I am re-posting this, it was first published on February 20th, 2010.

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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.

You can read his story below or by clicking here.

If you would like to help Mubiru and our other patients on Hope Ward click here to find the many different ways in which you can give. Please tell others.

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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.

In September 2009:

Mubiru had been on the Hope Ward for about two months. With an improved diet, constant care and daily physiotherapy as well as constant dressing of his wounds, Mubiru’s condition had greatly improved. At this point he was still feeding through a nasal tube most of the time, though he had started a little self feeding. He regained ability to talk and even sang a song to one of our visitors on Hope Ward at the time. Mubiru is a charming naughty boy and all on Hope Ward became very fond of him. One nice cool evening he even requested his carer Mabel to take him out on the wheel chair to enjoy some fresh air in the hospital compound. The physiotherapist noticed that he tried to move his arms and legs (though he would cry while doing so) during his physio sessions.

By November 2009:

Almost all Mubiru’s wounds had healed, his hair had grown back, he was finally fit enough to start a series of surgeries to treat infections in his bones and to straighten his contracted legs. However at this time Mubiru was incontinent and had been wearing diapers since he came to Hope Ward…he had lost ability to control his bladder and bowels because of his long period of abuse.

At this time, Mubiru had gained more strength and began to talk more, much of his memory had returned and he began to give more details of what happened to him before he was brought to Hope Ward. His father had a final court case in the same month (November); Mubiru gave his police statement for the case and we were hopeful that justice would be served but he was only accused of neglect and given an eight month sentence.

We witnessed a very emotional moment on Hope Ward when we called Mubiru’s mother and had him talk to her, he cried really hard and yet she did not commit to come visit him, she was afraid that she would be arrested. Mubiru’s mother has several children from different men, she had left Mubiru with her mother who died shortly after and Mubiru was taken to be with his father where he was abused and almost killed. On the day we put Mubiru in touch with his mother, he asked her when she would come and take him and she said she couldn’t come for him and this really broke his heart. At the time, she had just delivered another baby with her current husband and was not ready to travel to Kampala or take up responsibility for Mubiru.

Today (Feb 2010): We would say that Mubiru has undergone remarkable transformation (as you can see from the pictures). He has had multiple surgeries on his legs, he has had intensive nutritional care and he has grown into a lovely cheeky, healthy boy. He no longer wears diapers and can control his bowels and bladder again; he can feed himself and no longer needs the nasal feeding tube. Mubiru is now receiving physiotherapy to strengthen his muscles and we are training him to walk again. We had braces fitted for his legs which he wears to gradually straighten them. Mubiru’s condition today is much more hopeful than it was about eight months ago when he first came to Hope Ward.

A physiotherapist told me that if you are confined to a bed or if you do not move at all for about three weeks; your body can deteriorate at a very fast rate, and your muscles will atrophy to the extent that you will not be able to walk without rehabilitative physiotherapy. Mubiru was confined to a box and not fed for months; he was left with untreated wounds that transmitted infection to his broken bones. That is why he is unable to walk today. With improved nutrition, tender loving care and good physical exercise, Mubiru will walk again; though this may take a long while.

Presently the hospital ward is not an ideal place for Mubiru to be, if anything he is more exposed to infections from other admitted patients. We have hope that Mubiru will recover and can regain the health and joy a young boy his age should have. However the reality is that his father is now in prison and he cannot return to the people who abused him, broke his bones and left him to die. We are in the process of trying to find a suitable home for Mubiru and we will continue to partner with the home to provide free physiotherapy and any surgery if he needs it to facilitate his return to the normal life of an active and happy young boy. Your kind consideration of our request and compassion for Mubiru will be highly appreciated.

A few weeks ago a relatively young lady (Rose*) walked into my office looking ten years older than she actually was. She came looking for help for her mother with an ultrasound scan report indicating that her mother had a mass in her cervix and another mass nearby as well as a collection of fluids in her abdomen. She told me a horrifying story of a woman in excruciating pain and health workers who could not do much for her because specialists at a certain facility were engaged in an exercise that could not afford them time to attend to this patient.

