The Double Burden of Ebola and COVID-19 Viral Infections and the Readiness for Safe Surgical Care Provision in Uganda and the Eastern Democratic Republic of the Congo: an Online Cross-sectional Survey

Objective: This study aimed at highlighting the extent to which Uganda and the Eastern DR Congo are ready for safe surgical care provision during the double burden of Ebola and COVID-19. Methods: An online cross-sectional study was conducted in selected National, Regional Referral and General Hospital facilities of Uganda and in the Eastern part of D.R. Congo from 1st August 2020 to 30 October 2020. Data was analysed using Stata version 14.2. Results: A participation rate of 37.5% for both countries (72/192). The mean bed capacity of participating health facilities (HF) was 184 in Eastern DR. Congo and 274 in Uganda with an average surgical ward bed capacity of 22.3% (41/184) of the beds in the DR. Congo and 20.4% (56/274) in Uganda. The mean number of operating rooms was 2 and 3 in Eastern DR. Congo and Uganda respectively. Nine hospitals (12.5%) reported being able to test for Ebola and 25 (34.7%) being able to test for COVID-19. Only 7 (9.7%) hospitals reported having a specific operating room for suspect or confirmed cases of Ebola or COVID-19. Provision of appropriate Personal Protection Equipment to personnel were reported to be available in 60 (83.3%) hospitals. The mean of readiness score for provision of surgical care was 7.8/16 (SD: 2.3) or 60% in both countries with no statistical significance in multiple linear regression analysis (p>0.05). Conclusion: The majority of participating hospitals in both countries had a low level of readiness to provide safe surgical care due to lack of supplies to limit the exposure of Healthcare workers (HCW) to Ebola and Covid-19 viral infections, and poor funding. Governments and non-governmental organizations should work together to enhance health facility supplies and readiness for safe surgical provision in resource-limited settings.