About 3 years ago I sat with another good friend, Dr. Ian Clarke, and we talked about the 5 year plan that we had developed for his organisation in Uganda, International Medical Group. I’ve known Ian since 1979 when he was my landlord in a student house in Belfast. In the mid-eighties I was at the church meeting in Bangor when the congregation prayed blessings on him and his family as they made their way out to Uganda to start a hospital in the bush (which became Kiwoko Hospital), in the middle of the Luwero Triangle which was only just beginning to recover from the Amin madness.

Now some 23 years later we were sat in a hotel in Kampala and having discussed the IMG 5 year plan, I was telling him of my mad idea that I wanted to come out to Uganda and work with him to make it happen. With the gracious acceptance by Pamela and our children, I started my full-time role as MD of the group, soon to be the CEO, in May 2009.

An essential element of that 5 year plan was to bring on board equity investors who could provide the capital and expertise that would help us to achieve our shared vision. I don’t really know what I thought I was coming to, somewhere in the back of my mind I thought that this would be a great way to give something back and to make a difference in the lives of those that had less than we were used to in the UK; how wrong, or at least naive, was that, International Development and Public Health is much more complex, certainly less black and white (no apology) than that.

In the early part of 2009 we were made an offer by a leading private equity firm operating in East Africa, which had a special interest in Healthcare. The offer was just far too low and came with too many conditions, so we rejected it and then continued to manage IMG for the next two and a half years, not being able to fully move forward with our capital expansion plans and every day needing to consider careful management of cash-flow (a bit like most businesses in the UK today). Managing a business in the developing world is, in my experience, no different from managing one in the UK; it is always about MONEY and PEOPLE.

International Medical Group employs more than 750 staff, constitutes probably the best private hospital in Uganda (IHK), 10 primary care health centres (IMC) (GP surgeries) and provides pre-paid health plans (IAA) for 41,000 members. We serve more than 250,000 patient visits each year. We have an NGO, IMF, that provides essential basic healthcare to the poor, with a special focus on community based reproductive health services. We also have a health sciences university, IHSU, which today had its 2^nd graduation ceremony and is training more than 850 students of nursing, health management and public health.

In its first 10 years Dr. Ian and the team had continued to grow and extend the services of IMG from whatever surpluses they could make from the revenue being generated. This had worked very well in the early years but now we had reached a stage of our corporate development when we needed a much more significant injection of capital.

It seems that for most of 2011 I’ve been working on the 5 year Business Plan, re-working the financials, the cost-benefits and selling our potential. Early in 2011 we had 2 serious equity investment offers, both of which were definitely of interest, but we had to chose just one and after a very intense 6 months of due diligence, it is just so great to have finally closed and to have executed a deal. We now have new private equity investors, with a capital investment that will enable us to start moving forward with our development plans. Just as importantly, these new shareholders will also bring essential corporate and medical experience and a link into the largest healthcare group in India. Now we can we start the next phase of the 5 year plan. So we have definitely reached the “end of the beginning”.

On a personal note, I need to now spend the next week being a student at IHSU and do my last 4 exams and start my thesis for my MPH, that too has taken more than 2 years.

International Medical Foundation and supporters such as Suubi Trust now have a fantastic opportunity to work with the Mayor and the Ministry of Health to help bring quality health services to a local population of more than 500,000. Our initial focus will be on services for mother and baby.

Ian’s first post starts this discussion…

  Makindye Division has 330,000 voters on the voters register. If we consider this number to be inflated by as much as one hundred thousand, this still gives a voter population of 230,000 people. Since we know that this represents less than 50% of the population (as under 15 year olds now represent more than 50%) then we estimate the population of Makindye to be in excess of 500,000 people. Demographically Makindye is divided into slum dwell … Read More

via Makindye Division Chairman

Armagh doctor, #Busuulwa, wins local election in #Kampala suburb – The Irish Times – Fri, Mar 04, 2011 http://bit.ly/fdoo4b—
Kevin Duffy (@KevinDTweets) March 05, 2011

An Outsider, Ian Clarke, Dives Into Uganda Politics: IMO one of the better press articles – NYTimes.com http://nyti.ms/dOEZTj #Busuulwa—
Kevin Duffy (@KevinDTweets) March 05, 2011

Footage from Saturday’s Mad, Bum Numbing, exhausting, immensely fun campaign ride throughout Makindye. Londa owa’ Kagaali!

