Making a difference to Healthcare in Uganda

International Medical Foundation has a vacancy for a Projects and Funding Manager.

The role of Projects and Funding Manager requires you to source and apply for funding for the various community projects, taking on a strategic role in the Senior Management Team to ensure a comprehensive and well planned response to organizational development. You will also be required to track and oversee spend against budgets and progress to targets across the IMF portfolio of projects, with a particular focus on projects in Northern Uganda.

If you are interested and have some of the following skills and experience, then please get in touch… email hr@img.co.ug

• Master of Public Health or similar degree
• 3-5 years experience working in community-based health
• Proposal writing and applications experience
• Budgeting and planning skills
• Knowledge and experience of working with International Donor Agencies
• Experience of monitoring and evaluation
• Great interpersonal and writing skills
• Willingness to spend short periods in the field away from Kampala visiting project sites.

You can read more about the role in this document.

Even though STDs are very prevalent in Kampala, and are responsible for a lot of death and disease, very little attention and minimal resources are focused on this area, beyond HIV. The Touch Namuwongo team work with the poorest members of the Kampala community local to IHK and offer services for HIV, TB and STDs. With respect to STDs, prior to Alison’s involvement, the team were just able to treat the symptomatic cases in their hospital clinics and community outreach. However, this approach was only scratching the surface of the problem as 50-70% of disease can be silent. There was no system or resources in place to identify and screen those members of the community most at risk from these diseases and who were often without symptoms. As well as unknowingly transmitting these diseases on to others, the presence of STDs also facilitates transmission of HIV so further fuelling the HIV epidemic. Alison developed a risk score tool capable of identifying such members of the community and which would also then appropriately target their limited resources to the most in need of treatment. Despite resources being very stretched, with the enthusiasm and commitment of the Touch Namuwongo team, the support of IMG and the help of kind donations they were able to get establish a comprehensive service which identified both symptomatic and asymptomatic disease.

Alison also obtained some funding from Oxford University to carry out a research project that aimed to derive and validate this risk score tool. As an associated benefit, the study also funded a large volume of screening and medicines for treatment of STDs in the data gathering process.

The Touch Namuwongo team took on the extra burden of work involved in the study without complaint and worked tirelessly to deliver the service and also produce the data which is in the process of being analysed to develop an effective protocol going forward.

Initially Alison was heavily involved in the actual running of the clinics, but by the time Alison returned to the UK, the team was delivering the service without any additional input and continues to do so with great effect, despite the challenges and hard work this entails. Even though the clinics are already very busy, the team recognise what a valuable service it provides and so continue to reach out to the community to encourage others to be screened and treated, especially those communities where the need is greatest. They have got a good relationship with the local commercial sex workers, who continue to attend the clinics and who themselves are becoming advocates of the service.

The research funding has now drawn to an end and so there is a desperate need for on-going funding to continue to deliver this valuable service. Alison continues to raise funds for the STD programme through Suubi Trust, recently speaking at a local church lunch and is soon hosting a Ugandan party for supportive friends in her native St Albans.

What it is like to experience cancer in Uganda? The following is an account of an average consultation in the life of an oncologist in Africa.

One evening, I was just about to leave my clinic room when I heard crying outside. I opened the door to find a young man lying, doubled up in agony. Nurses helped me to pick him up, find a bed and morphine for him. I later found out his story – he was recently married for only three months when he had been diagnosed with an advanced stomach tumour. Because he lived in the mountains, six hours east of the capital, Kampala, there was very little health care – the poor man didn’t even have paracetamol. His friends had heard of “Dr Helena” in the treatment of cancer and managed to scrape together enough money for a one way bus ticket to my clinic in Kampala. The next morning, I found him sitting up, smiling, eating breakfast. What a transformation!

The man survived many months and even went back to tending his crops. Morphine and other drugs were shuttled up and down the mountains by the local Bishop. Sadly, his new wife left him and eventually he passed away. The Bishop told me that with the pain relief, he died with peace, comfort and dignity.

I will never forget that young man. His utter helplessness highlighted the desperate plight of Ugandan cancer sufferers.  Many do not have treatment or even simple pain control for cancer, whether due to limited access, lack of funds, late presentation, superstition or ignorance. It made me wonder just how many others are crying out for help, in desperation, suffering from cancer.

Coming from a background of “number crunching” and meeting “targets” in the UK, I have had to re-evaluate what constitutes successful treatment.

Working in Uganda has transformed my perspective on results  – it isn’t necessarily about statistics or paper targets, it is about real people, about individuals and the small or large differences that you can make in that person’s life. By working hard at cancer awareness, earlier detection, provision of complex chemotherapy, radiotherapy, surgery and palliative support we can start to reform the face of cancer care in Uganda.

In this way, my personal experience of working in Hope Cancer clinic is meaningful. To each individual that attends, we do whatever we can to assist. Since it’s inception in 2006, hundreds of patients have been treated charitably and, yes, we are seeing survivors come through, able to live life to the full… and that makes it all worthwhile.

You can read more about the work at Hope Cancer Care Clinic by clicking here…

Click here to download the November 2010 Newsletter which has a number of patient stories and updates.

The first project that Suubi Trust supported was the development of a level 2 bio-containment facility at International Hospital Kampala to provide a MODS TB culture and sensitivity service. That was back in July 2007.

Since then we have completed the clinical trial and are now using the method to help diagnose patients from IHK and from our community programmes such as Touch Namuwongo.

