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Clare Mulvany first posted the following on her Blog in July 2006. At the time she was on a journey around the globe interviewing ‘people who change our world’ about their life stories. Her theme of “Social Entrepreneurs” has since blossomed into a new book, “One Wild Life”, about which I will post details later.

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I first came across Ian Clarke through a viewing of the ‘Longest River’, when he joined the rafting crew down the Nile (see previous blog ‘Quite Bright and Filming’). Watching him in action, I was impressed by his commentary and observations while passing through the conflict zones of South Sudan, and particularly with his leadership ability within the team. So when I heard about his work in Kampala, I was eager to track him down.

Dr. Ian Clarke

Ian, an Irish medical doctor, originally came to Uganda as a GP and from there set up a rural hospital North of Kampala. His work there showed him the need for high quality medical service provision across the country. He was also eager to show that when it comes to the medical profession that ‘quality’ and ‘Uganda’ can be combined. ‘I decided that my goal was to start a hospital in Kampala and raise medical standards’, he commented. ‘But this time, instead of targeting the rural poor, where I had been working, that I would target the emerging middle income group, and use the money that they pay to upgrade the services and thus effect the overall health services’

So emerged ‘International Hospital Kampala’, a private hospital which provides specialist services in the city. Included are Oncology and Plastics departments, and a nursing school.

‘So it means that you can have a third world country, but it does not mean that it is third rate’, he added-with pride.

The hospital is now at a stage of attracting private sector sponsorship to support a charitable ward in the hospital, so that people who cannot afford the services can still access them. (Since then of course Hope Ward has been implemented and has treated very many charity patients… KFD)

There are also has plans for a medical university, so as to raise the bar on training, and to expand clinical services regionally.

‘The core value is making a difference- and if you are making a difference, you are bringing hope. The ideal of wanting to make a difference, is wanting to multiply ourselves. We are not there just for our service, even making the competition buck up a bit, but we want to take some of the principles we learned and teach other people’.

It has been an intense few years for Ian, who himself has had a battle with illness. I asked him what has kept him going.

‘I have a very strong belief in people, and I think it is my belief in people which enables me to do what I do’, he added. ‘Plus some of it is just determination. You don’t give up and you don’t expect to make huge strides at once. Things happen incrementally, and then you look around in a couple of years, and say, yes, look at what we have done’.

tradeaiduk

We are very pleased to announce the receipt of a further £6,000 from Trade Aid UK to help support our Health Centre in Pader, Northern Uganda, which has treated, free of charge, 1,652 patients since last October (as at mid-May).

Click here to read more about Trade Aid UK.

Ruth Gracey, one of the Suubi Trust Trustees, writes:

“On a recent visit to IHK I met physiotherapists Alex, Irene and Charlotte (Charlie), and saw the Hope Physiotherapy Outpatient Clinic in action. The clinic, funded by Suubi Trust, offers physiotherapy to patients who would otherwise be unable to afford it. Each patient is initially offered 8 sessions of treatment: if further improvement is considered likely at the end of this time, then some further sessions might be arranged.

Amongst those currently benefitting from the outpatient clinic are Bethany and Anitah, both from the Watoto Children’s Home.

IHK Charlie with Bethany2

Bethany, who has cerebral palsy, is making good progress in learning to walk.

IHK Physio clinic Irene with Anitah3

Anitah, who has developmental delay in a number of areas, is being encouraged to crawl and stand.”

Ruth Gracey, one of the Suubi Trust Trustees, writes:

“A highlight of my recent trip to Uganda was the opportunity to travel to Lira and meet the team at the clinic there.

Situated 6 hours drive north of Kampala, Lira was severely affected by the activities of the Lord’s Resistance Army (LRA). Thousands of people fled their homes in the countryside and took refuge in the town.

Aid agencies established emergency camps on the edge of town, on school playing fields, or anywhere where there was space. Schools struggled to function, and local medical facilities were overwhelmed. The situation was further complicated by the number of children who had lost one or both of their parents, and by the spread of HIV/AIDS. It is only in the last two or three years, with the retreat of the LRA, that the camps have been disbanded and displaced people have begun to return to their home villages.

Lira clinic team

With the support of the Suubi Trust the Lira clinic is able to treat up to 200 charity patients a month. Each charity treatment is subsidised, with the patient paying only 2,000 shillings (less than £1). Each month health education worker Ambrose Ogwang distributes charity referral forms to a number of schools, churches and other community groups. These groups then select individuals, often children, who are in need of medical treatment but unable to afford the standard fees.

