How Tanzanian helped stop Marburg in its tracks

AT the Africa Health Agenda International Conference (AHAIC) 2025 in Kigali, the spotlight turned towards a quiet heroine from a remote corner of Tanzania.

As applause rippled through the auditorium, Vedastina Shumbusho, a 37-year-old Community Health Worker (CHW) from Nyakalima village in Bukoba District, stepped forward to receive the Women in Global Health Africa Award.

Her story, which began in the silent hours of a March night two years ago, had travelled far just as the disease she helped stop might have done, had she not acted with speed and clarity.

The award was a tribute to her swift and courageous action in March 2023, when she reported a cluster of mysterious deaths in her community through Tanzania’s electronic Event-Based Surveillance (eEBS) system.

Her report led to the rapid detection and containment of a deadly Marburg virus outbreak, a disease known for its high fatality rate and devastating potential. Her intervention is credited with saving countless lives, not just in her village, but potentially across the region.

Yet, as she stood on stage, Vedastina remained modest. Her message to delegates was simple but urgent: “We are the eyes and ears of our communities. If we ignore what we hear today, we may lose thousands tomorrow.” It was a message she had lived beginning in the early hours of March 16th, 2023, when, at 3:00 am, she filed a digital report that would change the trajectory of the outbreak.

The alert detailed unusual symptoms fever, weakness, internal bleeding and multiple unexplained deaths in a nearby household. It was more than just a report; it was a signal that something serious was unfolding in the hills of Kagera Region, bordering Uganda.

ALSO READ: EU envoys praise Kilimanjaro project impact

In this rural region, where access to healthcare is limited and mobility is high due to cross-border trade, the ability to detect outbreaks early is critical. And that ability depends, in large part, on frontline workers like Vedastina. Her decision to report the cluster wasn’t driven by panic but by trained observation.

Having been trained in 2021 under a programme implemented by Amref Health Africa in Tanzania and the Ministry of Health, with support from the US CDC Tanzania through the Global Health Security Agenda (GHSA), Vedastina was one of nearly 250 CHWs equipped with the tools and knowledge to spot health threats before they spiral.

In late 2022, she received further training in eEBS reporting and was provided with a smartphone loaded with a structured reporting app. What followed that night was a textbook case of early warning systems in action. Her eEBS alert triggered immediate scrutiny by district and national health teams.

The Ministry of Health deployed a Rapid Response Task Force and within days, laboratory testing confirmed the presence of Marburg Virus Disease.

Thanks to early detection, swift coordination and timely isolation measures, a full-scale outbreak was averted. By June 2nd, 2023, Tanzania officially declared the end of the outbreak. But this successful intervention did not begin with a smartphone. It began with community trust.

In rural Tanzania, CHWs are far more than health educators, they are neighbours, friends and often the most reliable point of contact between households and the healthcare system. Over the years, Vedastina had earned the trust of her community through consistent home visits, quiet listening and deep respect for cultural norms.

In areas such as Karagama and Kayanjeru, CHWs are known for their discretion and empathy qualities that allow them to uncover the stories people are often reluctant to share.

When the first Marburg cases appeared beginning with a 30-year-old man who died shortly after arriving at Maruku Dispensary there were no immediate alarms. But when more of his relatives began to fall ill and die and when a healthcare worker also succumbed, concern grew.

A motorcycle taxi driver, who had transported some of the sick, began to speak to locals and leaders about the strange symptoms. It was through this informal network that the information reached Vedastina via a WhatsApp group specifically created for CHWs and their supervisors to share unusual events in real time.

What set her apart was not just her access to this information, but her ability to recognise its epidemiological significance. Her training enabled her to distinguish normal seasonal illness from a potential public health emergency. She took nothing for granted. She verified details, cross-checked symptoms and submitted a report that was both timely and thorough.

“In our community, people speak in codes symptoms are sometimes described with metaphors and illness is often hidden due to fear or stigma,” Vedastina reflected at the conference.

“But because they trust me, they speak. And when they speak, I listen not just with my ears, but with what I know.” Her contribution not only prevented a crisis but demonstrated the transformative power of community-based surveillance.

The eEBS system she used is part of a broader effort by the Tanzanian government to digitise disease detection, especially in high-risk areas like Kagera.

Through the GHSA project (Sept 2020–Sept 2025), more than 500 CHWs have been trained and equipped to report health events using mobile technology, backed by mentorship and supervision.

“eEBS is revolutionising the way we detect and respond to disease threats,” said Lusungu Ngailo, Project Manager at Amref Tanzania.

“Vedastina’s case is proof that with the right tools, local knowledge becomes national intelligence.” Her story has since been incorporated into national health training modules and has inspired efforts to strengthen community surveillance systems across East Africa.

More importantly, it has highlighted the often invisible yet irreplaceable role of women at the frontline of global health. Receiving her award in Kigali, Vedastina stood not just for herself, but for thousands of CHWs across the continent who do the difficult, unglamorous and essential work of safeguarding public health.

Back home in Nyakalima, she has returned to her usual routine: Visiting families, monitoring pregnancies, checking on children and listening carefully to the quiet signs of change. For her, the work continues not for recognition, but because her community depends on it.

“We are not just health workers,” she said. “We are protectors of tomorrow.” In that truth lies the legacy of her 3am alert a single act of vigilance that rippled far beyond her village, into regional strategy, national policy and now, continental recognition.