Dr Ian Clarke aka Busuulwa, probably the worlds only Irish Ugandan, is running for LC3 in the district of Makindye. He chose the bicycle as his electoral symbol, as it is a dynamic symbol of development, being the primary mode of transport when he arrived in Uganda, just as the country was emerging from civil war. As a final campaign push we took our bicycles out into the streets of Makindye, bruising our backsides over the potholes he intends to fix once elected. It was immense fun, if exhausting. The vote is Wednesday 2nd March. VOTE FOR THE BICYCLE!

I thought this entry deserved both of these photos; one to show how it all began with Dr. Ian treating patients on the floor in Kiwoko and the second because I just had to show those legs and the shorts. When I first met Ian in Bangor in the early 80s I can assure you that he didn’t dress like this for his GP surgery.

What we do today at International Medical Group, all the people’s lives that are touched and changed for the better, and by that I mean staff and their dependents as well as the patients, all of that is possible because of this man’s vision, his heart for the people and his tremendous drive and passion to make things happen; to make a difference.

Ian has just published his second book “How Deep is this Pothole?”.

The Hon. Judge Julia Sebutinde – International Judge on the war-crimes Special Court for Sierra Leone, at The Hague, Netherlands writes:

‘An inspiring story of vision, entrepreneurship and adventure. In a country that many would write off as a basket case, Clarke shifts paradigms and pushes boundaries, investing in the lives of the disadvantaged and war-ravaged, restoring dignity and bringing hope. In a combination of resourcefulness and what he describes, paradoxically, as “commonsense decisions”, Clarke turns a dream into reality in the field of healthcare in his adoptive home, Uganda, A must-read.’

You can get your own copy from this link

This latest image on Google Earth shows how the hospital site is looking in 2010. Developments in the last 12 months include the new staff car park and the sales and marketing offices at the back of IHK (on the left side of the photo). Also the new office block used by Physio, the Chairman and the CEO shows as the white building in the centre of the image. 12 months ago that was just 2, 40-foot containers, one on top of the other. Moving non-clinical staff out of the main hospital building enables us to continue expanding the number of patient beds and consultation rooms.

These satellite images taken over the last 10 years show progress from what was just an empty field to a 110 bed hospital, many out-patient departments, a large pharmacy and 3 labs, serving 100,000 patient visits each year and of course the university on the top floor.

Well done Dr. Ian.

International Hospital Kampala (IHK) makes 10 years on December 8^th 2010 since its official opening by the ex-Prime Minister, Professor Apollo Nsibambi in Old Kampala in 2000. IHK moved to its purpose-built facilities in Namuwongo in 2005 and in 2006 it launched its charity ward Hope Ward.

The Concert for Hope is presented by IHK with Qwela Band in Victoria Hall, Serena Hotel on Thursday, November 18^th 2010 at 6 p.m. and the proceeds from this event will go to the treatment of cancer patients at IHK’s Hope Ward.

IHK’s story cannot be told without going back to its inception. In 1987, Dr. Ian Clarke came to post-war Luweero as a missionary and from small beginnings, where he treated patients under a tree, he founded Kiwoko Hospital. He suffered from cancer himself, but after Kiwoko he came to Kampala in 1996 and started again, this time a private clinic, International Medical Centre (IMC). By 2000, IMC had grown to include a small hospital in Old Kampala, the first International Hospital Kampala. By 2003, IAA Healthcare had been registered and by 2005 the new IHK had been built. In 2007, International Medical Foundation (IMF), through which Hope Ward’s charity work and other community activities are funded, was commenced and in 2008 International Health Sciences University (IHSU) was founded.

