The team has now plastered the outside walls and is starting on the finishing works inside.

BlackBerry in a dark room with light coming from the other end makes it difficult to get a good photo.

Hope Clinic was established in 2000 and some of the leaders attending had been accessing services for more than 10 years. The clinic is located right in the heart of the community, within a short walking distance for those that it serves; so it is ACCESSIBLE.

The clinic is able to provide some services free, depending upon Ministry of Health, Donor and Charity support. Other services are priced simply to cover costs; HCL is a not-for-profit organisation. Against many measures its services are AFFORDABLE.

Services provided include comprehensive maternal healthcare and HIV testing and treatment. Patients are attended to by trained clinical staff, supported by experienced laboratory technicians and a well stocked pharmacy. So, unlike many public centres, HCL is appropriately staffed and supplied. Required services are AVAILABLE.

I came to the meeting expecting some push-back about costs or about the lack of hospital services (HCL is essentially an outpatient clinic, with Midwife led in-patient services for normal deliveries.) I was therefore quite surprised when the overwhelming feedback was that local people preferred to go to the local drug shops and traditional birth attendants because these provided much better “customer care”.

It seems that Cost is not the most important factor for patients, but rather how friendly and caring the staff are. I’m ashamed that after 3 years here in Uganda I’m caught by surprise by this. I’m sorry if I thought that those with less income would be content with the quality of healthcare service being provided and the fact that it was accessible and affordable. This is is an eye-opener.

Professionals in the Healthcare sector often think little or even disparagingly of the TBAs and Drug Shops. We often say that they are not providing sufficient quality of care, they don’t practice evidence based medicine and perhaps even that they are not safe. What I now see is that the patients who seek care and treatment are better able to judge the quality of customer care and they value friendly, caring service perhaps more than the quality and safety of the clinical services provided. That I think is because they can judge when customer service is good, easier than judging when the clinical care is good.

Perhaps we need to design a Health System in which the professionals judge the patient safety and quality of care and the patients judge the customer satisfaction?

Jen sent me the following infographic which, I think, gives a very interesting insight into healthcare costs in the USA.

>>>

The US spends more per capita on health care than any other country in the world. Americans can’t afford health care. While politicians are trying to find an answer to this crisis, people are struggling to find a way to pay for their medical bills. The average American family spends $19,393 annually for health care coverage. 60% of personal bankruptcies are linked to medical bills.

Created by: Medical Billing and Coding Certification

Ibrahim and the IMG Construction team continue to make good progress building the maternity theatre at Charis-IMC, Lira, N. Uganda.

Week 24a Roof trusses on, originally uploaded by Suubi Trust.

Roofing is going on as trusses have been installed. Purlins are to be put on then finally the roof cover(Iron sheets) later this week. All roofing materials have now been purchased as there was a delay in getting them due to scarcity of steel products in Lira town.

The days when one went to see a doctor and was met by a white-gowned doctor, with a stethoscope around his neck, a notebook and pen are on their way out, thanks to a decision by International Hospital Kampala (IHK) to embrace computer technology.

While the white gown and stethoscope are still in, the pen and notebook are now making way for computers. The hospital has introduced computerized smart cards that will see patients on its medical insurance scheme access their medical history at any of its 120 affiliate clinics. According to IHK Chief Executive Officer Kevin Duffy, every doctor’s office is now fitted with a networked computer on which they will be required to type their medical notes, ending the decades-old practice of writing on notepads.

“Even a lab request for a test will be fed into the system and the patient will just produce their card which has these details. Once the examination is done, the results will be fed into the system, so the doctor at the other end can respond and offer treatment quickly,” Duffy says. He adds that the system intends to cut back on the voluminous paperwork, treatment time and also improve hospital administration.

“Apart from shortening the treating time, one will now be able to determine better the optimum cost of primary healthcare, as well as control whether the treatment offered is appropriate,” Duffy adds.

Under the new system, which is based on biometrics, doctor or patient will only be able to access their medical history over the last 10 visits to hospital through a live fingerprint. “What this means is that the patient’s details are confidential, secure but easily accessible in a shorter time than previously,” Dr Ian Clarke, the IHK chairman, explains.

A patient is required to present his or her card, which when placed in a fingerprint reader will be used to register the member’s fingerprints at the initial visit and match it to the member’s benefits at any point of service, say laboratory, pharmacy and doctor’s office. Clarke explains that under this system, the patient is unable to obtain treatment on the health insurance scheme unless their fingerprints match with what is saved in the system.

The new card system comes through SMART Applications International Ltd, a Kenyan firm that is piloting the solution in Uganda. According to its Managing Director, Pauline Muriuki, IHK has exclusive rights to the card system for one year, but she says several other hospitals have already expressed interest in it.

Dr Muhame Rugambwa, the director of Medical Services at IHK, says this new measure takes the doctor-patient environment into a new era. “In the future I expect to see hospitals with a wireless connection where a doctor does his ward rounds with a tablet computer, keys in his medical notes and they are available on the system for other doctors to consult and advise accordingly; it’s the future of medical practice,” he says.
mtalemwa@observer.ug

At least 16 Ugandan women die each day whilst giving birth and perhaps up to 10 times that number suffer complications that significantly affect their on-going quality of life.

In the UK, 7 children are shared between 10 adult women; in Uganda each woman has, on average, 7 children.

