Dr. Richard posted the following update about his work at our health centre in Lira, north Uganda. We are working here in collaboration with Charis and Fields of Life. You can read Richard’s Blog here.
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Half way through our time now so back to Kampala for debrief.
We prepared a list of areas we need to change to achieve our aims. Some require lots of investment and a discussion as to whether its reasonable to provide the service or not. Some are smaller and relate to training, decor of the centre,use of space, HR issues etc.
Very positive discussions all day. We have a really good team at IHK to support us. Kevin (the CEO) and Dr Andrew started us off in the morning with positive support for our big ideas. Some will require investment from Fields of Life, and hopefully they will agree as they too want affordable care at HC4 level.
Health Centre Level four
Population served 50,000-100,000
The average district has 4-7 level four facilities
In addition to services provided at level three there will be a working operating theatre with twenty four hour C section capability for emergency Caesars.*
Ultrasound should be available with a qualified technician*
Maternal waiting homes are found at this level in some countries and patients may be fed from hospital kitchens. In Uganda the guardian system is operated and relatives have to feed the patients.
Outreach activities by other agencies are often available at these facilities such as tubal ligations by MSI and VVF camps by AMREF.*
Other expected services at level fours:
• Basic dentistry by dental technicians
• DOTS for TB and HAART programmes for HIV*
• Laboratory facilities with a lab technician
• Pharmacy and supply chain to distribute pharmaceuticals and supplies to level three and level two health centers
Staff at level four:
• Qualified doctor in Uganda or in other countries specialist clinical officers
• Clinical officers
• Nurse anaesthetist*
• Midwives
• Nurses
• Laboratory staff
• Pharmacist*
• Nursing aids
An ambulance should be available for referring patients to the district hospital.*
We would really be the only HC4 in Lira municipality(population in the district is 750,000!).There is a referral government hospital but it is overwhemed and serves a population of about 2 million with only 254 beds and skeleton staffing. Other smaller NGO and private health centres but a major problem is staffing and keeping good people, especially doctors and sadly the turnover and often the lack of doctors limits the health service ‘up country’. We will plan to rotate doctors to Lira from Kampala and incentivise them to stay
So, as a result of our discussions, we have ironed the more straight forward issues and agreed that with the Fields of Life support we will provide all the services on this list. Some like our dental services, we can move forward now and some like the Theatre and surgery will take longer. Not too long though, as building in Uganda happens very quickly….planning permission etc what’s that?
Back to Lira today and start to plan the outreach services and o some training.
