporating mainstream COVID-19 messaging in all teacher-learner interactions, building on community resilience and leadership, continuous communication and impact messaging with heavy focus on risk reduction.
In his presentation entitled; REFLECT study implications for policy, Mr. Brian Luswata the Principal Legal Officer from Ministry of Health (MOH) reported that MOH is conducting an integrated Covid-19 response to the entire public regardless of nationality. He indicated that available data shows that over 151 refugees countrywide have contacted Covid-19 and 3 deaths have been registered. He further revealed that MoH conducts regular trainings of health workers in refugee settlements and quarantine facilities have been created to counter any spread of the pandemic. He noted the timeliness and importance of this study, saying it will directly feed into policy and guidelines on the prevention of COVID-19 and other similar pandemics.
Mr. Brian Luswata the Principal Legal Officer from Ministry of Health (MOH) making a presentation at the event.
Representing the Dean, Makerere University School of Public Health, Dr. Elizabeth Ekirapa commended the REFLECT study team led by Dr. Seruwagi noting that the study will shed more light on how to deal with issues like human behaviour during the Covid-19 pandemic.
“When COVID-19 started people were saying nobody is dying and now people have started to die. Human beings keep coming up with explanations in a manner that you wouldn’t expect. So this study will help us learn on how we can deal with ourselves’’ said Dr. Ekirapa who is also Chair of the Department of Health Policy Planning and Management at MakSPH.
She further appreciated the REFLECT study’s multisectoral approach adding that the findings will contribute to changes in the different multisectoral approaches Uganda is using to address COVID-19.
Dr. Elizabeth Ekirapa commended the REFLECT study team led by Dr. Gloria in her remarks
In her remarks, Prof. Josephine Ahikire, the Principal of the College of Humanities and Social Sciences (CHUSS) said that the role of Makerere University is to create knowledge that will be used for societal development and transformation.
She equally thanked Government of Uganda for continuous support to Makerere University through the Research and Innovation Fund (Mak-RIF) which also has a provision for research on COVID-19. She congratulated the researchers for the timely study which underscores the academia role in social work, humanity and public health. She also thanked the partners for supporting the initiative.
Prof. Josephine Ahikire – the Principal College of Humanities and Social Sciences (CHUSS) giving her remarks at the event
Jesse Kamstra, the Country Representative for Lutheran World Federation (LWF) commended Uganda’s effort in the fight against Covid-19.
“I feel safer in Uganda than any other country due to the different adaptations they have taken up to make this disease less spread in the country’’ said Kamstra.
As implementing partners in the study, he mentioned that LWF expects actionable recommendations and evidence-based understanding of social behaviours of refugees during COVID-19. He further noted that the recommendations will be used to adjust future programming together with other implementing partners like Office of the Prime Minister (OPM)’s refugee department.
Jesse Kamstra the Country Representative Lutheran World Federation (LWF) at the event commended Uganda for fighting Covid-19 at the REFLECT STUDY launch
Ms Ellen Bajenja Kajura the Country Director for ACORD, also one of the study partners, expressed her pride at the partnership with Makerere and the other partners. Even from preliminary findings, she talked about some of the immediate actions her organisation will begin taking forward like designing child-friendly messages on Covid-19 in addition to strengthening ACORD’s programming in child protection and gender-based violence.
At the event, Dr. Misaki Wayengera, Chairman of Scientific Advisory Committee (SAC) on the National Taskforce for COVID-19 revealed that despite challenges brought by Covid-19, total reopening of various sectors will go on.
‘’We started opening up but some sectors remain closed because we are still studying transmission dynamics, however we shall continue opening up because we will have to live with COVID-19’’ he explained.
Dr. Misaki Wayengera, Chairman of Scientific Advisory Committee (SAC) on the National Taskforce for COVID speaking at the REFLECT STUDY launch
Professor Noeline Nakasujja the Adhoc Chair (psychosocial) on the COVID-19 Taskforce and also Head of Psychiatry Department of Makerere University College of Health Sciences noted the significant increase in Mental Health issues and psychiatry referrals during COVID-19. She decried the limited infrastructure or community capacity to handle these. She called on all stakeholders to work together in their different capacity to address mental health and psychosocial support especially for more vulnerable populations like those in refugee settings.
Prof. Noeline Nakasujja speaking at the event
During the event, refuge representatives shared their experiences during pandemic response.
On what makes Uganda one of the best refugee host community, Ms. Lilly Anek a Refugee representative from Adjumani had this to say: ‘’Uganda is the best refugee host country because they treat us like brothers and sisters. This is why we intermarry as South Sudanese and Ugandans… people treat us so well’’ Similarly, other refuge representatives like Sandie from Kyaka II at the event were in agreement with her statement as they confirmed receiving handwashing detergents, face masks and training on COVID-19 prevention. Together, they called upon government of Uganda to put in a place an additional taskforce in the refuge communities so that new entrants are quarantined before joining the community.
