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.

Each year 100,000 babies die at birth, that’s 76 deaths per 1,000 live births.

The shame of these numbers is that these deaths are, on the whole, preventable. Mums need good ante-natal and post-natal care, safe delivery attended by trained staff, post-natal care for Baby and simple immunizations. Such care needs to be provided alongside other healthcare programmes that tackle the major causes of death such as pneumonia, diarrheoa and malaria. This in conjunction with Social and Environmental Health initiatives to ensure access to family planning, safe clean water, sanitation, waste disposal and better housing.

So if we know what should be done and most of it is not so difficult to implement, why does the problem persist and why, in most countries in Africa, does the trend seem to be going in the wrong direction?

Put simply it’s about MONEY and PRIORITIES.

The African Union agreed at the 2001 Abuja Summit that each country should spend 15% of its budget on healthcare. 9 years later most have failed to do so. Uganda spends just about 9% of its budget on healthcare and Maternal Child Health (MCH) gets just a small proportion of that, though this is set to increase to UGX 260b in 2010-11. At the recent AU Summit in Kampala, officials simply stated that 15% was unattainable in the foreseeable future. If all ministries were to be given the budget they were asking for, the total would be more than 150% of what’s available. A very significant percentage (~40%) of the UGX 600b Uganda health budget is provided by other donor countries and those are not able to make any further increases due to current worldwide commercial and economic pressures.

So we’re on our own and it’s even worse than that. Uganda needs to allocate more of its own domestic budget to healthcare. However there is growing evidence that even if it reaches the ‘magic‘ 15% this still won’t be enough. It is just too simple to talk about percentage of overall budget or GDP. One must also look at the actual amount being allocated and spent per person. Currently in Uganda less than USD 10 are spent on healthcare for each person. A 50% increase in budget allocation, to reach the 15%, would take this to about USD 15 per capita. That is still such a long way from the WHO recommendation of a minimum of USD 40 pp pa.

Maternal, infant and child health are the greatest challenges facing Africa ahead of the 2015 deadline for achieving the Millennium Development Goals. The Countdown Report estimates that it will cost an additional USD 8 per person per year to provide the required healthcare interventions mentioned above.

117 African Health, Social Development, Gender Based, Youth, Human Rights Organisations, and Trade Unions have joined together to recommend to AU member states progression towards a more comprehensive health, population and social development formula described as 15 % Plus.

Whilst this laudable and should get our support, I am not at all convinced that AU governments will make, or be able to make, such a commitment and implement it.

There has to be another way.

You can read more about all of the above by selecting from the search results at this Google Link.

Joy and Bwine are a humble couple that loves their son Mathew Ayebare (Pictured) deeply and have done their best to take care of him.  Mathew is a little over two years old and has been in and out of hospital since he was a year old.

Joy noticed that Mathew at nine months did not seem to respond or behave like her other two children. However, she did not read too much into it at the time. When he made a year, Mathew started getting seizures. When he was taken to hospital, they were told he had epilepsy and he was started on treatment.  But the seizures did not stop.

The anxious young parents took Mathew back to hospital where he had a CT scan that revealed bleeding in his brain. This is when they learned that their son had a very complex and rare congenital defect known as arteriovenous malformation. An arteriovenous malformation (AVM) is when there is abnormal connectivity between arteries and veins.

www.brain-aneurysm.com says that most brain AVMs present with a brain hemorrhage (severe headache, nausea, vomiting, and collapse/loss of consciousness). Instant death rate is believed to be at about 10% for first-time hemorrhages from a brain AVM, and this is about the same as the instant mortality rate for first-time brain aneurysm ruptures. Many AVMs present with seizures, and some present with neurological symptoms (paralysis or sensory disturbance) due to the mass of the blood vessel tangle causing direct compression of brain tissue.

Joy and Bwine desperately needed a “miracle” for their son.  They were referred to Dr. Hussein Ssenyonjo who agreed to perform the operation. However, it would be a very complex operation with a long stay in Intensive Care after the operation. The family could not raise money to have the surgery done and; so, they approached Hope Ward at International Hospital Kampala.

Hope Ward is a charity ward at the International Hospital Kampala that partners with various companies, organizations and individuals to provide complex medical treatment for the very needy in Uganda. Sponsors include Bead for Life, Muvule Trust, Stanbic Bank, MTN, Narrow Road, Hwan Sung, Suubi Trust, Bless a Child Foundation, IAA Health Care and the International Hospital Kampala (IHK).

Mathew was admitted to Hope Ward and had a successful surgery at IHK. His family was only asked to contribute Shs 2m out of a total of Shs 6.2m.  The International Hospital covered 30% of the  bill and does the same for all Hope Ward patients. The balance was covered by donations from Hope Ward supporters. Dr. Ssenyonjo waived his fee and his only concern was saving Mathew’s life.

Before surgery, Mathew had a 10% chance of living but his future is much brighter now.

Yesterday I had the chance to visit with some of our clients on the Aldo project in Lira, Northern Uganda. One of these is Joyce. She used to work as a secretary until she fell ill with TB. Joyce is HIV positive; this and the TB combined made her very sick, she became bed-ridden and was no longer able to work. Joyce lives alone and is away from her family in the village as a result of seeking work in town.

Joyce told us how she received help from the Lira IMC team, in particular from Trixcy and Jasper who run our Aldo project. As she was unable to attend the clinic, they have been bringing the drugs to her and on their regular visits have made sure that she was able to take them. They have offered support and counselling. Her neighbours and church friends helped her with meals and personal hygiene. These acts of kindness have meant that Joyce has been able to regain her strength. She is now able to move around again, she has a good appetite and is almost finished her course of TB treatment.

