Code Pink

Based on a work at

Cancer is the epidemic of modern times. Unlike other diseases that have plagued people throughout history such as tuberculosis and polio, we haven’t yet discovered a vaccine against it. One of the most common manifestations of this disease is breast cancer, which affects not only one in eight women, but also thousands of men in the United States. In fact, only lung cancer is more destructive. And if someone you love gets breast cancer, it will cost more than just their health: treatment typically costs between $50,000 and $100,000, the latter of which is more than twice the annual median U.S. income. Early detection is the key to surviving breast cancer, so share this graphic with people you love to help them learn stuff about beating cancer before it has a chance.

Click on the image below to see the full infographic.

Alison and Michelle Raise more than £3,300

Alison and Michelle

Alison and Michelle raised more than £3,300 from their family and friends who sponsored their recent marathon in Edinburgh.

These funds will be used to continue supporting the STI clinic in Makindye division, Kampala. This clinic provides counselling, testing and treatment, free of charge, to those that could not otherwise afford to access such care.

The clinic is an integral part of our Touch Namuwongo Programme which also provides counselling, testing and treatment for HIV/AIDS and TB. We are currently planning to extend these services to include safe male circumcision.

In recent years about 20,000 adults living in Makindye division have accessed services from the Touch programme.

Our thanks also to Helen for her continued support for the STI clinic.

Week 38 – Build Finished

After 38 weeks, I am very pleased to announce that the build of the maternity theatre in Lira is now finished.

Week 38 Painting Outside

The Bush Hospital Foundation is in the process of acquiring and donating the necessary medical equipment. The value of this is likely to be about £15,000.

We are continuing discussions with a number of potential donors regarding on-going provision of funds to cover the cost of providing maternity and emergency obstetric services to local women.

You can read earlier postings about this programme by clicking here.

HIV Counselling and Testing in Makindye

An essential step in helping to prevent the transmission of HIV is to be able to access testing and from that to know your status.

In the last few years, Hope Clinic Lukuli, Touch Namuwongo and our recent SMC Programme have, between them, provided HIV counselling and testing (HCT) to more than 70,000 adults in the Makindye division of Kampala.

From those tested, some 2,300 have been enrolled into treatment programmes and of those, 725 are currently receiving antiretroviral treatment (ART).

1-1 Counselling by Touch Namuwongo during HCT in Makindye

Toward an AIDS-Free Generation

U.S. Chargé d’Affaires, Virginia Blaser made a statement recently about the on-going support by the USA for healthcare in Uganda and for the fight against HIV/AIDS in particular. You can read the statement in full here.

This statement of support comes at an interesting point in time. The Uganda Ministry of Health has just recently announced that a recent survey shows the prevalence of HIV has increased to 7.3% of adults, that’s about 1.2m people, more than double the number estimated 7 years ago.

In Uganda, with the support of Target TB, Touch Namuwongo (IMF) has improved access to health education and HIV testing in the community through outreach work. Here a fully trained community healthworker undertakes blood tests at a mobile clinic.

In June the Government of Uganda announced that the allocation of national budget to the Healthcare sector would be reduced from 9.8% in 2011/12 to just 7.6% this year. Depending on the exchange rate this is equivalent to about $307m.

In her statement, Blaser starts by reminding us that since 2004, the American people have invested over $1.7 billion in support of the national HIV response in Uganda. Most of this has been channelled through PEPFAR, for which we should always give a note of thanks to former President George W. Bush.

In 2003, Bush launched the President’s Emergency Plan for AIDS Relief (PEPFAR), pledging $15 billion to end the suffering and save lives threatened by the AIDS epidemic. In 2008, Congress agreed to provide $38 billion more.

In Uganda an estimated 600,000 people living with HIV need to be treated with ARVs but only 330,000 are currently receiving these life-saving drugs and of those the USA directly supports funding for 314,000. Antiretroviral treatment, ART, means that a person living with HIV can expect to live as long as their fellow countrymen who are HIV infection free.

We know that ensuring early and sustained access to ART for all those that need it will be a very significant intervention in the fight to reduce the growing numbers of new infections. So it is good to hear Blaser state:

the PEPFAR program in Uganda will review its programs to ensure that we prioritise treatment expansion to ensure all who need ART receive it

On July 5th Blaser stated that $425m will be given in Aid to boost Uganda’s health sector. This is more than 60% of the total Aid being given by USA to Uganda and is some 40% more than the GoU budget allocation.

That budget allocation is coming under increasing scrutiny. Blaser urges the GoU to increase the allocation to the 15% committed in the Abuja Declaration. Whether or not the country can afford to reach that target, it should perhaps be a little more circumspect before revealing that it spends some $150m to send VIPs overseas for healthcare treatment.

It is clear to me that fighting HIV is more than just about GoU budget or Aid from USA. That budget and Aid need to be used more effectively, we need to focus our attention on proven interventions that we know will work. Implementation will involve many different partners from all parts of the health sector and as Blaser says:

By working together, we can free Uganda from this terrible epidemic.  Let us all fight together for an “AIDS-free generation.”

Dr. Simon Blankley, VSO, working in Uganda

This short video, 3:15, by Schuman Hoque highlights some of the work done by Dr. Simon Blankley whilst he was here with International Medical Foundation in Uganda. Simon came as a VSO and helped to develop the TB programme at IMF, in collaboration with our funding partners Target TB, based in the UK.

The relationship with Target TB will enter a new phase later this year when we complete the final application phase for renewed funding by DfID, which will extend Touch Namuwongo, our HIV/TB programme in the Makindye division of Kampala.

TB kills 3,800 people every day,
more than Malaria and AIDS.

The video shows the teams working at International Hospital Kampala and in the community outreaches both in Kampala and in Lira, N. Uganda.

You can view this video on its original website in HD and higher quality here.

You can read more about our award winning TB prorgamme here.

Patients Want Good Customer Care

Yesterday I had the privilege of attending a meeting with more than two dozen community leaders from the zones surrounding Hope Clinic Lukuli.

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

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?