Ambrose took us on a tour of Lira and introduced us to some of the groups who participate in the referral system. Over the course of the day we met head teachers, deputy heads, pastors, church workers, and representatives of community organisations, all of whom expressed their thanks for the support of Suubi Trust. We were also able to meet some people who had benefitted directly from treatment at the clinic.

Lira Lira Primary school Deputy Headteacher Mr Yapi Sam Bob and pupils

Arriving at Lira Primary School during morning break we were given an enthusiastic welcome by hundreds of excited children! Deputy head teacher Mr Yapi Sam Bob explained that many pupils at the school come from very poor families, but with access to medical care, enrolment and attendance at the school have improved.

Ruth, Zulaika and Ambrose

While at the school we were delighted to meet Zulaika, who had been referred to the clinic some time ago. She was found to have a heart condition, but is now receiving the drugs she needs and is back at school. Her family came to Lira during the insurgency, and have chosen to remain there for the moment, so that Zulaika will have access both to education and to the medical care she needs.

Mr Yapi Sam Bob especially asked us to pass on his greetings and thanks to St Peter’s School in Canterbury, who have raised money to help pupils at the school receive treatment at the clinic.

At the New Covenant Christian Centre we were introduced to Margaret, an older lady who had suffered for some time with stomach problems. She had gone to a local clinic and been told that she would need tests and medicines, neither of which she could afford.

Magaret outside her home in Lira

The church referred her to the IMCC clinic, where she was treated successfully. Now that she can cook and look after herself again her son has been able to return to college and resume his studies to be a health worker.

Later in the day we visited St Phillip’s Catholic Church and Nursery School.

Lira St Phillips NUrsery School

Once again we received a very warm welcome, with the children forming an impromptu choir to sing to us!

Lira St Phillips RC Primary pupils3

The boy in the blue tee shirt is just one of those from St Phillips treated at the clinic and now back at school.

Our final visit of the day was to the Concerned Parents Association (CPA), founded in 1996 when the LRA abducted 139 girls from St Mary’s College, Aboke. It was only earlier this year that the last of the girls finally returned. The CPA now offers support to formerly abducted children, provides vocational training for orphans and vulnerable young people, and offers training in conflict resolution.

Lira Memorial to LRA conflict erected by Concerned Parents Association

Just before Easter they erected a memorial to the victims of the LRA insurgency on one of the main roundabouts in Lira.

At the end of our brief, but busy, visit to Lira it was obvious that there is a huge need for health education and subsidised medical care amongst the poorest of Lira’s community. Ambrose and the rest of the IMCC team are making a valuable contribution towards meeting that need, and very much appreciate the funding and support they receive from UK.”

I am writing this quick update on the veranda of my cottage, over looking Lake Victoria. For those of you who have not yet heard the news, I am now working as Managing Director at International Medical Group, details below. This is a wonderful opportunity and allows me much closer involvement in the many different projects that Suubi Trust is helping to support. I will be posting some personal updates on facebook; My facebook profile.

Our Treasurer, Steve Taylor, has been preparing the 2008-09 accounts (April 6th to April 5th) and we thought that you might be interested in learning how much was raised and what we’ve done with it. It’s probably worth reminding you that:

  • All money received by Suubi Trust is used to support the work in Uganda. We make no deductions either from your contributions or from tax relief claimed through Gift Aid.
  • Our trustees are volunteers who do not charge for their time, or claim any payment or expenses. We have no administration costs.
  • Operational costs for Hope Ward and the charity clinics are subsidised by Dr. Ian Clarke. Suubi Trust does not pay rent or contribute to the capital costs of establishing this required infrastructure.

You helped raise a total of £73,300

These funds were used to support and provide:

  • Primary healthcare for more than 2,500 patients and an immunisation programme for young children at the Lira Health Centre:- £18,000
  • Complex healthcare on Hope Ward; on average there are about 6 in-patients being treated at any one time, though we have capacity to treat as many as 15 if we have sufficient funds:- £5,600
  • Cancer Treatments on Hope Ward; at times there can be as many as 15 outpatient day case chemotherapies each week:- £6,200
  • A new charity based Physiotherapy clinic treating patients with complex, long-term rehabilitation needs:- £820
  • The purchase of essential equipment for Heart Surgeries:- £350
  • Contribution to other International Medical Foundation projects, including a large HIV-AIDS outreach programme into the community living in and around the Hospital and a TB Lab which is now close to completing a clinical trial for a new low-cost, fast diagnostic test:- £17,217
  • The opening of a new Health Centre in Pader, Northern Uganda, which has treated, free of charge, 1,652 patients since last October:- £25,113.

