Dr. Alison (VSO) working with Touch Namuwongo

Alison with her familyAlison Cowan, a GP from the UK, and her family have recently returned after a fabulous 18 months in Uganda working with the IMG group through the charity VSO. She came to Uganda initially to facilitate the training of medical staff across the various IMG primary care clinics. Through this work she came to appreciate the enormous burden of sexually transmitted disease (STD) and its devastating consequences within Uganda and especially Kampala and recognised the need for a comprehensive sexual and reproductive healthcare service. So, once her original placement objective was fulfilled, she extended her placement to work with the Touch Namuwongo Team based at the International Hospital of Kampala (IHK), within the neighbouring communities, to tackle this growing problem of STDs.

Even though STDs are very prevalent in Kampala, and are responsible for a lot of death and disease, very little attention and minimal resources are focused on this area, beyond HIV. The Touch Namuwongo team work with the poorest members of the Kampala community local to IHK and offer services for HIV, TB and STDs. With respect to STDs, prior to Alison’s involvement, the team were just able to treat the symptomatic cases in their hospital clinics and community outreach. However, this approach was only scratching the surface of the problem as 50-70% of disease can be silent. There was no system or resources in place to identify and screen those members of the community most at risk from these diseases and who were often without symptoms. As well as unknowingly transmitting these diseases on to others, the presence of STDs also facilitates transmission of HIV so further fuelling the HIV epidemic. Alison developed a risk score tool capable of identifying such members of the community and which would also then appropriately target their limited resources to the most in need of treatment. Despite resources being very stretched, with the enthusiasm and commitment of the Touch Namuwongo team, the support of IMG and the help of kind donations they were able to get establish a comprehensive service which identified both symptomatic and asymptomatic disease.

Alison also obtained some funding from Oxford University to carry out a research project that aimed to derive and validate this risk score tool. As an associated benefit, the study also funded a large volume of screening and medicines for treatment of STDs in the data gathering process.

The Touch Namuwongo team took on the extra burden of work involved in the study without complaint and worked tirelessly to deliver the service and also produce the data which is in the process of being analysed to develop an effective protocol going forward.

Alison with Immaculate one of theTNP team

Initially Alison was heavily involved in the actual running of the clinics, but by the time Alison returned to the UK, the team was delivering the service without any additional input and continues to do so with great effect, despite the challenges and hard work this entails. Even though the clinics are already very busy, the team recognise what a valuable service it provides and so continue to reach out to the community to encourage others to be screened and treated, especially those communities where the need is greatest. They have got a good relationship with the local commercial sex workers, who continue to attend the clinics and who themselves are becoming advocates of the service.

The research funding has now drawn to an end and so there is a desperate need for on-going funding to continue to deliver this valuable service. Alison continues to raise funds for the STD programme through Suubi Trust, recently speaking at a local church lunch and is soon hosting a Ugandan party for supportive friends in her native St Albans.

The team with some added extras Alison’s children

Experiences of an Oncologist (cancer specialist) in Africa

By Dr. Helena Nam:

What it is like to experience cancer in Uganda? The following is an account of an average consultation in the life of an oncologist in Africa.

One evening, I was just about to leave my clinic room when I heard crying outside. I opened the door to find a young man lying, doubled up in agony. Nurses helped me to pick him up, find a bed and morphine for him. I later found out his story – he was recently married for only three months when he had been diagnosed with an advanced stomach tumour. Because he lived in the mountains, six hours east of the capital, Kampala, there was very little health care – the poor man didn’t even have paracetamol. His friends had heard of “Dr Helena” in the treatment of cancer and managed to scrape together enough money for a one way bus ticket to my clinic in Kampala. The next morning, I found him sitting up, smiling, eating breakfast. What a transformation!

The man survived many months and even went back to tending his crops. Morphine and other drugs were shuttled up and down the mountains by the local Bishop. Sadly, his new wife left him and eventually he passed away. The Bishop told me that with the pain relief, he died with peace, comfort and dignity.

I will never forget that young man. His utter helplessness highlighted the desperate plight of Ugandan cancer sufferers.  Many do not have treatment or even simple pain control for cancer, whether due to limited access, lack of funds, late presentation, superstition or ignorance. It made me wonder just how many others are crying out for help, in desperation, suffering from cancer.

Coming from a background of “number crunching” and meeting “targets” in the UK, I have had to re-evaluate what constitutes successful treatment.

