This week Dr. Richard provided TB training for local volunteers in preparation for Phase 2 of our TB programme.

Interesting day yesterday. I have mentioned our HIV outreach clinic “Touch Namuwongo”.Since TB and HIV are interlinked the 110 community volunteer workers from Touch came for training about TB. I don’t think I’ve ever done a whole days training on my own with such big numbers.

83 turned up and what a fantastic group. They all stood at the beginning and sang the national anthem …all 3 verses…then prayers…then they got stuck in. Cheering and clapping all day especially when I told them they could save 500 lives if they found the 500 TB cases I think there are in Namuwongo.

Lovely Deborah, my TB nurse had been on duty the night before and I kept saying to her. “Go home Deborah” but she refused and really delighted me by saying “this is too interesting”

Quite a few did not understand all of what I was saying so Francis my other TB nurse translated key bits into Luganda. Quite good actually, as it gave me time to get my breath back. No idea what he said but he said it all with lots of passion

Amazing the work they did in small groups.Not like teaching medical students!. They were fighting to present first,they were funny and they desperately wanted prizes for the best presentations.

This is Florence and Charles. In her presentation she said the main thing the CVW’s should do is love all their clients. This wag in the audience called Charles asked her,”how was she going to love all her clients”! She said “come out here and I’ll show you”. Lots of cheering…great fun. Who said women are not empowered in Uganda.

They do love T shirts and they are important as it identifies them as a volunteer worker. They go house to house, speak in market places, go to churches and schools. Amazingly for no pay just 10,000 Ugandan shillings… £3… when they come to training days

You may recognise the gent modelling the Tshirts.He nearly got crushed in the rush when we were handing them out. Not too impessed with his posture!!

The Blog has now become available as a book which you can buy for a very reasonable £10. This will include a £3 donation to Suubi Trust, to help raise funds for Hope Ward at IHK.

If you would like to know what life is like here for volunteers, learn about our innovation in TB Diagnostics and read some very touching patient case studies then please let us know and we can arrange for a copy to be sent to you.

You can of course read more about this on their Blog, linked above.

If you would like a copy then please use this form to let us know…

We will not give your email address to anybody else.

Posted in Hope Ward, TB Lab, Volunteers Tagged: Dr. Grania Perceval-Price, VSO ]]> http://blog.suubitrust.org.uk/2009/07/10/the-flip-side-becomes-a-book/feed/ 0 Kevin image image http://blog.suubitrust.org.uk/2009/03/24/richard-feinmann-on-volunteering-in-hope-ward/ http://blog.suubitrust.org.uk/2009/03/24/richard-feinmann-on-volunteering-in-hope-ward/#comments Tue, 24 Mar 2009 00:01:58 +0000 Suubi Trust http://blog.suubitrust.org.uk/?p=1069 ]]>

Dr Richard and children on Hope Ward, (Lub Dup, the sound of our heart beat)

What to do when you are a sexagenarian physician who has retired from hospital practice with 40 years in the NHS under your belt and golf/Sudoku not really appealing? Well, my health visitor wife and I applied to Voluntary Service Overseas (VSO) and I am writing this from a hospital in Kampala, Uganda, where I have been working for five months.

VSO did seem to want us and so long as your health is good, age is not a bar; the average age of volunteers is climbing all the time. So, off to Uganda and although it was hard adjusting to a huge change of lifestyle and temperature I recommend it. It’s great to be blissfully unaware of crashing stock markets and to be in a continent where everyone thinks Obama is their president too.

I really believe VSO and Africa do need doctors of my age. 30+ years of general and chest medicine gives experience which is so useful to hospitals in Uganda who aspire to provide quality care. I can treat and manage TB which is useful and I am fast becoming expert in HIV, but Uganda needs experienced generalists. Senior doctors who can make decisions (usually right ones), can’t operate but know when you need a surgeon, can reasonably confidently manage sick kids, teach and mentor and bring management skills both clinical and general, are certainly needed.