The journey which started with a clinic under a tree in a post-war area resulted in two hospitals and several medical organizations employing almost 1000 people. This is not a story involving just one man, but of someone who at first found a few people who were willing to join him in his vision, but then there were more and more, until there was a great throng of Ugandans – making a difference and building hope.

The Concert for Hope resonates IHK’s strong belief that sustainable solutions are many times found in our willingness to work together to create the difference that we seek. If we work together, we can make a difference to people’s lives – one life at a time. This is how IMF and Hope Ward have touched thousands of lives – bring hope to the most needy in Uganda by providing free treatment to patients who would have otherwise died.

The Concert for Hope will tell the full story of this journey in music and readings through images, readings and songs presented by the popular Afro-fusion Band, Qwela. Those who want to know the full story can read it through Dr. Clarke’s eyes in his new book, “How Deep is this Pothole?”; sequel to his first book, “The Man with the Key has Gone” and a window into Uganda’s history over the past two decades.

Our hope is that the Concert for Hope will not only increase cancer awareness – it will additionally open avenues for Hope Ward to raise the much-needed resources for cancer treatment for needy patients. We hope that more and more people will join this cause and share our belief that all of us can make a contribution to making a difference in our country – one small step at a time.

Turning health into wealth in Uganda – The Irish Times – Fri, Aug 13, 2010.

Dr. Ian Clarke, IMG Chairman, interviewed by The Irish Times:

“What we have been trying to do is to use the income made from our private patients to upgrade the services at both the private hospital and the community clinics, thus positively impacting health services in the country for everyone.”

Read more here…

Sometimes programmes do not go according to plan, regardless of best intentions or the significant needs that we are trying to address. After almost 2 years we have, regretfully, decided to withdraw from our partnership with the District Health Office in Pader.

Pader Health Centre:

A public-private-partnership established in October 2008 by International Medical Foundation with the Ministry of Health, Pader District Health Office and Local Government in Pader to renovate, equip and improve the running of a Health Centre III with the goal of upgrading it to a Health Centre IV.

In addition a project in partnership with the Ministry of Gender, Labour and Social Welfare to provide treatment to Landmine survivors with support from UNDP.

Unfortunately, after many attempts to rectify operational issues, particularly issues related to district staff who were not reporting to work and not co-operating with our Medical Officer, the In-Charge, we had no option but to withdraw.

It is a shame that this is the outcome of a venture that held so much promise but it was not all for nothing. Almost 12,000 people were helped in our time there, as follows below.

Dr. Ian wrote about this outcome for his column in The Sunday Vision: click here to download a copy.

IMF Contribution:

• Staff and technical support to run the health facility. A contribution in 2010 of UGX 22m (£6,200) to cover operational costs for the clinic.

Other Partners’ Inputs

• Funds through Suubi Trust to purchase drugs and meet other costs in running the clinic; UGX 10m (£2,800) in the first half of 2010.
• In the 2008 and 2009 Suubi Trust provided funding totalling UGX 148m (£42,000). Some of these funds were used to refurbish the health centre so it could once again be used to treat patients, service the ambulance and supply solar panels, batteries and the cables for installation of an electricity supply.
• HIPS provided over UGX 16m (£4,500) to help treat those with HIV/AIDS.
• In 2010 UGX 59m (£16,800) was received from UNDP to provide treatment for the landmine survivors.

Project Outcomes and Impact:

Between January and May 2010 1,517 charity patients were registered and treated as IMF patients and 5,688 were treated as Ministry of Health patients, all made possible through our partnership and support. In the last few months of 2008 and throughout 2009 more than 3,500 patients were treated.

In April, May & June 2010, 737 landmine survivors received treatment in Pader, Gulu, Lira, Loro and Anyeke through International Medical Centres. Five patients were sent to Hope Ward – International Hospital Kampala for complex surgeries.

Patient Stories:

You can read about some of the patients that we helped during our time in Pader by clicking here.

Exchange rates as at August 1st 2010.