When I discussed these reports with our specialist gynaecologist and oncologist they suspected that the lady had advanced cancer of the cervix. The Hope Ward team reviewed the case and agreed that there would be no added value in admitting this lady to Hope Ward. She was probably receiving all the care she could at this alternative hospital because she already had a visit from a palliative care nurse and a supply of morphine.

When we broke this news to Rose she could understand the logic behind the situation but pleaded with us to admit her mother. She said that her mother was tired of being at this other facility and had asked them to take her home to die. Her sisters had sent her to Hope Ward in hope that we would admit her and provide better care. Unfortunately at this time the ward was fully occupied. She begged us to admit her mother and at least even provide space for her to sleep on the floor but this was against hospital policy.

After many hours of discussion with this lady, the oncologist agreed to at least review her mother in the clinic and advise the family. So she was given an appointment for the following day. However Rose and her mother did not return to the clinic on the next day. Her mother’s condition worsened and she was admitted into hospital. She came back with the same request, if we could only admit her mother because she felt that she was not receiving adequate care at this other hospital; again our ward was full. We tried to explain this to Rose and she said she could understand but she just had to fight for her mother and could not bear the sight of her mother in so much pain and suffering.

Two days later I came to work early in the morning and found Rose seated on a bench at the Hope Ward balcony and her mother on the floor. She was in too much pain to sit down. Fortunately the Hope Ward team had discharged a patient the previous day, so Rose’s mother was given a bed. The challenge the Hope Ward team now faced was to stabilise the patient;

her abdomen was so distended she felt like it was going to explode and she was extremely anaemic and so pale. Dr. Sheila the medical officer on Hope Ward, had the task of slowly easing fluid out of her abdomen but this was such a delicate procedure as her vital signs would crash if the fluid was withdrawn too rapidly.

The following morning I came in to work and found Rose’s mother on oxygen; fluid had accumulated in the pleural cavity surrounding her lungs probably as a result of an infection or a spread of the cancer to her lungs. At about midday I heard sobbing and wailing out on the balcony, I looked out and saw Rose pacing up and down. She went back to her mother’s bedside and dropped to the floor wailing. She kept on saying that the fluid had killed her mother; and I was thinking ‘no cervical cancer has killed your mother’.

This was one of the most difficult cases I have handled on Hope Ward. During a family conference with Rose, before her mother’s death we had explained the challenge we faced because her mother had presented to the hospital when the cancer was too advanced to respond to treatment. We stressed the importance of having her and all her sisters screened for cervical cancer in good time. All through this difficult period I had not seen any of Rose’s sisters. Within a few hours of her mother’s death there was a crowd of people from Rose’s family sitting on the Hope Ward balcony. I paced around for a few minutes feeling that the right thing to do would be to pass on my condolences to the family but I had a strong urge to grab Rose & her sisters and tell them ‘you need to be screened for cervical cancer, you have more of a choice than your mother did’; but I had to face the bitter truth, that was not a message they would respond to at this time.

Dr. Helena the oncologist at International Hospital Kampala, IHK, notes that East Africa has been documented as having highest rates of cervical cancer in the world; the number of women with cervical cancer in Uganda is amongst the highest percentage in the whole world. As an initiative to help women access cervical cancer screening Dr. Macrine runs a well woman clinic at IHK; in this clinic she screens about 50 women per month and in the first half of this year she has had 6 cases of diagnosed cervical cancer. The good news is that she has had cases of women with abnormal cells in their cervix which she has treated and re-screened after some time; we could say they have been saved from developing cervical cancer in the future. This service is not only offered to private clients but can also be accessed by needy patients through the Touch Namuwongo community clinic.

