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Suubi Trust:Focus for 2010

All of the funds raised through Suubi Trust are used to support the work of International Medical Foundation, IMF, in Uganda.

IMF is currently engaged in at least a dozen community based healthcare programmes across Uganda. Only a few of these are fully funded by grants, most rely upon financial support from corporates and individuals.

Suubi Trust helps to support a number of these as follows:

Hope Ward.

This medical and surgical ward at International Hospital Kampala, IHK, is dedicated to the provision of hospital care and treatment free of charge for those who otherwise could not afford it. IHK, as part of its corporate social responsibility, is the prime sponsor providing staff, management support and facilities free of charge and helping to meet the cost of some treatments. A number of local corporate organisations are also active sponsors, including e.g. Hwan Sung which has recently offered support for a number of heart surgeries to be performed in the next few months.

Suubi Trust continues its support for the Hope Physiotherapy Service and Hope Ward Cancer Care which requires a monthly budget of about £2,000.

Pader Clinic.

Pader, in the north of Uganda, is a region devastated by 20 years of war and unrest. In the last couple of years peace has started to emerge and those people that had been displaced are beginning to return to their home villages. IMF is working in partnership with the Ministry of Health, MoH, to help manage and improve the local health centre. Last year Suubi Trust provided funds to renovate this facility and now continues to support services by e.g. meeting staff costs for the Medical Superintendant and some of his senior team. This IMF team manages and works alongside other staff who are provided and employed by the MoH. In 2010 we are hoping to extend the services offered to include much needed blood transfusion, ante-natal, maternity and some minor surgery. This would move the facility towards being a Health Centre IV, what we in the UK used to call a Cottage Hospital. We will need to raise at least £30,000 this year.

Lira Clinic.

This private clinic was established initially to provide care and treatment for those living in and around Lira, also in the north, who are either members of healthcare schemes, have health insurance or can afford to pay cash for treatments received. Since 2008 Suubi Trust has provided funds to meet the cost of primary healthcare for the poor and needy who cannot afford it. Headmasters and church leaders are asked to select their most needy children and parents who are given a voucher which, when presented at the clinic, entitles them to care just as if they were members of a private healthcare scheme. Treatment costs are heavily subsidised by the private clinic, essentially being just the marginal cost of drugs and consumables, which means that each charity patient can be treated for as little as £7.50. The clinic is able to provide care to 250 charity patients each month, so funding needed is about £1,800 per month.

eQuality Health.

This new venture for 2010 is a collaboration between those living in and around Bwindi, in SW Uganda, the Bwindi Community Hospital and IMF. The aim is to establish an affordable community healthcare scheme that enables people to pay for healthcare collectively and in advance, instead of waiting until they become sick and fearing the cost of care. It helps protect the poor and enables them to have some control over their healthcare. IMF will administer the scheme working closely with the leaders of local community groups, referred to as a Bataka. A set of 25 quality measures have been agreed and IMF will audit services provided by BCH against these. A monthly capitation fee will be paid by IMF to BCH dependent upon it meeting set targets within this quality framework.

We are hoping to enrol at least 30,000 people onto this scheme and each will contribute UGX 6,000 (£2). The cost of providing care is estimated at UGX 12,000 (£4) per member; costs at BCH are subsidised by the Church of Uganda and other sources of funding such as Marie Stopes International, Elton John AIDS Foundation and The Eurochange Charity.

IMF and Bwindi Community Hospital have agreed to work together to raise funds and new sponsorship to meet the initial gap in funding with the hope that in years to come the scheme will become self-sustaining. In 2010 we will need to raise £60,000.

Dr. Ian Clarke writes about the loss of Moses Munezero, copied from The Sunday Vision:

As I write this column I am sorrowful, because I have lost a good friend and a good man. Moses Munezero was killed in the night bus ambush which happened on the Mbarara- Kabale road this week.

He was a young doctor working in Lira who first worked on a community HIV project in Hima and then moved to Lira to help me set up a clinic, where we not only treat those who can pay, but hundreds of charity patients and those with HIV.