My ward is Hope Ward, a charity ward at International Hospital Kampala, so I’m lucky to have good facilities, good nurses and doctors and a clean hospital. The patients are destitute and come from all over Uganda and they are very sick. I don’t think we’ve had a CD4 count over 10, and the TB presentations are extraordinary, not to mention extra pulmonary. This is a country where 58% of the population of 30 million is under 18, yet abortions are illegal, where the government hospitals are understaffed and oversubscribed. Even in government hospitals health care is not free. Life expectancy is under 50 and HIV may affect 10% of the population with half having TB. Uganda is a member of “the bottom billion club” and the sad stories of patients selling their HIV drugs to buy food are all too true.

Many of my patients are babies or young people. It’s very different to the average age of a UK medical ward. They mostly have HIV with complications, but they are remarkably resilient. Rehydrate, feed them with naso gastric porridge (works wonders), restart their TB and HIV treatment and they seem to get better even though they look at deaths door on admission. Initially as an adult physician I was scared stiff of managing the babies and although many still cry when I pick them up (I’m told it’s my white skin!), we seem to manage.

I’m really busy, and my range is from pneumocystis pneumonia (PCP) in a 9 month old to myasthenia gravis in an 82 year old…both survived!! Of course there are lots of lows, and you have to keep reminding yourself you can’t cure all of Africa. I get really tired because it’s hot and humid with unfriendly mosquitoes, but I think I’m making a difference. A year might be enough but we’d do it again.

It’s good to go with your wife and support each other through the ups and downs. She’s working with the National Community of Women Living with AIDS (NACWOLA), an organisation staffed by dedicated women many with HIV and giving help to women and children with the disease. Her role is to develop child protection policies and a youth strategy.

HIV has wiped out many parents and it’s elderly grandmas who often bring up the children. We are socially very busy both with locals and other volunteers. We have just been to our third wedding out here!

Winston Churchill called Uganda the “Pearl of Africa” and it is a beautiful country with lovely friendly people. Its only blemish is appalling roads and heavy smelly traffic in Kampala.

So, that’s it, I am a physician, paediatrician, house surgeon, TB and HIV specialist and a fundraiser. I teach, do appraisals and appointments, go to hospital meetings and have good friendly colleagues. Patients are universally grateful, even when I get it wrong, and I’m not being complained about or sued.

Come on you bulge-baby doctors…Africa needs you.

Richard Feinmann is a 62 year old general and chest physician who retired a bit early after a serious health scare. He felt he had more to give and jumped at the chance to work with his health visitor wife in Uganda.

TB is preventable, treatable and curable and yet
it kills close to two million people a year.

Little red rods kill 2 million people every year and we can cure it!

Dr Richard, Bosco and the team at IHK continue their work to validate our implementation of MOT, a new, low cost, diagnostic method which we hope will significantly impact our work, especially among those living with HIV. We are hoping that the validation will be complete by this summer.

You can read more here…

Dr Richard “This is why I am in Uganda…”

Posted in TB Lab Tagged: Bosco, Dr. Richard Feinmann ]]> http://blog.suubitrust.org.uk/2009/03/24/world-tb-day/feed/ 0 Suubi Trust acidfastbacilli.jpg WhyIAmInUganda http://blog.suubitrust.org.uk/2008/06/08/grania-a-plan-comes-together/ http://blog.suubitrust.org.uk/2008/06/08/grania-a-plan-comes-together/#comments Sun, 08 Jun 2008 17:00:09 +0000 Suubi Trust http://suubitrust.wordpress.com/?p=520 ]]> Grania, a VSO, is leading our work at the TB Lab; the following is taken from her blog…

Finally! It’s great when a plan comes together, and, after quite a bit of work and waiting, a Big Plan has finally come together…

A few months ago, official funding for our MOT validation study was cut. This meant that we couldn’t pay for the trial to prove that MOT (the new test for diagnosing TB) would work in Uganda, and especially if it would work in patients who also had HIV.

