A plan for a Health Scheme that enables all members of the community in Bwindi
to access sustainable and quality health services.
The Challenge of Sustainable Health Care in Bwindi
How do poor people living in rural Africa afford the quality of health care that they need?
They cannot rely on Government. By the time cash trickles down from the capital city much of it has been ‘lost’. Bwindi Community Hospital receives less than 1% of its funding from Government.
They cannot afford a fee for service. User fees force payment upon those who are least able to afford to pay hospital bills, leading to catastrophic health expenditure when people have to sell assets, such as land or animals, to pay for treatment.
They cannot rely on donors forever, as support will eventually dry up leaving the community with no health care.
eQuality Health – the solution
International Medical Foundation is working with Bwindi Community Hospital to design, implement and manage a sustainable solution to the funding of health services in Bwindi (SW Uganda). We are starting a Health Scheme called eQuality Health Bwindi.
All members of the Bwindi community have the chance to ‘subscribe’ to this scheme by making a single annual payment of UGX 6000 (£2) per person which entitles them to use Hospital Outpatient and Inpatient services including investigations, drugs and even operations at a cost of only UGX 1000 (30p) per visit. This scheme enables people to pay for health care collectively and in advance, instead of waiting until they become sick and fearing the cost of care. It protects the poor, and enables them to have some control over their health care. It also maintains high quality services for the people of the Bwindi area for the future.
eQuality Health Bwindi already has 30,000 community members who have shown an interest in the Scheme. This is a very poor region and our initial research has indicated that each member can only afford £2. Bwindi Community Hospital has estimated that the cost of care will be at least £4 and so we need to work together with sponsors and supporters of Suubi Trust to help meet the difference.
This year IMF has agreed to work with Bwindi Community Hospital to launch a new community based healthcare scheme, eQuality Health Bwindi.
We are very impressed by the great work being done at BCH by Dr. Paul Williams and his team. We also note the exceptional levels of transparency and accountability that they give to their partners and supporters. The following video is a recent update for Eurochange Charity which has been supporting CHAP (Child Health Access Programme); an initiative providing free quality healthcare to all of the local children under 5 years of age.
CHAP is a forerunner of what we are hoping to achieve with eQuality Health; we will post more about this in the days to come. In the meantime you can read more by visiting http://www.bwindihospital.com/e-Quality%20Health.html
Amina was brought to Hope Ward by a wonderful lady who was on a VSO placement in Masindi. She had served so many ladies as a Traditional Birth Attendant in her community. However a motorcycle accident left her relying heavily on a pair of crutches unable to bear weight at all on her broken leg.
Amina came to us eight months after her accident; she had spent 5 of those months in a plaster without much improvement and little hope. Amina spent only five days on Hope Ward, had surgery and within less than a week after she was discharged she could bear weight and had improved remarkably!
Click here to download the latest Hope Ward Newsletter which has some recent patient stories.
Hope Ward is the charity ward at International Hospital Kampala (IHK). It was first opened in April 2006. Almost four years later the ward has a 17 bed capacity and hosts a Cancer Treatment unit. Half the ward is set aside for children and the other half is divided into Male and Female sections with one isolation room.
IHK provides the Ward space, facilities and utilities for Hope Ward free of charge and in addition subsidises all Hope Ward bills by at least 30%, thus charging only marginal cost on all Hope Ward patient treatments.
The Overall Aim of Hope Ward is to:
Cater for the underprivileged in need of high quality complex treatment, who would otherwise not afford this much needed and often life saving care. We intend to do what we can to alleviate the suffering and improve the quantity and quality of life of our patients.
In 2009 there were 248 admissions on Hope Ward with a total of 2,437 bed nights; 93 were children no older than 10 yrs and of the adult admissions 79% were women.
The total amount spent on patient treatments, Hope Ward staff salaries, specialist fees, as well as transport and other assistance given to very needy patients was UGX 499m (£160,000). Hope Ward sponsorships covered 36% of these costs, the rest (£100,000) was paid by International Hospital Kampala.
Please help if you can by donating online, click the Justgiving image below.
Last year there were almost 250 patients cared for on Hope Ward. I am always inspired when I read the patient stories and I wanted to share this one in particular; in summary Mubiru’s story is:
Abused by his grandmother at age 12, locked in a metal box,
Rescued by his neighbours,
Thought to be dying, handed over to a hospice,
Brought by the hospice nurse to Hope Ward, unable to move, talk or look after himself,
After very many months of loving care and treatment now looking for a new home and a new start.
Mubiru Lwasa is a young 12 year old boy who has suffered a great deal. Mubiru has never really had a place to call home. His mother and father are separated and have moved on to marry other partners and have other children. He lived with his mother for several years and she took him to primary school however he fell sick and she took him back to his father. At this point she had five children with her current husband (not Mubiru’s father) and she could not continue to care for him. This would mark the beginning of a long period of suffering and abuse in Mubiru’s life.
Mubiru was taken out of school and did hard labour for his grandmother and at some point was beaten so badly that his hand and leg were fractured. He was locked up in a metallic box and starved almost to the point of death. When Mubiru’s father noticed that his son was dying, he took him back to his village in Mpigi for fear of the cost of transporting a dead body.