In recent weeks I have had the great pleasure of meeting again with the team members providing this care at International Hospital Kampala and at the clinics in Pader and Lira. Their dedication and professionalism joins with your generosity to make a difference in the lives of so many.

Thank you so much for your continued support.

Kind regards,

Kevin.

Chairman: Suubi Trust and International Medical Foundation.

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International Medical Group is the leading private provider of health care services in Uganda. There are three main divisions to the group and the model is similar to HMOs in the USA:

1. IAA Health Care provides Health Schemes to employers for their employees and families and also some personal schemes . These schemes meet the costs of any treatments required. There is no NHS in Uganda. Members can get treatment from IMG, or from a number of selected medical service providers.

2. International Hospital Kampala, the largest private hospital in Uganda, provides care for IAA members, for those with health insurance and for cash and invoiced patients. IHK has 100 beds for in-patients, plus general outpatient and specialist clinics. It is the country’s first ISO certified hospital.

3. International Medical Centres has 13 community based Health Clinics throughout the country. These provide primary health care, similar to a GP Surgery in the UK, and refer patients to IHK as needed. Some of these are stand alone clinics and others are in large Factories and Schools.

IMG employs about 530 people and has more than 100,000 clients.

IMG provides staff, facilities and infrastructure to International Medical Foundation to support and enable its charity and grant funded projects.

In 2008, IMG made a financial contribution, to these charity projects, of more than £80,000.

Kaluba has been a patient on Hope Ward and his story was printed in today’s Monitor:

Our thanks to Dr Richard and the clinical team who have helped to make such a significant change in Kaluba’s quality of life and to Dr Ian and other supporters who generously sponsor such care on Hope Ward.

Only a month ago, Sam Kaluba was in pain and had difficulty walking and working by himself. Then he underwent surgery at no cost. He is recovering and says the pain is much less now, writes Fred Muzale.

health1b_2Remember Sam Kaluba, the 46-year-old who could neither walk nor do any work because of the swelling (keloid) on his right cheek? Well, he can now walk and has resumed work. Seated in his bicycle garage at Ntenjeru Trading Centre in Kayunga District, Kaluba chats with his customers and friends.

He smiled when he saw me unlike before when he was crying in pain from the big swelling. The keloid which had threatened to ruin his future started as a small pimple when he was only five years old. It was only last month after Daily Monitor had written about Kaluba’s condition that Dr Ian Clarke, the Chief Executive Officer, International Hospital Kampala, and another sympathiser, Ms Grace Nagendi from Engenderhealth learnt about his suffering.

Dr Clarke offered free surgery for Kaluba at his hospital while Ms Nagendi offered money to transport him and his sister to the hospital.

Kaluba whose ailment was diagnosed by doctors as a keloid, which is caused by an abnormal overgrowth of cut scar tissue, had lived with it for over 43 years. He had no money to go for an operation because he could neither walk nor do anything to earn a living as he was always in pain.

Kaluba who has a wife and 11 children, was emaciated and weak. He was always groaning in his two-roomed house because of the pain and weight of the swelling. He had given up on life but all that is now in the past. When Dr Clarke read about his ailment, he called the author of the article, asking him to take Kaluba to IHK to be operated.

health1_6_thumb

At IHK, he underwent medical checkup where it was confirmed he had a keloid and was told by a doctor only identified as Dr Ben to report on Thursday the following week for an operation.

health1c

On the said day, the anxious Kaluba who was in pain and could not walk easily, woke up early and accompanied by his sister Grace Nakato, travelled to Kayunga Taxi Park and boarded a taxi to Kampala. On reaching IHK, he was admitted to Hope Ward until the following day when he was operated on.

According to Dr Clarke, Kaluba underwent surgery and was injected with steroids. He was also subjected to radiotherapy to ensure that the keloid doesn’t come back.

“The main problem with keloids is that after a patient undergoes an operation, they will always recur, but we have injected him with steroids and also applied radiotherapy on him to prevent it from recurring,” Dr Richard Feinmann, a specialist at Hope Ward, IHK said, adding that over Shs1m was spent on the operation.

Following the operation, Kaluba was required to report to the hospital every two weeks for medical examination. “He has to report back regularly for medical examination so that we examine his wound and also give him more drugs,” the doctor said. It may take at least a month for his wound to heal and Dr Feinmann explains that there are plans to carry out plastic surgery on him so that the scars are not seen.

Kaluba now says he feels better and has started doing his work – repairing bicycles, which he had been doing before his ailment worsened.

“I’m fine now. The pain has almost subsided. I am really grateful to IHK, Ms Nagendi, Daily Monitor and whoever contributed to my treatment,” Kaluba said with a broad smile.