I visited him four weeks ago and he was excited about the possibility of extending the clinic to have a theatre to carry out emergency caesarean sections and other operations. Moses was the kind of person whom one depended on, because he was steady and never let people down. He was that rare breed of person who was truly unselfish and spent his life helping others. He wanted to be good at what he did and considered the patients more important than his own personal needs.

Moses represented the very best of Uganda, in these days when we hear a lot about corruption and Ugandans who are in a hurry to get rich quick by any means. He was a role model, the kind of person you would be happy for your daughter to marry — competent, serious-minded and compassionate. He was a Ugandan who restored hope when one was tempted to feel the society was rotten. It is this which makes his death all the more tragic — because he was killed by Ugandans who illustrate the level to which our society has fallen.

The thieves placed big stones across the road, which the bus crashed into and then overturned, killing at least five people and injuring many. The thieves were not appalled by what they had done, but boarded the bus and systematically robbed the dead and the dying. The worst of society had killed the best in society. Is this the kind of place that Uganda has become?

We have so many good people, but they are being pushed aside by those who have no conscience, feel no tenderness and show no mercy. Uganda has been here before — when the State Research Bureau disposed of people as if they were pieces of meat; we have only just got rid of the menace of Kony, but now it has become dangerous to do everyday things, like taking a bus ride at night.

One of the main purposes of government and civil society structures is to maintain law and order, so that people can go about their daily lives without fear of molestation. The death of Moses is an indictment of these organs of society. His death was due to a combination of lack of law and order and lack of care by the driver and the operators of the bus company. If the driver had been going more slowly within the speed limits, he could probably have seen the stones and stopped. If policing is now so weak, that thieves can operate with impunity along a major highway, then the system is ineffective.

The combination of these two deficiencies resulted in the death of a fine young Ugandan, and let us not kid ourselves, this death could have been avoided. But will anyone take responsibility? Will the Police, who have failed to enforce speed regulations on the buses and to patrol the road? Will the government, who have allowed an incipient lawlessness to take hold, which breeds violence and death? Or will everyone just shake their heads and agree that it was a tragedy, while we wait for the next hold-up or next bus accident to happen?

We are losing the good people in our society, because we are failing to control the worst elements.

Published on: Saturday, 19th December, 2009

With deep sorrow we announce the death of our colleague and friend, Moses Munezero, who has been our Clinical Officer in the International Medical Centre – Lira. He was one of 5 tragically killed in a bus accident which seems to have been caused deliberately by a gang of robbers who had set a road block late at night.

Moses joined International Medical Group in February 2005 and was one of the pioneer staff when we started running the Hima Cement staff/ community clinic. He was then re-assigned to the IMC-Lira in 2007, and was very instrumental in setting up this clinic and has been in charge of it since.

To say that Moses was a brilliant, hardworking, honest and supportive colleague is an understatement – we will greatly miss him. Perhaps what can encourage us is to see what the fruits of his hands are and hope that we can continue to uphold the spirit of excellence that Moses exhibited in his work.

Moses treating a baby at Lira Clinc

Moses with the team at IMC - Lira

May his soul rest in peace.

The following article by Dr. Ian Clarke was published by Sunday Vision.

THIS week we celebrated World AIDS day. Though celebration is hardly the right word for such an occasion, it was an opportunity to highlight the fact that AIDS is still with us and take stock of the progress which has been made in combating this epidemic. In Uganda, the picture regarding AIDS is mixed — we have taken some steps forward and also gone backwards. The overall rate of HIV is now lower than it was 10 years ago, so that is progress. But more new cases are arising, so we are going backwards in that area. Surprisingly many of these new cases are in married couples or people in stable relationships and the risk of infection within a married couple is now twice the risk of infection through a prostitute!

The reason for this is that there are so many discordant couples — where one partner is positive, but the other is negative. This may be because one of the partners has another relationship, or that they were already positive when they commenced the relationship. Either way, as long as the couple are having sex, they are sitting on a time bomb. There are all sorts of possible combinations and permutations in sexual relationships and the permutations don’t get much more complicated than in Uganda. In this country, we have people with wives, co-wives, side-wives and girlfriends. Relationships may be described in terms of monogamous, serially monogamous, polygamous, informally or serially polygamous.