The importance of this is that TB in patients with HIV is harder to diagnose, and often the tests that work in non-HIV patients are not as good in HIV patients.

So, I decided to try my hand at fundraising.

But as I soon found out, without validation data it is hard to get people, especially the Ugandan Ministry of Health, to trust and start using the MOT test. The first attempt was fairly futile, wandering down Kampala’s UN Alley, sitting in lovely air-con offices, being told politely in various ways “No, Sorry!” So I began to look further afield and made some enquiries with a few UK TB charities. From this, I received some promising feedback from one called Target TB.

As a complete novice at fundraising and not knowing where to start when writing a proposal, I hooked up with the hospital’s fundraiser, Máiréad (a fellow Norn Irish lass – there’s a large Northern Irish mafia here.) She helped to show me how fundraising proposals should be approached, and on researching the Target TB goals we quickly realised we needed to expand our proposal beyond just the trial. Over a cup of tea we planned out an ambitious idea to try and revolutionise TB care here. Máiréad worked her magic and made these tentative plans written on the back of an envelope sound exciting and feasible and the proposal was sent.

I was feeling slightly pessimistic, expecting a letter saying “Thank you for your enquiry, but….” But instead we kept passing the phases of proposal acceptance, and at the end of April Target TB had their final meeting with the Board of Directors. We found out shortly after that they have accepted our grant proposal, want to come into partnership with the IMF TB project and even better are giving us the full amount we asked for… £46,600!

So what is all this money paying for? Well, to begin with it will cover the validation trial so that we can convince the Ministry of Health to accept the MOT culture method. And it will also contribute to the scientific evidence behind this method. Once the trial has been completed (which we are hoping will be by the end of the summer) the really exciting stuff starts – the plan on the back of an envelope to establish a dedicated TB nurse service.

In the UK, most TB care is administered by specialist TB nurses. These nurses ensure that every patient has a smooth path through the diagnostic period, is allowed time to have the diagnosis and the importance of taking the medication explained to them, and is given access to someone approachable to turn to if they encounter any difficulties. It has been consistently shown to improve the quality of TB patient care, and importantly reduces the amount of people who stop taking their medication (putting them at risk of multi-drug resistant TB).

We will be setting up this TB nurse service in line with the new IMF outreach project, which will be offering HIV testing, treatment and care to the underprivileged population of Namuwongo district living around the hospital.

I really feel that with this grant we have an opportunity to make a difference to TB care in Uganda, and importantly we’ll be pioneering a new method of managing TB, in the underprivileged first and then to the fee-paying patients in the hospital. It’s going to involve a huge amount of work (I am the principal investigator for the trial), so I’ve now got to get everyone organised and ready to go for July. Then I have to start the relevant nurse training as there is no equivalent here – we’ll be starting from scratch. I’m looking forward to the challenge!

• We received £125 from individual supporters in the UK.
• A sponsor gave £1,000 to help meet University fees for Bosco, our TB lab tech.
• Inverness Medical UK gave £511 in the form of discount for essential supplies to help support sugery in Hope Ward.
• In Kampala, Hwan Sung gave $30,000, to support heart surgeries in Hope Ward.

Read more about previous Giving here…

One of our key supporters has very generously donated £1,000 to help Bosco meet the fees for his degree course. In return Bosco has committed to continue working on the TB (MODS-MOTS) project at the lab for the next two years.

Bosco continues to perform comparative tests using various methods to help establish the viability of the MOTS technique.

Dr Grania continues to work with the various academic and clinical research organisations with the aim of getting formal acceptance of the MOTs method.

We have made a number of grant applications for funding to support community outreach programmes working with those living with HIV/AIDS and TB.

Dr Grania (TB Lab Programme Coordinator), Dr Muhame (Hope Ward), Dr Ian Clarke, Mairead (Programme Grants Coordinator), Katherine (Lira Clinic Programme Coordinator), and Patricia (Hope Ward Programme Coordinator).

Our thanks to them and all of their supporters in sunny Penzance.