He thinks if he had not received treatment, he would be dead by now. “It’s God who did all this for me. Where would I have got all that money to pay the medical bills?” he wondered. Having been confined to his home for almost 10 years, people in his village and in Kayunga Town where he used to ride a boda boda, were surprised to see him walking and without the swelling. A visibly happy Kaluba walked through Kayunga Town the day he was discharged, greeting friends who hugged and also gave him money.

His wife, Ms Agnes Nakityo was the happiest. “Even though some people laughed at me because my husband had a big swelling and looked ugly, I never thought of divorcing him but I am happy that he has been treated,” she said as she looked at her husband with a smile.

Kaluba also says he plans to start riding his boda boda bicycle so he can get money to build a nice house for his family and also educate his children.

Tom

Dr Richard writes…

Tom

here you see a sad little Tom with a Burkitts Lymphoma behind his left eyeball. As you can imagine he was in so much pain and cried and cried.

Tom with Dennis and Maria

You can see him above with Dennis and Maria our fabulous Chemotherapy nurse (and Dr Hamza our excellent oncology doctor).

Burkitts is largely an African lymph gland cancer. We see Hodgkins lymphoma in UK but rarely Burkitts. It is curable with chemotherapy and here you see a smiley Tom after 2 of his 6 course of chemotherapy.

Tom after treatment

Burkitts is the commonest cancer of children in equatorial Africa. Interestingly it is linked to the glandular fever virus…Ebstein Barr virus and chronic malaria infection in these children may reduce immunity to the EB virus so that it cause this cancer.

Although Dennis had a biopsy which suggested another cancer it would not surprise me if he has Burkitts which looks very similar under the microscope.

Edward

Dr Richard writes…

Edward

This is Edward from Touch Namowongo and I guess this is our commonest admission. Advanced HIV and pulmoary Tuberculosis… a deadly combination. He came in on a stretcher because he was so weak and malnourished…He weighed 26.5kgs. They get so sick they can’t eat or drink and end up looking like this..really skeletal. We gave him food through a naso- gastric  and TB drugs and after about 3 weeks he walked home with his wife …weight still only 36kgs.

We feed with porridge…everybody gets it on Hope Ward…I’m not sure what nutritionists would make of it but its made from either maize or millet flour (I think it tastes horrid…uneducated palate) and it clearly contains plenty of calories and it works.

HIV prevalence is probably rising in Uganda and maybe nearing 10% of the population. About 50% of patients with HIV will have TB and  it is the TB or other “opportunistic” infections which kill not the HIV. Unfortunately by the time they get to Hope Ward they are often so very sick because they come so late.

Grace

Dr Richard writes…

Grace, a lady in her late thirties, went into labour with fourth child. Went to health centre and diagnosed obstructed labour (baby could not get out). Went to hospital and had caesarian section but too late (happens commonly) and baby was stillborn and there was much damage to her pelvic organs. Went to Mulago hospital…in for two weeks …no treatment. Went to another hospital diagnosed fistulae (new passages between bowel and vagina) and bowel and abdominal scar. In other words bowel contents coming out from the wrong places… This hospital kept her for two weeks but no surgery.

A VSO colleague brought her to Hope Ward 6 weeks after birth. She was discharged yesterday in full working order thanks to Hope Ward and Dr Moses after another 4 weeks in hospital. We were able to get her really fit with blood transfusions and feeding for long and complex surgery.

The picture is of her and her sister just before discharge.

Grace

There are 100,000 women with this complication of obstructed labour in Uganda…often known as VVF…Vesico vaginal fistula…damage to bowel causes connection to bladder and vagina. What an awful condition and so easily preventable.

For some reason of all the patients we have treated on Hope Ward this lady’s outcome pleased me more than any!

Zainab

Dr Richard sent this update about one of our patients on Hope Ward:

Zainab

I was just going home before Easter w/e when I met little Zainab and her mother. She’s come back fom her home in Hoima (north western Uganda) for more skin grafting. She was brought to us before Christmas, sponsored by Stanbic Bank, because her T-shirt caught on fire in the kitchen at home and she got awful burns to the top half of her body (fortunately not her face). She had contractures to both elbows so that her arms were completely bent and useless. Our star plastic surgeon Dr Ben straightened her arms and did lots of skin grafting but eventually we ran out of skin on her legs to graft and so she went, after 3 months in IHK, home to heal up a bit. And now she’s back for more grafting. Childrens injury statistics I think are fearful in Uganda. Its not really surprising with charcoal or wood burning cooking and 7-8 children per family . Hard to keep an eye on them all!

and here is Zaniab with her friend Dennis playing together on the ward

Zainab and Dennis on Hope Ward

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