* Real names changed to protect individual’s privacy & right to confidentiality

Name: Nansubuga Hajara

Age: 1 year 7 months

Medical condition: Malnutrition, right leg sepsis that required skin grafting

Nansubuga Hajara a 1 year and 7 months old baby born to Ssebanakita Mohammed 25 years old and Namatovu Shadia a 20 year old mom reside in Kawanda Wakiso District. Father is a truck driver and the mother sells second hand women clothes for a living. At two months after birth, Hajara developed complications with her right leg that could not completely stretch, she was taken to a local herbalist who worked on her and she got better. A few weeks later, Hajara was taken for immunisation in Nsambya Hospital. She was immunised on the same leg that the Herbalist had worked on. The injection site became very septic. The family tried treating the septic wound from Home but the wound just continued getting worse. Hajara was taken to Mulago National Referral Hospital, but on assessment, the medical team at Mulago noted that the child had malnutrition and they were referred to Mwanamujimu nutritional Rehabilitation ward. In Mwanamujimu, the child was put under nutritional Rehabilitation, but the septic wound just worsened, continued with the treatment, debridement was done to get rid of rotten Flesh. All this was done on the General ward by Dr Muhamme, with continued daily wound dressing.

Unfortunately there was minimal improvement in Hajara’s condition then Dr Muhamme decided to approach IMF(Hope Ward) to assist in taking up the patient who at that time needed skin grafting to be done but family could not afford the costs in Mulago National Referral Hospital.

Hajara was admitted on Hope Ward where she got under the care of our pediatricians (Dr Jackie and Dr Renjini) and Physician (Dr Edith).She was put under intensive Nutrition Rehabilitation care with high protein/ energy feeds for about 1 and a half months with of course the routine nursing care and treatment as due. Her Nutrition deficiency was then totally eliminated and on the 20^th September 2010, skin grafting was done for the once very septic wound; (Dr Sam) was the lead surgeon for this operation. Wound dressing and antibiotic treatment have been done and Hajara is really doing very well and so are the parents that do greatly appreciate all the medical attention that they have received from Hope ward.

How the parents feel about the services received:

The dad is very happy he was given this opportunity to receive medical attention here at Hope ward and appreciates all the services they have received.

Written by Shifa Mwesigye, published Wednesday, 30 March 2011 22:22 and linked here.

The photo above from The Observer, click to see original posting.

David’s condition caused him to be rejected by those around him and left him suffering from his open sores and wounds.

A journalist found him during one of the President’s election rallies and some time after he was brought to Hope Ward. There he received care, compassion and healing.

He now stays with a foster carer and others have offered financial support, which may help to send David to school.

A real heart-warming story of how we can each play a part in helping to change the misfortune of others.

Earlier stories about David:

Too sick to mix with humanity

Muhwezi: Not too sick to mix with humanity anymore.

Sick boy moved to IHK

• Medical condition: Chronic Deep Venous Thrombosis

Mbazira Ramulah is a 27 year old adult female residing in Kabalagala Zana Zone, a single mother with 2 children, a grade three teacher who stopped teaching because of her medical condition.

Ramulah has had a blood clotting disorder for the last ten years and has been on Warfarin, that she has been getting from Mulago. She begun with simple blisters, but on scratching these, they developed into wounds. She received some treatment from Mulago but the wounds did not heal. She has also tried using herbal medicine but still there has not been any improvement. She normally feels a burning sensation especially in the evening and morning hours on the lower limb wounds.

Ramulah was identified by Dr Ian in the Community; he brought her to Hope Ward where she was assessed by Dr Sheila. On physical examination she had swollen painful limbs with open wounds and redness associated with dilation of the surface veins. A number of investigations were done including CBC, primary coagulation studies, doppler ultrasound, X-rays, RFTs LFTs. We initially thought surgical intervention could be necessary but on assessment by the general surgeon, Dr Sam, opted for medical treatment with the use of Warfarin, daily wound dressing and 24 hour limb elevation.

Within about 2 weeks of treatment on Hope Ward, the wounds had started showing signs of healing. The wounds healed well, she was discharged and is now routinely seen as an outpatient with visits to both our in-house Surgeon and Physician.