With all these different types and combinations, it is no wonder that AIDS is still an issue and in the face of discordancy within such networks the old message of Abstain, Be faithful or Use a condom is inadequate. The International Agencies have been looking for new ways to communicate the issue and someone came up with the message — Get off the sexual network, which for ordinary Ugandans must be one of the most obscure messages about AIDS they could have dreamed up. The message is a bit too subtle for most Ugandans — it sounds like getting off the London underground or Facebook and how does one apply it to real life? If people are already in complex relationships, they are either in that situation unwittingly because they do not know what their partner is doing, or they are aware that they have more than one partner but continue because they enjoy that lifestyle. Either way, telling them to get off the sexual network is meaningless and the simple message is — don’t have sex with anyone unless you know their HIV status, even if you have been married for many years. This means that you not only need to test yourself, you need to take your partner with you, and if they refuse, then stop having sex, or protect yourself by using a condom. This is an issue which you cannot leave to trust, it is a matter of life and death and if you don’t take the decision the death will be yours. If you are the person in the relationship who is positive, you must also ensure that your partner is protected, which you can do by using a condom.

For this World AIDS Day, the message should be straight to the point — don’t have sex with anyone, even your husband or wife, unless you know their status. It is your life and it is your responsibility to protect it. Don’t put your life in the hands of your partner, because all too often, if you happen to get infected, they will deny that it was from them and then blame you for bringing HIV into the relationship.

Do a test with your partner and know their status.

http://www.sundayvision.co.ug/detail.php?mainNewsCategoryId=7&newsCategoryId=137&newsId=703368

Irene Biraro-Seguya has completed the PDM in HIV/AIDS management and will be doing the MPhil next year. The Africa Centre for HIV/AIDS at Stellenbosch University recently awarded her Best Student in 2009; she shared the evening with Archbishop Emeritus Desmond Tutu who was honoured with the Van Emden Prize.

She has managed to do this, whilst also being a busy mum and performing a very demanding role as the Director of Nursing at International Hospital Kampala, Uganda’s largest private hospital.

She holds a BSc degree in Nursing from the University of Eastern Africa Baraton in Kenya and Botswana. She is passionate about nursing and believes that nurses are crucial agents of change for improving health care delivery in sub Saharan Africa. Moreover she believes that empowering women in poverty to take action and to be at the forefront of decision making is fundamental for sustainable development in the fight against poverty and disease – particularly HIV/AIDS.

The following was originally posted on the VSO website.

Chest physician Richard Feinmann is volunteering with VSO in Uganda, where life expectancy is just 51 and over a third of the population live in poverty. Here Richard describes some of the challenges facing patients and why exposure to these challenges is so crucial for UK health professionals.

I hadn’t realised VSO would want people of my age. All my VSO contacts went overseas straight out of university, so I was a little tentative when I contacted VSO and said,  “I’m an old git, I have reasonable health and these talents, are you interested?” And I really did expect them to say no but was pleasantly surprised. So here I am and I think it’s the best decision I ever made.

Here at International Hospital Kampala I’m called “Doctor Richard”, which is quite nice in a way – all the doctors are called by their first name. It’s a private hospital but has a charity wing, Hope Ward, which is where I work. It’s for people who can’t afford healthcare. There are a lot of people in Uganda with no money. If you don’t have money, you can’t get transport to the hospital or clinic. And even if you do get there you don’t have money to pay for drugs to get you better. The Ugandan government does provide free drugs for HIV, TB and malaria but they often run out. Sad stories of patients selling their HIV drugs to buy food are all too true.

Making sustainable changes

A lot of patients, particularly those with HIV and TB, come to us quite late and we really think they’re going to die. We feed them up with this disgusting stuff called millet porridge and they get their drugs and within a fortnight they’re up and about. It’s remarkable. There are not always successes, but people often bounce back when you just don’t think they will. So it’s a really rewarding job, but we’re only scratching the surface.