When Mubiru’s father arrived in Mpigi the people in his village were shocked by the site of the boy’s emaciated body. The villagers refused to let Mubiru’s father rest until he had taken him to hospital. On arrival at Mulago hospital the nurses and others who saw Mubiru’s father carry his crippled smelly body into the hospital were so outraged they wanted to lynch him. Mubiru’s father was then ‘rescued’ by the police and taken to Luzira prison.
However now that Mubiru’s father was taken away there was no one left to take care of Mubiru while he was at Mulago. Fortunately a kind Ugandan lady (Mable) had compassion on him and chose to look after him, though she did not really have much to offer him but loving care.
Medical personnel at Mulago thought Mubiru was dying and contacted a nurse who works for Hospice Uganda. This lady contacted Hope Ward and asked us to admit him for treatment as she did not think he was terminally ill.
When Mubiru first arrived at Hope Ward, he was in very bad shape. He had sores and wounds all over his body. He could barely support himself in the wheelchair and the slightest movement would make him scream. Mubiru could neither talk nor feed himself, he was incontinent, he was very pale and the hair on his head was so thin, his lips were pale dry and chapped, he looked like a patient with full blown AIDS.
Andrew was brought to Retrak from the International Hospital Kampala (IHK). A week earlier Andrew had been found lying half dead along Kampala’s railway line, a train had hit his left leg and crushed it. The medical staff at IHK were wondering how he could be hit by a train when Andrew began to convulse from fits. It was established that Andrew suffered from epilepsy and must have been crossing the railway when he suffered an epileptic attack. Andrew received excellent care at IHK, but nevertheless needed to have his left leg amputated. Following his operation Andrew could not believe he had only one leg and found it hard physically to adjust his movement and coordination accordingly. It was clear he would need both psychological and physical therapy.
Not knowing his background, IHK referred Andrew to Retrak where social workers and the project nurse provided him with support, counselling and a stable, loving environment. Over time this care enabled him to accept his medical condition, make friends and gain confidence in participating in educational and sporting activities. The Retrak nurse was able to identify a neuro- paediatrician who was able to treat Andrew’s epilepsy and slowly his fits reduced and became manageable.
Following his recovery Andrew felt ready to return home to his family. Retrak staff were still somewhat unclear as to how Andrew ended up on the streets but with him so keen to return home, they set off cautiously to try to resettle him in Lugazi with his family. In Lugazi, nobody there could believe that he had returned and Andrew was so happy, shouting and calling to his siblings “I am back!” Immediately, everyone began celebrating his return, and he is now happy living at home with all his extended family.
*Children’s names have been changed and they are all happy for us to share their story with you
Hope Ward Cancer Care is one of our prime areas of focus this year. You can read below some of our patient stories, click here for a full listing.
Your support is making such a difference.
Dr. Helena and the Oncology Nursing team Aisha, Joshi, Irene and Maria wish to thank all of our sponsors for their generosity and help. Quite simply each gift means life or a better quality of life for each cancer sufferer and helps to relieve, often immeasurable, suffering.
Thank you also to all those who partner with us and facilitate each person’s care. Rapid appropriate referrals have and will continue to save lives.
Hospice Africa, who do a great job in finding desperate patients who need oncology support – we currently have 7 patients referred on treatment
Bless a Child Foundation who partner with us at every level of cancer prevention, treatment and palliative support
Softpower Jinja who kindly assist with treatment and transport – for 3 children at present
Corsu – for additional surgical support
Dr. Richard Bogle for his generous gifts of support
We set ourselves a target to raise £25,000 in 2010; to date our total raised is £7,796, which is a great start but we have some way to go… please help, you can give online now by clicking here.
We had this comment recently from Jennifer, one of our volunteers last year:
I have only recently discovered this sad news. I would like to thank all that have donated time and money to the Suubi Trust, International Hospital Kampala, and those at Hope Ward that took great care of him during the year of his life that he spent there. Whilst I was there I saw him going from being a very sick little boy to a smiling, happy one, playing with some of his new toys.
Please continue to support Suubi Trust so it can continue to help more of those with serious illness without the means to help themselves.
Enock broke the nation’s heart when he passed away. He was already ”famous’ when he first came to Hope Ward Cancer Clinic having been interviewed and discussed on many national TV and newspaper communications.
FROM: THE DAILY MONITOR UGANDA’S NATIONAL NEWSPAPER
The major deaths of 2009
November 4: Enock Ssebanga, Uganda’s poster-child for torture, succumbs to leukaemia at 21 years. His parents; Mr Charles Kayongo and Ms Regina Nabakoza, who locked and starved him for days in an abandoned store, are out after serving their jail sentences. The Monitor’s August 7, 2000 cover picture of Ssebanga’s scraggy body is a rude reminder of sorts about ongoing parental wickedness in our society.
Enock had advanced disease and sadly died within a year of receiving 6 months of chemotherapy at Hope Ward Cancer Clinic. Dr Helena relates that towards the end, Enock knew he was fading and tried to make his peace with his past and forgive the things that had happened to him.
A plan for a Health Scheme that enables all members of the community in Bwindi