Working in Uganda has transformed my perspective on results  – it isn’t necessarily about statistics or paper targets, it is about real people, about individuals and the small or large differences that you can make in that person’s life. By working hard at cancer awareness, earlier detection, provision of complex chemotherapy, radiotherapy, surgery and palliative support we can start to reform the face of cancer care in Uganda.

In this way, my personal experience of working in Hope Cancer clinic is meaningful. To each individual that attends, we do whatever we can to assist. Since it’s inception in 2006, hundreds of patients have been treated charitably and, yes, we are seeing survivors come through, able to live life to the full… and that makes it all worthwhile.

You can read more about the work at Hope Cancer Care Clinic by clicking here…

Click here to download the November 2010 Newsletter which has a number of patient stories and updates.

Advent: Day 13 TB

The first project that Suubi Trust supported was the development of a level 2 bio-containment facility at International Hospital Kampala to provide a MODS TB culture and sensitivity service. That was back in July 2007.

Since then we have completed the clinical trial and are now using the method to help diagnose patients from IHK and from our community programmes such as Touch Namuwongo.

This work has been supported over the last 3 years by a number of dedicated volunteers including Dr. Mark Russell, Dr. Grania Brigden and Dr. Richard Feinmann. They have worked alongside the local team including Dr. Edith and Bosco, who can be seen in the photo working with some cultures.

TB killed an estimated 1.7 million people globally in 2009, it is the biggest killer of HIV/AIDS patients in Africa. This new method helps us to get an accurate and cost-effective diagnosis much more quickly than before; for our TB patients starting the right treatment quickly is very important. You can read more about our work with TB patients by clicking here.

Advent: Day 9 HIV/AIDS

One of our Touch clients receiving his HIV/AIDS test result

 

IMF has a number of community based programmes helping to raise awareness about HIV/AIDS. We provide counselling and testing, help those who are negative to stay safe and for those that are positive we are able to help with treatment and care.

Uganda has in past years been very successful in tackling this huge problem but there are now worries that the trend is moving up again.

HIV/AIDS prevalence may be on the rise again in Uganda, there are a reported 360 new infections per day.

Dr. Richard reported some time back about Edward one of our patients very sick with HIV/AIDS and TB. This shows the importance of our community work; we need to get to people sooner, before they become so ill.

 

 

Advent: Day 6 Rose’s Journey

On July 11th 2009, more than 60 supporters from across the globe: USA, UK and Uganda, joined Rose Clarke to walk 52 km from Bamunanika to Kiwoko Hospital, a journey Rose had made back in 1989. For Rose and her friends, this walk was in celebration of her many years of freedom, restoration, growth, the courage to heal, second chances, and finding her voice and purpose.

A great day spent with friends, raising money for Hope Ward, read my tweets from the day here.

Advent: Day 5 Judith Nyesigire

This photo is from June 2008, before I came to work full-time in Uganda. Judith, in the middle, worked with the communities in and around Jinja, helping to train and support the community health volunteers. We had a very interesting day watching her interact with these volunteers and teaching them to tell others about HIV/AIDS. Click here to read more.

Sadly less than a year later Judith died, she too becoming another maternal health statistic.

Such a loss, that in another place and time, may have been prevented. We miss her.

Also in this photo, Helen Lay who came with VSO and worked for 2 years helping to professionalise our management and accounting processes. Jemimah Kiboss-Kyeyune continues her role today as the IMF Programme Manager. In the distance is Ian’s car that I borrowed for the day and had to abandon due to the poor road conditions!

A happy day but now tinged with sad memories.

Death Announcement – Moses Munezero

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.

Best Student: Postgraduate Diploma in HIV/AIDS Management 2009

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.

Judith Nyesigire

I recently received the following very sad and shocking news:

Judith Nyesigire

The staff and management of International Medical Group with deep sorrow announce the sudden death of their colleague and friend, JUDITH NYESIGIRE which occurred last night, Friday April 17th.

Judith has been working as a Clinical Officer/ Health Educator at the IMC – Jinja Clinic. She has been the lead health educator and program assistant for the IMG/Hands of Help community program. We have worked with Judith since March 2006. She will be greatly missed.

I met Judith for the first time last summer and spent a very interesting day with her in a rural community close to Jinja. I was very impressed with her professionalism and commitment to those she was helping. She travelled many miles each day, on dust tracks, which are very muddy when it rains, to meet with the community volunteers that she helped train. I’ve re-posted the blog entry about this visit, see below.

Her family are in our thoughts and prayers.