Life for Joyce is still very, very tough. She struggles to earn some money by buying and selling eggs and is keen to find other forms of work that she can perform as she continues to recover. She doesn’t want hand-outs; she wants to be able to make her own way, with a little help and support. Joyce, for me, is a great example of why we are doing this. It doesn’t take a lot to make a significant difference in people’s lives. My role is to help facilitate and support that. People like Joyce can turn their lives around when they get a little support from family, friends and neighbours. Specialist help from those like Jasper, Trixcy and others at Lira IMC can then make a difference. Joyce is very thankful to all who have helped her, as she says without such love and kindness she wouldn’t be here today.

The Aldo Project is supported by Hands of Help in Australia and seeks to help those like Joyce who are living with HIV. The project works in the community, with the community, giving preventative education, counselling, testing and treatment.

Barbie in Kisugu, one of the communities being reached by IMF in its Touch Namuwongo programme.

Jemimah has prepared an update outlining the various projects that IMF is running and noting the numbers of people being reached.

Part of what we do is working with those affected by HIV/AIDS.

IMF has in the last 2 years, with your support; reached more than 25,000 people with health education and preventative messages, tested more than 11,000 for HIV/AIDS and provides treatments for more than 600, of which about 300 are receiving ART.

Click here to read more.

In May 2010, I developed cough, severe chest pain, diarrhoea and weakness. My son supported me on his bicycle to the clinic. I was weak, in severe pain, I couldn’t walk, and I was in a confusion state. People in the Village thought that I was not going to come back alive.

The clinic staffs organized for my transport and I was rushed to Hope Ward. I am grateful to Management of IMF, I was treated freely, fed and well taken care of. I thank Management of Royal Van Zanten and clinic staffs for their support. I can now work in my garden and take care of my children.

The environment in Hope Ward brought a smile in my face.
Hope Ward gave me hope to carry on.

The Chairman LC1 had this to say;

I thank IMF, Royal Van Zanten and the clinic staffs for the Good work they are doing in our community. Most of our people are affected with HIV and treatment is very expensive of which they cannot afford. Thank you for helping Nagawa, you gave her hope to continue taking care of her children.

In July 2010, I developed severe diarrhoea, fever and vomiting. I was rushed to the clinic in bad state. I could not walk, eat or drink. I was very weak and had lost hope in life. I knew I was going to die.

Royal Van Zanten management arranged for my transport and I was rushed to International Hospital Kampala Hope Ward. With support from IMF, I was treated, fed and well taken care of freely. I stabilized after a few days and was discharged in good condition. I can now walk and eat.

I thank Management of IMF, Royal Van Zanten management and the clinic staff for their support.

Regina’s mother had this to say:

I had lost hope. I thought my daughter was going to die but when I reached the hospital I knew she will survive. I thank the Management and all the staffs of hope ward for their spirit of hospitality.

‘IMF brought back hope that was lost.’

3 of these are receiving care in the Intensive Care Unit (ICU), 2 remain very sick on ventilators and 1 is hoping to return to Kenya when she is stable enough for discharge.

We have 7 patients on our medical/surgical ward; 5 of these have had surgery, mostly Laparotomies. These patients are steadily improving and will remain under observation for some days yet.

5 American citizens were evacuated, 2 to South Africa and 3 to Kenya. We have checked on their progress and have been told that their condition is good and all are recovering well.

2 patients asked to be transferred to Nsambya Hospital; we are trying to contact these individuals to ensure that they have received all necessary care and treatment.

5 patients were discharged and have returned home.

4 people died, or arrived dead on arrival, on Sunday night. The body of one of these, an American citizen who was dead on arrival, is still at the IHK mortuary awaiting plans by the FBI and the American Embassy to process his evacuation to the USA for burial.

Since Sunday, 5 have died as a result of their injuries, mostly caused by shrapnel penetrations to the head.

Our Psychiatry team has been receiving additional training over the last few days at Mulago Hospital. They will start structured services at IHK on Monday for victims and for our staff.

The IHK Board of Management send their condolences to those who have lost loved ones and our best wishes for speedy recoveries to those still being treated.

Louise, Daniel and Emily will be climbing Kilimanjaro later this month and have decided to donate some of the funds they are raising to help support the work at Hope Ward.

You can visit the justgiving page for Louise and Daniel by clicking here…

On the 17th of July Louise Seres and Daniel Wade will be climbing Africa’s highest mountain, Kilimanjaro. The trip is totally self funded so all money raised will go to charity.

The charities chosen, Suubi Trust and Kigezi Healthcare foundation (KIHEFO) are both working towards a better standard of healthcare for patients in Uganda.

Suubi Trust – Treats adults and children in Uganda at Hope ward located at Kampala International Hospital and also treats patients in clinics in Lira and Pader; all such care being essentially free of charge.

Emily’s page is here…

I am a 3rd year Pharmacology student currently sitting my final exams.

Last summer I travelled to Uganda and again I fell in love. I visited the International Hospital in Kampala and I was hugely taken by one particular ward, called the Hope Ward. This ward is run by the charity I am collecting for on this page. They treat patients who are not able to pay for their treatment. These people are generally the poorest people in Kampala, or refugees from the troubles in North Uganda, Rwanda, or DR Congo. They have a specialist cancer centre and the oncologist told me “it is very hard to determine a patient’s treatment by how much we had donated this month, as opposed to the treatment they need”.  But they make do.

We are posting updates below about some of those being treated at International Hospital Kampala.

IHK is providing, and will continue to provide, such treatments free of charge to those that cannot afford to pay and hopes to cover the costs from Government support or donations from individuals.

If you would like to help, you can give securely online by clicking either of the two images below.

Thanks for your continued support.

Best wishes, Kevin.