As the dust settled at the end of a long August day, Dr. Achan sat at her desk in the Moroto District Health Office, the screen of her laptop glowing in the twilight. The latest edition of the “KARAMOJA PUBLIC HEALTH EMERGENCY OPERATIONS CENTRE WEEKLY EPIDEMIOLOGICAL BULLETIN” had just arrived. For her, this wasn’t just a report; it was the region’s pulse, a story told in numbers, and she was one of its authors.
The email subject line was simple: “Week 35: 25th – 31st August 2025”. Achan took a deep breath and opened the attachment. The key highlights jumped out at her immediately. Relief washed over her as she read, “0 Maternal deaths reported in the region” and “0 Malaria-related deaths reported”. These zeros were victories, hard-won battles in the clinics and communities.
But the relief was tempered by other figures: “5 Perinatal deaths reported” and, closer to home, “48 Animal bites reported the highest burden in Moroto and Kotido”. Achan made a mental note. The recommendation was clear: “All district One Health Teams to ensure animal bites are fully investigated”. That would be a priority for tomorrow’s meeting.
She scrolled down to the section on epidemic-prone diseases. The list was a familiar adversary: 4 cases of measles, 124 of typhoid fever, and 82 of brucellosis. Her own district, Moroto, had reported 12 cases of Hepatitis B and a worrying case of Bacterial Meningitis. These numbers weren’t abstract; they were people—neighbors, children, and elders—relying on a system that was stretched thin but holding.
The biggest challenge this week was malaria. The numbers on the screen confirmed the anxious reports she’d been hearing from the field clinics. The bulletin stated there was “a sudden increase in malaria cases from 11,210 in Week 34 to 13,052 in Week 35, 2025”. The graph showed a sharp upward spike, with the report noting that “week 31, 34-35 cases are seen beyond the upper limit, which indicates a malaria surge, and this calls for proper intervention in the region”. The ongoing distribution of mosquito nets and anti-malaria drugs was holding the line against fatalities, but the surge was a powerful reminder of how quickly things could escalate.
Achan then turned to the section on reporting, a constant source of professional pride and frustration. While overall reporting completeness was high, the bulletin gently chided that “more emphasis needed on improving the timeliness of report submissions by the district biostatisticians”. Her own district, Moroto, was listed among those needing to “conduct targeted follow-ups with the health facilities contributing to the delayed submission of reports”. She knew the excuses—spotty internet, overworked staff—but she also knew that delayed data could cost lives.
Yet, there were signs of resilience everywhere in the report. She remembered the fear when the “Mpox outbreak in Moroto District was confirmed on 1st April 2025”. It had tested their response systems to the limit. But the team had pulled together, implementing everything from “Active case search” to “Community awareness including Schools and churches”. Reading that “The last active Mpox case was discharged on 2nd May 2025” still filled her with a profound sense of accomplishment. They had faced it down.
Looking at the immunization data, Achan saw a “mixed picture”. Some districts were posting coverage over 100%, suggesting data entry issues, while others lagged far behind. The recommendation to “Target support to low-performing districts” was a call to action for the entire regional team.
Closing the file, Achan stared out the window. The Karamoja Cultural Festival was ongoing in Nakapiripirit, a vibrant celebration of life that seemed a world away from her charts and tables. But she knew they were connected. Her work, and the work of hundreds of others documented in this bulletin, was dedicated to ensuring there were more lives to celebrate, more children growing up healthy, and more seasons of joy.
The bulletin was their weekly promise to the people of Karamoja: we are watching, we are working, and we will not give up.