The event was graced by officials from Office of the Prime Minister (OPM) which manages the national refugee response, UNHCR, representatives from the ministry of health, Makerere University, civil society, the media and other stakeholders. Discussions during this dialogue centered around the growing numbers of challenges during Covid-19, perceptions and nomenclature, infrastructural limits in refugee hosting communities and adaptations to the new normal in this Pandemic era.
Dr Julius Kasozi representing UNHCR assured the study team that UNHCR is more than ready to take forward and implement any actionable recommendations from the REFLECT study. In his closing remarks as government representative, Mr. Byaruhanga of OPM said there was a lot to learn and adapt from the study. He encouraged the study team to engage further with his office to ensure ownership and uptake of the study findings.
More about the REFLECT Study
The research topic is “Knowledge, adherence and the lived experiences of refugees in COVID-19: A comparative assessment of urban and rural refugee settings in Uganda”. The project has been shorted to the acronym REFLECT (Refugee Lived Experiences, Compliance, and Thinking).
The study is cross-sectional mixed and has a multinational focus covering refugees from South Sudan, Somalia, and Eritrea, Democratic Republic of Congo (DRC), Rwanda, and Burundi. Similarly, Study sites are Kisenyi in Kampala, Kyaka II Refugee Settlement in Kyegegwa, South-Western Uganda, and eleven (11) refugee settlements in West Nile.
The 92nd Guild Ministry of Health is set to host the Annual Makerere Guild Medical Camp, a three-day outreach that will bring free and essential medical services to students, staff, and the surrounding community. The camp will run from 17th to 19th September 2026, from 8:00am to 5:00pm each day, at the Freedom Square.
Themed around promoting student wellness for academic excellence, the medical camp is organised under the leadership of Hon. Wamezaya Ebenezer, the Minister of Health in the 92nd Guild Government, in alliance with several partner organisations supporting the university’s health and wellness agenda. The initiative reflects a growing recognition within student leadership circles that academic performance is closely tied to the physical and mental wellbeing of the university community.
Comprehensive Range of Services
The medical camp will offer a wide range of services designed to address both routine and specialised health needs. On the general health side, attendees will have access to general and specialist medical consultations, allowing students, staff, and community members to seek professional advice on a variety of health concerns without the usual costs associated with private or even public healthcare.
A female medical personnel attends to a male client.
Screening services will also be a central feature of the camp. Organisers have confirmed that sickle cell testing, malaria rapid diagnostic testing, and HIV screening will be available on site, giving participants the opportunity to know their status and receive guidance on appropriate next steps. Eye care services and laboratory diagnostics will round up this category, addressing common but often neglected areas of student health.
Beyond diagnostics and consultations, the camp will provide free essential medicines to those who need them, easing the financial burden that often accompanies treatment even after a diagnosis has been made. Reproductive health counseling will also be offered, giving students a confidential space to discuss matters that are frequently overlooked in general campus health conversations. Mental health counseling completes the list of available services, an inclusion that speaks to the increasing attention being paid to psychological wellbeing within the university community.
A Camp Open to the Wider Community
While the camp is organised by the Guild Ministry of Health and centred on student welfare, its reach extends beyond the student body. Organisers have made it clear that the free medical services will be available to students, staff, and members of the whole Makerere community, positioning the event as a broader public health contribution rather than a strictly internal university affair. This inclusive approach mirrors similar outreach efforts previously undertaken by student leadership and university departments, which have sought to position Makerere University not just as a centre of learning but as an active contributor to community welfare in the areas surrounding its campuses.
A male client gets his BMI checked.
Freedom Square, long regarded as the symbolic heart of student activity and expression at Makerere University, was selected as the venue for the three day event. Its central location and historic significance make it an accessible and fitting site for an initiative of this scale, expected to draw considerable numbers of participants over the course of the camp.
Health as a Pillar of Academic Success
The organisers have anchored the medical camp around the message of promoting student wellness for academic excellence, a theme that underscores the connection between health and academic performance. University life often places significant demands on students, both physically and mentally, and untreated health concerns can quietly undermine academic progress long before they become visible crises. By bringing screening, treatment, and counseling services directly to students at no cost, the Guild Ministry of Health is addressing barriers that might otherwise prevent students from seeking care, whether due to cost, distance, or stigma, particularly around mental health and reproductive health matters.
The 91st Guild Minister of Health, Hon. Bbosa Sharif (L) poses by the event banner in the Freedom Square.