How Ramulah feels about the services received

She is very happy and thankful to Dr Ian who was able to bring her to Hope Ward. She will be resuming her teaching profession as soon as she gets another job.

Click here to read the article…

You may recall reading about Bukenya who was treated on Hope Ward for 2 months in 2007 with a similar condition.

Being a complicated surgery, Doctor refused and told me to pray to God so as he would discuss it with IHK In charge. The next communication was giving me an appointment as when to have surgery. I couldn’t believe it! The surgeon told me that I would only stay in hospital between 7-14 days.

After operation I found myself in a comfortable bed at Hope Ward. With very good nursing care, I improved gradually, after day 10; I was ready to go home and developed severe abdominal pain with vomiting. The general condition worsened and I was re-admitted. Imagine 14 days hospital stay turned into 30 days! But during my stay, I really received quality care, with love from the entire staff of Hope Ward.

They worked tirelessly day and night, giving me care, support, counselling, very special and treatments including investigations. I had lost hope! I believe if it wasn’t the quality of care from the devoted staff of Hope Ward, I would be dead! I believe the treatment was very very expensive but I managed to receive it all. I am improving gradually and very happy with my family who had lost hope too!

My sincere thanks goes to ALL IHK staff especially: DR. MOSES G., DR. HAFISA, DR. SAM, THEATRE STAFF, my dear nurses of Hope Ward, and to our dear funders/sponsors of Hope Ward who contribute generously towards patients care and treatment.

May the loving God reward you always. Thank you so much.

Yours Sincerely,

Nnabatanzi Rose Mubiru

From MASAKA-KITOVU

In the 11 months to the end of November 2010 Hope Ward admitted 227 patients for a total of 2,730 bed-nights.

This year, funds raised for Hope Ward amounted to UGX 89.4 million (~£25,000); 43% of these funds came from our corporate sponsors – Bead for Life, Mvule Trust & Narrow Road.

Most (80%) of the Hope Ward expenses amounting to approximately UGX 459 million (~£130,000) were paid by International Medical Group.

Please click on the image below to download the annual summary report which has some further financial details and a few patient stories.

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.

We have some spare capacity in Hope Ward and with additional funding we could help many more needy people in 2011. Please support us in whatever way you can.

Thank you all very much.

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This is “Emma” in October 2010 with his mother and Sister Aisha, chemotherapy nurse.

Emmanuel (“Emma”) is doing remarkably well – When Dr Helena returned from a trip to UK, she noticed that he had grown several centimetres and put on weight. We were all devastated when he relapsed from his leukaemia over a year ago. He was subjected to further aggressive re-induction, consolidation and now, maintenance chemotherapy. We are delighted at the latest bone marrow results this October 2010 that continue to show remission. He and especially his mother are very brave. Emma now faces a few more years of maintenance therapy.

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Maria came to the Hope Ward Cancer clinic a short time ago, Dr Helena believes this young girl is one out of so few who has a disease which is potentially curable. We have started chemotherapy and hope and pray that she will have continued help to complete her treatment as she is a very bright and precious little girl, the apple of her mother’s eye.

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Eva is so positive – she was one of our first patients to be treated with breast cancer that had spread to the lymph nodes in March 2006. She is still in remission and whenever she comes she wishes to say a big “thank you” for all the help the team and sponsors have given her – she says she owes her life to those who have contributed. She has now set up and runs a small shop in a village.

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Margaret is a humble and gracious woman and has no support – tragically, 7 out of 8 of her children have died. She couldn’t afford treatment for a womb mass and leg swelling. We investigated her problem and are considering a combination of gynaecological, radiotherapy and systemic treatments..

Calvin is just one of our many hundreds of patients treated free of charge in Hope Ward. He had operations regularly with us for over two years, after which he was able to go back to school at the age of 25.

Elephantiasis is an infection that blocks lymph drainage from the legs. They swell over many years until they are the size of elephant legs. You can read more about Calvin’s treatment and see the before and after photos (which may upset some) by clicking on the photo above.