This work has been supported over the last 3 years by a number of dedicated volunteers including Dr. Mark Russell, Dr. Grania Brigden and Dr. Richard Feinmann. They have worked alongside the local team including Dr. Edith and Bosco, who can be seen in the photo working with some cultures.

TB killed an estimated 1.7 million people globally in 2009, it is the biggest killer of HIV/AIDS patients in Africa. This new method helps us to get an accurate and cost-effective diagnosis much more quickly than before; for our TB patients starting the right treatment quickly is very important. You can read more about our work with TB patients by clicking here.

We are very proud of all our staff at IHK and of course it takes more than just doctors and nurses to keep a hospital operating. Our maintenance team do a great job at keeping the hospital clean and safe; thanks.

One of our Touch clients receiving his HIV/AIDS test result

IMF has a number of community based programmes helping to raise awareness about HIV/AIDS. We provide counselling and testing, help those who are negative to stay safe and for those that are positive we are able to help with treatment and care.

Uganda has in past years been very successful in tackling this huge problem but there are now worries that the trend is moving up again.

HIV/AIDS prevalence may be on the rise again in Uganda, there are a reported 360 new infections per day.

Dr. Richard reported some time back about Edward one of our patients very sick with HIV/AIDS and TB. This shows the importance of our community work; we need to get to people sooner, before they become so ill.

On July 11th 2009, more than 60 supporters from across the globe: USA, UK and Uganda, joined Rose Clarke to walk 52 km from Bamunanika to Kiwoko Hospital, a journey Rose had made back in 1989. For Rose and her friends, this walk was in celebration of her many years of freedom, restoration, growth, the courage to heal, second chances, and finding her voice and purpose.

A great day spent with friends, raising money for Hope Ward, read my tweets from the day here.

This photo is from June 2008, before I came to work full-time in Uganda. Judith, in the middle, worked with the communities in and around Jinja, helping to train and support the community health volunteers. We had a very interesting day watching her interact with these volunteers and teaching them to tell others about HIV/AIDS. Click here to read more.

Sadly less than a year later Judith died, she too becoming another maternal health statistic.

Such a loss, that in another place and time, may have been prevented. We miss her.

Also in this photo, Helen Lay who came with VSO and worked for 2 years helping to professionalise our management and accounting processes. Jemimah Kiboss-Kyeyune continues her role today as the IMF Programme Manager. In the distance is Ian’s car that I borrowed for the day and had to abandon due to the poor road conditions!

A happy day but now tinged with sad memories.

Please click on the image above to download the latest IMG Newsletter. This edition includes the following items:

• Announces some new Specialists on Board
• Outlines our Charis IMC Partnership in Lira
• IMC Mbarara Move and Expansion
• An update from International Medical Foundation (IMF) – Bringing Hope
• News about a Laparoscopic Surgical Camp at IHK
• Plans for more Open – Heart Surgery at IHK, scheduled for November
• New Developments in IAA
• The Latest at IHSU
• Key Priorities for 2010
• Our Commitment to Staff Wellness

Enjoy…

As I write this column I am sorrowful, because I have lost a good friend and a good man. Moses Munezero was killed in the night bus ambush which happened on the Mbarara- Kabale road this week.

He was a young doctor working in Lira who first worked on a community HIV project in Hima and then moved to Lira to help me set up a clinic, where we not only treat those who can pay, but hundreds of charity patients and those with HIV.

I visited him four weeks ago and he was excited about the possibility of extending the clinic to have a theatre to carry out emergency caesarean sections and other operations. Moses was the kind of person whom one depended on, because he was steady and never let people down. He was that rare breed of person who was truly unselfish and spent his life helping others. He wanted to be good at what he did and considered the patients more important than his own personal needs.

Moses represented the very best of Uganda, in these days when we hear a lot about corruption and Ugandans who are in a hurry to get rich quick by any means. He was a role model, the kind of person you would be happy for your daughter to marry — competent, serious-minded and compassionate. He was a Ugandan who restored hope when one was tempted to feel the society was rotten. It is this which makes his death all the more tragic — because he was killed by Ugandans who illustrate the level to which our society has fallen.

The thieves placed big stones across the road, which the bus crashed into and then overturned, killing at least five people and injuring many. The thieves were not appalled by what they had done, but boarded the bus and systematically robbed the dead and the dying. The worst of society had killed the best in society. Is this the kind of place that Uganda has become?

We have so many good people, but they are being pushed aside by those who have no conscience, feel no tenderness and show no mercy. Uganda has been here before — when the State Research Bureau disposed of people as if they were pieces of meat; we have only just got rid of the menace of Kony, but now it has become dangerous to do everyday things, like taking a bus ride at night.

One of the main purposes of government and civil society structures is to maintain law and order, so that people can go about their daily lives without fear of molestation. The death of Moses is an indictment of these organs of society. His death was due to a combination of lack of law and order and lack of care by the driver and the operators of the bus company. If the driver had been going more slowly within the speed limits, he could probably have seen the stones and stopped. If policing is now so weak, that thieves can operate with impunity along a major highway, then the system is ineffective.

The combination of these two deficiencies resulted in the death of a fine young Ugandan, and let us not kid ourselves, this death could have been avoided. But will anyone take responsibility? Will the Police, who have failed to enforce speed regulations on the buses and to patrol the road? Will the government, who have allowed an incipient lawlessness to take hold, which breeds violence and death? Or will everyone just shake their heads and agree that it was a tragedy, while we wait for the next hold-up or next bus accident to happen?

We are losing the good people in our society, because we are failing to control the worst elements.

Published on: Saturday, 19th December, 2009