More than 20,000 Ugandan babies are born each year infected with HIV passed from their mother.

So maybe Ugandan women should just have less children, wouldn’t that help to solve these problems? If only it was that simple. Trying to impose our Western culture or world-view on others is not the answer; we must work with those that we want to help, to provide solutions that they will find acceptable and appropriate.

Recent research shows that more than two thirds of women who want to use modern family planning are unable to get regular, sustainable access to it. (Guutmacher, 2009)

Suubi Trust is working with local health teams throughout Uganda to help resolve these issues. In Lira, Northern Uganda, it is partnering with a local faith based organisation, Charis, to implement solutions that will help to improve maternal and child health for the poor living in the local communities.

Some of the local women who will benefit from the Maternal-Child-Health services being provided at the Charis healthcentre in Lira, N. Uganda.
Click for more photos...

These include ante-natal services in which women can access the necessary treatment to help prevent mother to child transmission of HIV and receive family planning after delivery.

We are building a Maternity Theatre that will help provide safe delivery, with emergency obstetrics care, such as c-sections, as and when needed. Friends and supporters of Suubi Trust have raised the necessary funds for this and a generous donor has offered to buy all of the necessary equipment.

The theatre will be operational by September 2012 at which time we will be seeking donor support to sponsor ANC and Safe Delivery for those local women who could not otherwise access such services.

You can read more about this project by clicking here and here.

Alison writes:

Alison and Michelle have chosen to pound the streets of Edinburgh to raise money for the Suubi Trust, a charity that they know is making a huge difference to many of the most vulnerable people in Uganda through its numerous healthcare projects.

Having just recently spent 18 months volunteering in Uganda as a doctor, Alison was privileged enough to be involved in many of these health projects and so has first hand experience of the amazing work that they are doing despite very limited resources. Visit their website http://blog.suubitrust.org.uk/ for more details.

We know that every penny you donate will make a huge impact to many lives in Uganda so with your support we will make sure we stay the course, even if it is on our knees!!

Please click on the photo above and help support Alison and Michelle…

We are working with An African Dream to help provide much needed healthcare to the pupils and caregivers at St. Mark Memorial Orphanage & Primary School in Kyanya, near Kasese in West Uganda.

A 2nd health day was held on March 1st 2012. You can read about the 1st day by clicking here.

The day started with health education on the following issues to the pupils during assembly:

1. Hygiene

We health educated on Personal hygiene including hand washing, tooth brushing, cleanliness and tidiness and also environmental hygiene. We constructed 2 hand washing facilities, tippy taps, outside the latrines

2. Discipline and academic excellence

We encouraged the pupils to maintaining discipline both at home and at school, to respect their parents, teachers, fellow pupils and other people in the community. We discouraged use of vulgar language and peer influence. We encouraged them to work hard, and be determined to excel.

3. HIV/AIDS prevention

We educated the children on modes of HIV transmission.

We emphasized on abstinence as the only measure for the pupils to stay safe from HIV infection. During individual counselling we noted that some pupils especially girls were already sexually active but ignorant of the consequences.

We encouraged them to support their family members and fellow pupils they could be knowing are living with HIV and not stigmatize them.

We discouraged them from sharing sharps both at school and at home.

4. Girl child education

A concern of girls dropping out of school or absenteeism themselves from school once they reach menstruation age was raised and therefore we planned and met all the girls from the age of 13 years and above and the following issues were addressed;

• Adolescent and girl body changes
• Care during menstruation

Girls raised a concern of lack of access to sanitary towels since most of their parents are poor to afford them and this exposes them to soiling their clothes at school and once their friend laughs at them, they don’t come back to school. We taught them how to make local pads with cotton clothing, keeping them clean and always talk to their female teachers and their parent in case of any problems. Teacher Jane was selected for the follow up on the issue and we promised to support her with written article on girl child development.

We made a follow up and have since identified an organization called GEM that is advocating for girl child, provides materials and teach them how to make recyclable pads.

Sexual Reproductive Health

We also provided reproductive health education to the parents and referred the mothers who needed family planning services.

During the day 127 individuals were provided with counselling and testing for HIV. 2 tested positively and have been referred to a local programme for on-going treatment.

Treatment of Minor Illnesses

On the day 203 individuals received treatment for illnesses and basic conditions, including malaria, respiratory tract infections, urinary tract infections, conjunctivitis and fungal infections. Some, with more serious conditions, including 2 with suspected Hepatitis B and 6 with suspected Diabetes, were referred to Kilembe Hospital for further care.

Other photos can be seen by clicking here.

Pamela and I are just catching up on some ER DVDs, almost 10 years old now, but some of the issues travel far and long.

It is hard to plan and manage hospital operations when we are so reliant on good medical personnel. Uganda has a huge shortage of doctors and even in the last week we lost one of our in-house OB/GYN to a hospital in Botswana; the “Brain Drain” is very real.

This Country needs to quickly train more MOs and to explore more seriously how it can safely “task shift” to lesser credentialed, specifically trained cadres; e.g. we need Clinical Officers who can safely and legally perform C-Sections and Nurse Practitioners who can take on more clinical work. Our Clients need to be more willing to accept that some services can and should be provided by Midwives rather than Obstetricians.

Oh and the day after Dr. Mark died, the ER continued on as normal; sure his friends were sad and missed him but neither Mark nor any of us are indispensible.

K.