The doctors here are very hard working and very bright, but they don’t get a lot of support and every day they’re seeing things they’ve never seen before. So it’s good to supervise them on the ward rounds, to say, “why did you do that? Had you thought of doing it this way?” I work with the nurses too. Before they just weren’t used to being asked for their opinion, but now they’re so forthcoming. It’s very satisfying for me to see them change and their standards improve. To make all this sustainable I’m about to start working alongside a Ugandan specialist physician who will take over my role. It’s really important to have a figurehead, a key person who will teach and work with nurses when I leave.

I think it’s absolutely key for health workers in the UK to have exposure to Africa. If you haven’t, you just can’t imagine what the difference in healthcare is. It has been a real eye opener. I think every doctor should experience it if they can.

http://www.vso.org.uk/story/23756/richard-feinmann-chest-physician-uganda

Sunday November 15th 2009 saw over 300 runners gathered at Kololo Airstrip in Kampala to take part in the Hope Ward Fun Run. Many were taking the opportunity to preview the 10km course for the following week’s MTN marathon.

The day was an enormous success with UGX 3,320,000 (GBP 1,072) raised through generous donations from individuals and corporate teams. Bead for Life, Mildmay and Voluntary Service Overseas all entered corporate teams of 10; the Paediatric Infectious Disease Clinic employees came out en-mass to support the event.
The money raised will allow Hope Ward to continue to provide medical services to those most in need.

A big thank-you to the organizers of the event: Robert, Cara, and Jemimah. Thanks also to Irene for the video clip.

An African Dream

Last weekend I was able to join Dennis and Rob on a visit to the projects set up in memory of Mark Wynter, close to Kasese in the Rwenzori foothills, West Uganda. (An African Dream)

I first met Mark about 10 years ago at church in Hazlemere and sometimes we talked about his plans for a life’s work in Uganda. Sadly Mark died in 2005 before he could fully realise this dream. His wife Sophie and his friends continue the work today in his memory.

They have built and continue to support a Primary School, providing the fees so that many of the local orphans can attend.

St. Mark's Primary School

In the villages around the school they work with community leaders to provide support for widows; in one such initiative they help to meet the initial costs of farming pigs as an income generator.

Widow's are helped to raise pigs for income

This is a very poor community, the local people have almost nothing and quite literally are still living in mud huts up in the hills. They raise the pigs and a few hens and grow coffee to sell in the local market.

80 years old...

Even though these people are very poor, they have dignity. Whilst visiting this community I didn’t have the overwhelming since of hopelessness that was so very evident in the fishing village we visited the following day.

In time we will explore opportunities to help improve healthcare for this community.

More pictures at:

http://www.flickr.com/photos/suubitrust/sets/72157622858359680/

Read about An African Dream at:

http://casaluz.net/index.html

http://aaduganda.blogspot.com/

Sosina is 27 yrs and from an Eritrean-Ethiopian background. She fled her country during the war in the early 2000s and lost contact with all her family – she still wonders if they are alive or dead.

Teshome Sosina

Sosina arrived in Uganda, a refugee with no family, no home and no job.

Due to difficulty in accessing healthcare, she had a breast lump growing for 2 years. She heard about Hope Ward through a kind neighbour and she was diagnosed with locally advanced breast cancer. She has been started on primary chemotherapy and moderately extensive surgery to ensure entire removal of disease. This is likely to be patched with a skin graft and will be followed by radiotherapy and hormone therapy.

Mariana is a 49yr old Congolese refugee. In 2008, during the war, her family were caught in the crossfire, in northern Congo. Mariana’s husband was killed but she fled with her brother and 4 children to a UN camp, in the west of Uganda (Nakivaly camp).

Mariana and her brother

Sadly, the story is yet again, of a 2 year delay in assessing a growing breast lump. Mariana had difficulty accessing food let alone medical care. She was so weak that she found it difficult to eat. Since she was diagnosed with locally advanced breast cancer, kind NGOs have helped with improving her diet. We are currently treating her cancer with primary chemotherapy after which we may consider surgery, radiotherapy and hormone treatment.

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