Harnessing Local Resources to Build Health System Resilience in Amuru District

 

When cholera erupted in Lorikowo West Village on July 2, 2025, Amuru District once again found itself confronting a familiar and exhausting pattern. Positioned along the porous Uganda–South Sudan border and surrounded by refugee-hosting districts such as Lamwo and Adjumani, Amuru has long been vulnerable to emerging and re-emerging disease outbreaks. 

In 2025 alone, the district suffered three separate outbreaks, mpox, cholera and measles, each testing the limits of an already strained health system.

These recurring emergencies came at a time when global health funding is shrinking. Amuru, like many districts in Uganda, has heavily depended on external support from partners. By mid-2025, however, reduced financing made it increasingly difficult for the district to sustain strong epidemic preparedness, maintain surveillance, or deliver essential health system-strengthening interventions.

But amid the confusion and resource shortages that marked the early days of the cholera outbreak, an unexpected solution emerged from within the community itself.

A group of retired public health experts, sons of the soil with decades of national and international experience, approached the WHO Field Coordinator for Northern Uganda with an offer to help. They requested only one thing: permission to serve.
After consultations with the Resident District Commissioner, who chairs the District Task Force, and with the leadership of the Acholi Regional Public Health Emergency Operation Center, the volunteers were cleared to join the response. Their return to the frontlines was met with relief, gratitude, and renewed hope.

Dr Jackson Amone, former Commissioner for Clinical Services at the Ministry of Health and a veteran of multiple Ebola responses across Africa, described their motivation simply: “We wanted to give back to the community that fed, educated and nurtured us.” His words carried weight not just for what they meant, but for who he was, a respected Acholi son returning home in a moment of need.

For another volunteer, Dr Bob Malley Omaya, the decision was deeply personal. “I was born, raised and studied in Atiak, only six kilometres from the cholera epicentre at Elegu border. This is my community; I don’t need money to serve them,” he said, reflecting on the end of his professional contract with WHO Uganda due to funding constraints. “Maybe this is the time God wants me to serve them.”

The team of retirees offered their expertise across surveillance, laboratory support, coordination and leadership, case management, infection prevention and control, water supply, sanitation, hygiene, risk communication and community engagement. Their intervention was critical. Through their guidance, mentorship, and hands-on support, the cholera outbreak was contained swiftly and remarkably without a single fatality.

Their presence reinvigorated frontline health workers, many of whom had been overwhelmed by the relentless pace of outbreaks and chronic under-resourcing. At Bibia Health Centre III, one of the major cholera treatment hubs, the arrival of the volunteers transformed the mood entirely.

“I was fatigued as the Head of Case Management because the challenges were overwhelming,” recalled Milton Okello. “But when Dr Amone came, I got fired up like I was possessed with the Holy Spirit. His warmth and fatherly advice changed the attitude of the whole team positively.”

Beyond managing the immediate outbreak, the volunteers helped strengthen coordination, leadership and governance within the district’s Rapid Response Team. Their involvement demonstrated a powerful and sustainable model for boosting local health security by tapping the skills and goodwill of retired professionals who remain committed to their communities.

The experience in Amuru provides important lessons for the Government of Uganda and other low  and middle-income countries. The Ministry of Health could develop a database of retired health workers willing to serve in emergencies, ensuring that local expertise is quickly mobilized when needed. Other ministries and agencies could adopt similar approaches to bolster service delivery and address broader social determinants of health.

As the global funding landscape continues to shift, Amuru District’s story illustrates a compelling truth: resilience can grow from within. By harnessing the passion and knowledge of experienced local professionals, communities can protect themselves, strengthen health systems, and safeguard futures, even in the face of uncertainty.

Distributed by APO Group on behalf of World Health Organization – Uganda.