The inclusion of mental health counseling alongside more traditional physical health services is particularly notable. It signals an evolving understanding among student leaders that wellness cannot be addressed through physical checkups alone, and that psychological support deserves equal standing within campus health initiatives. Similarly, the presence of reproductive health counseling reflects an effort to normalise conversations that many young people find difficult to initiate on their own.
What to Expect
Over the three days, participants can expect a structured environment at Freedom Square, with separate service points catering to the different categories of care on offer. Medical professionals will be on hand to conduct consultations and screenings, while counselors will provide guidance on reproductive and mental health matters in a setting designed to protect privacy and encourage openness.
Given the scale of services on offer and the open invitation extended to staff and community members in addition to students, organisers anticipate strong turnout throughout the three day period. Those interested in attending are encouraged to plan their visits within the stated hours of 8:00am to 5:00pm to take full advantage of the services available.
H.E. Bbosa Sharif receives female students at the Medical Camp.
For any inquiries regarding the medical camp, members of the university community and the public have been directed to reach out to Hon. Wamezaya Ebenezer, the Minister of Health, through the contact provided by the Guild Ministry of Health.
Building on a Guild Tradition
The Annual Makerere Guild Medical Camp is not a new concept within student governance at the university. Successive Guild Ministries of Health have used the medical camp as a recurring platform through which they translate campaign promises around student welfare into visible action. Each edition tends to build on the lessons of the one before it, with organisers typically expanding the range of services offered as new partnerships are secured and as feedback from previous camps is incorporated into planning.
Sickle Cell Screening (Left Tent) was one of the services offered.
This year’s edition, organised under the 92nd Guild Ministry of Health, appears to place particular emphasis on breadth of service, combining preventive screening, curative consultation, and psychosocial support within a single three-day window. The decision to bundle sickle cell testing, malaria and HIV screening alongside eye care and laboratory diagnostics suggests an intention to make the camp a one stop point for health assessment, reducing the need for participants to seek out multiple providers across the city for basic checks they might otherwise postpone indefinitely.
Why Timing Matters
The scheduling of the camp in September places it at a point in the academic calendar when many students are settling back into campus life after recess, a period during which health concerns accumulated over the break, whether physical ailments left unattended or emerging mental health pressures tied to academic anxiety, tend to surface. Offering free consultations and counseling at this juncture allow students to address these concerns early, before they compound into more serious complications that could interfere with coursework, examinations, or general campus participation.
A female medical personnel attends to a female client.
For staff members and residents of the areas surrounding the university, the timing also offers a convenient opportunity to access services that might otherwise require travel to distant health facilities or extended waiting periods within an already strained public health system. In this sense, the camp functions as a modest but meaningful supplement to existing healthcare provision in the vicinity of the university.
As the 17th of September approaches, the Annual Makerere Guild Medical Camp stands as another example of the Guild Ministry of Health stepping beyond the boundaries of policy and advocacy into direct, hands-on service delivery, a model that continues to shape the character of guild ministries at Makerere University. Students, staff, and members of the surrounding community are encouraged to take advantage of the free services on offer and to look out for further communication from the Guild Ministry of Health as the event draws closer.
For more info, reach Hon. Wamezaya on +256784541248
Makerere University School of Public Health, in collaboration with Jhpiego, invites applications for 49 short-term positions under the Scaling the Optimal Use of Multiple ACTs to Prevent Antimalarial Drug Resistance (STOP-AMDR) Project.
The short-term assignments will support data collection in Buikwe and Busia districts, with some national-level activities. Applicants are encouraged to review the requirements for their preferred position before applying.
Makerere University School of Public Health (MakSPH), through the Africa-Europe Cluster of Research Excellence (CoRE) for Preparedness and Response to Pandemics and Shocks, has shared findings from its study of Uganda’s Mpox response with stakeholders in Kasese, Amuru, Nakasongola and Mayuge districts to strengthen district preparedness for future outbreaks.
The Africa-Europe CoRE is a partnership co-led by MakSPH and the Centre for Research on the Epidemiology of Disasters at UCLouvain, Belgium. It brings together universities in Africa and Europe to strengthen research, training and preparedness for pandemics and other public health shocks.
The district-level dissemination meetings, held from 10 to 14 August 2026, brought together more than 100 local government, health and security officials, Village Health Teams, implementing partners and community representatives. The meetings enabled stakeholders to validate the district-level findings, identify practical actions and provide feedback for the study’s final analysis and national dissemination.
Mr. Philliam Jabim shares the Mpox response study findings with participants during the dissemination meeting in Nakasongola District on 12 August 2026.
Uganda confirmed its first two Mpox cases on 24 July 2024 at Bwera Hospital in Kasese District. The Ministry of Health declared an outbreak on 2 August 2024. As documented in the study, the response involved health workers, communities, local governments, security agencies, political leaders, and implementing partners.
