A qualitative study of Ebola survivors' psychological experiences of evacuation, treatment and community reintegration: Lessons in holistic person-centred care from the 2022 outbreak in Uganda.

The Ebola Virus Disease (EVD) is associated with significant mental health and psychosocial problems among patients/survivors. Effective strategies for addressing these problems necessitate an in-depth understanding of the sociocultural, economic and political context of the outbreaks, and survivors' own experiences of the disease. Yet, such context and survivors' experiences remain inadequately understood. We explore the pre- and post-diagnosis/treatment and post-recovery experiences of survivors of the 2022 EVD outbreak in Mubende District (Uganda) and draw lessons for better management of future outbreaks. A qualitative study was undertaken in Mubende District to explore the lived experiences of various categories of persons affected by the outbreak. Participants were sampled purposively. In-depth interviews were held with 15 EVD survivors. A thematic analysis of data was done. Our findings reveal that across the entire spectrum of their encounter with EVD, patients had a range of overwhelmingly stressful experiences that, according to the participants, took a toll on their mental health. These included stigma during evacuation and on return to their communities upon discharge, perceived inhuman treatment from health workers, lack of epidemic preparedness at the EVD facilities, witnessing frequent EVD deaths due to the EVD Treatment Unit's open/unpartitioned ward, delayed removal of dead bodies from the shared ward, systemic lapses in health services and EVD-induced livelihoods challenges. In conclusion, EVD patients'/survivors' experiences across the entire spectrum of their illness - from the period before diagnosis to their treatment at the EVD Treatment Unit and, later, their re-integration into their communities - are characterised with high levels of unattended, self-reported psychological distress. We propose a holistic person-centred approach to healthcare for EVD suspects, confirmed cases and survivors. Additionally, EVD education and sensitisation programs need to target health workers, among other population groups.