In response to the outbreak, a MakSPH research team led by Prof. Rhoda Wanyenze, Dr. Rawlance Ndejjo, Dr. Steven Kabwama and Mr. Douglas Bulafu conducted a study in May 2025 to assess Uganda’s Mpox response, including its policies, interventions, strategies and challenges, and generate lessons to inform recovery and strengthen preparedness for future public health emergencies.
Using purposive sampling, the research team conducted 20 key informant interviews and five focus group discussions in each of the four districts, drawing perspectives from western Uganda in Kasese, northern Uganda in Amuru, central Uganda in Nakasongola and eastern Uganda in Mayuge.
Participants and the MakSPH research team at the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026.
The study, titled Assessment of the Mpox Response in Uganda: Documenting Challenges, Lessons and Innovations to Strengthen Emergency Preparedness and Response Capacities, was funded by the Government of Uganda through the Makerere UniversityResearch and Innovation Fund (Mak-RIF).
“This study is helping us move beyond recounting the Mpox response to identifying the actions that districts and national partners can take before the next outbreak. By validating the findings with stakeholders who led and experienced the response, we are ensuring that the evidence reflects local realities and can inform stronger surveillance, risk communication, coordination and community engagement,” said Mr. Bulafu, who led the MakSPH team during the dissemination meeting in Amuru.
Mr. Douglas Bulafu engages participants during the Mpox response study dissemination meeting in Amuru District on 10 August 2026.
In Amuru, the 10 August meeting brought together over 25 stakeholders from the district health team, political leadership, security agencies, Village Health Teams, implementing partners and the community. On the same day, a second MakSPH team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, convened stakeholders in Kasese for a parallel validation meeting. The consultations then continued in Nakasongola on 12 August and concluded in Mayuge on 14 August, extending the study’s engagement across all four districts.
Across the districts, stakeholders said the results reflected their experience during the outbreak. They pointed to strengths in leadership, coordination, community engagement and partner support, while also describing gaps in documentation, logistics, diagnostic access, staffing, risk communication, public trust and continuity of essential health services.
They also noted inconsistent implementation of the World Health Organization (WHO) 7-1-7 target, which calls for detecting a suspected outbreak within seven days, notifying public health authorities within one day and completing early response actions within seven days.
The MakSPH research team, led by Mr. Keneth Sebukeera and Mr. Filimin Niyongabo, with participants during the Mpox response study dissemination meeting in Kasese District on 10 August 2026.
In Kasese, stakeholders highlighted gaps in documentation, financial and logistical resources, and human resources. They identified Village Health Teams and grassroots, religious and cultural leaders as important resources for community surveillance and risk communication. They called for stronger collaboration between technical and non-technical leaders, engagement with traditional healers, greater use of local radio for public sensitisation, and better facilitation of district epidemic response teams to reach distant communities.
Amuru participants called for proactive preparedness in the border district, citing misinformation and rumours as barriers to risk communication. They urged timely, accurate information from health workers and other authorities; training in disease surveillance and grant writing to strengthen capacity and resource mobilisation; and compassionate care, psychosocial support and community awareness to reduce stigma and support survivor reintegration.
During the meeting in Nakasongola, stakeholders identified Community Health Workers and Community Health Extension Workers as potential resources for strengthening community surveillance and addressing workforce shortages. Given the district’s position around Lake Kyoga and along the Kampala-South Sudan transit corridor, they also called for stronger documentation, note-taking and reporting, accurate real-time information, closer communication with the Ministry of Health, and collaboration among technical, political, religious and community leaders.
Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, contributes to the discussion during the Mpox response study dissemination meeting in Nakasongola District on 12 August 2026.
Ms. Eunice Vivian Asingo, Senior Nursing Officer at Nakasongola Health Centre IV, called for a permanent, adequately resourced outbreak-management centre to help protect routine services during future epidemics. “We appeal for better facilities to manage epidemics and outbreaks. At Nakasongola Health Centre IV, spaces previously used for outbreak management have been repurposed for other services, and we have limited staff. During the Mpox response, colleagues assigned to manage patients later returned to the general team, creating fear among staff already under pressure,” she said.
In Mayuge, Dr. Basembeza highlighted leadership, coordination and surveillance structures operating from district to community level as important factors in the response. He said the structures enabled the district to receive and respond quickly to community alerts. “Whenever there is a rumour or an alert, we are able to respond. Within 20 minutes, we had a response because of the structure we have,” Dr. Basembeza said.
Based on the findings, the research team recommends increased preparedness financing, stronger community engagement, decentralised diagnostic services through stronger district laboratory capacity, and improved health information and research systems.
Across the four districts, stakeholders reaffirmed that trusted community structures and coordinated action across sectors are essential to strengthening outbreak preparedness.
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