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.

Poor Housing Increases TB Infection

By Joe Nam, New Vision, published November 07th, 2011.

A study carried out in Makindye Division in Kampala, Lira Municipality and Wobulenzi town council has established a co-relation between poor housing and prevalence of tuberculosis in urban centres.

The research carried out by International Medical Foundation engaged 1,366 adults in 1,366 households. The majority of the respondents live in slums in conditions of what is considered poor housing.

“…we don’t have the capacity to stay in good houses. We stay in houses we can afford to pay for. We stay in houses without windows and our roofs leak. When you think of going back to the village, then you think about the hard life there…the places in which we live are surrounded by drainage channels, which flood, making it easy to contract diseases. However, we find ourselves in a situation we have no control over…” a respondent in Makindye says.

The survey found that awareness of TB was high in the population, mainly through some form of contact with a TB a patient. Myths and remarkable deficiencies in knowledge of TB cause, symptoms, transmission and prevention, however, abound.

The survey also found that although majority of slum dwellers are well within reach of a health facility, significant barriers in terms of actual service delivery exists due to lack of drugs, absentee health workers, prohibitive user fees and lack of transportation to health facility, hampered treatment of TB. TB-related stigma was found to be high in communities, with negative perceptions towards persons with TB due to association with HIV/AIDS.

The study recommended planned housing in urban centres for low-income earners, participatory engagement with slum dwellers to improve their environment, enforcement of the Public Health Act minimum standards in the construction of toilet facilities and improving access to medical care.

The study also recommended pegging of TB screening to HIV testing programmes due to the tendency to take HIV AIDS testing more seriously. Uganda is among the 22 countries in the world with the highest number of TB cases, with 100,000 new infections annually.

Tuberculosis Health Needs Assessment (2/2)

A key element of this study was to assess the housing as well as socio-economic determinants amongst slum dwellers.

1,366 households were surveyed in 3 low income settlements; one in the urban slums within Kampala and the other 2 in rural settings as a comparison.

As indicated in the previous posting there is a need for closer collaboration between the various agencies responsible for TB and for Housing.

Kisugu TB health needs assessment

Some of the survey findings are:

  • 66% did not own their property
  • 48% of properties had just one room, which on average was just 12 m2
  • Average of 5 people per property
  • Average of 3.8 people sleeping per room
  • 66% used a communal latrine

Kisugu TB health needs assessment

We don’t have the capacity to stay in good houses. We stay in houses we can afford to pay for, which exposes us. We stay in houses without windows; mosquitoes bite you and with leaking roofs.

When you think of going back to the village, then you think about the hard life there…the places we stay in are surrounded by drainage channels which flood and this makes it easy to contract diseases.

However, we find ourselves in a situation we have no control over.

Slum dweller, Kampala.

For a copy of the full report please email: imf@img.co.ug

Tuberculosis Health Needs Assessment

Target TB Logo

 

International Medical Foundation and Target Tuberculosis (Target TB) recently completed an assessment of how housing conditions and socio-economic factors affect vulnerabilities for Tuberculosis (TB). A total of 1,366 households were surveyed in 3 low income settlements within Makindye Division Kampala, Lira District and Luwero District.

Kisugu TB health needs assessment

Uganda is ranked 16th out of the 22 high TB burden countries by the WHO, and is one of only two of these high burden countries with increasing mortality. Population as well as urban growth has been increasing dramatically over the last 20 years, with much of this settlement unplanned. Two previous studies in Ugandan slums have shown higher prevalence of TB.

The study found that whilst the majority of those surveyed live within 5km of a health facility they were often unable to seek care due to a lack of drugs or health workers at these facilities, the cost of transport to and from the facility, the cost of drugs or being asked to pay a user fee even though such care and treatment is meant to be free at government health centres.

Lowofu TB health needs assessment

Those surveyed mentioned the stigma and discrimination experienced by those infected:

…you know TB and HIV/AIDS are more or less the same, so when one has TB, they feel ashamed of going to health centres in our community here…

Personal Health Adviser, Luwero.

The study highlighted crowding, poor ventilation and use of bio fuels, amidst a high TB and HIV burden, as important opportunities for partnership between the National TB Programme and the Housing and Environment sectors.

For a copy of the full report please email: imf@img.co.ug

 

Richard Feinmann on winning a BMJ Group award

Published on BMJ Blogs: Click here for original.

richardfeinmannI suppose I could be accused of banging on too much about doctors volunteering at the end of their career. But now I have another reason.

At my age, I thought the days of national and international meetings were long gone. So, what a surprise to find myself at the Hilton on Park Lane with my wife in a lovely new dress and about 500 of the great and good in medicine, for one of the best evenings of my life.

I’m never quite sure how anybody can afford to live in London. The Hilton does not come cheap but they certainly know how to put on a good do with lashings of champagne and an excellent meal. I was a little nervous about being on the same table as the others who had been shortlisted for the same award as the group I was representing, but the wine flowed and everything was very cordial.

This is the third year of the BMJ Group awards and there are 13 categories, or maybe 12 and one special lifetime award. I was nominated for the “getting evidence into practice” award for the work I did as a VSO volunteer working at International Hospital in Kampala. The story began with Dr Mark Russell, another VSO volunteer, persuading the hospital to build a category 3 TB laboratory. Then my friend Dr Grania Brigden, another VSOer, applied for funding for a research project from a UK charity called Target TB. The funding allowed us to culture the sputum of 500 HIV patients for TB. Culture is rarely done in Uganda because of cost but our MOTS test had been shown to be cheap and quick in Peru. I completed this phase of the work and set up Phase 2 looking at not only culturing but also checking drug sensitivities on a further 300 patients. We were now looking at our own clients using outreach staff and volunteers to find people who had a productive cough for more than 3 weeks. Having proved the test worked, the project has now been handed over to Ugandans and since 2009 over 1000 HIV sufferers have been tested and more than 50% have TB. Fortunately we found a very low incidence of drug resistance.

So there I was, slightly pickled with champagne and thinking about my good friends in Uganda – over 100 Ugandan volunteers, Bosco in the lab, Dr Ian Clarke and Kevin Duffy who run the charity that employed me at International Hospital, Deborah my TB nurse, and Helen and Jemimah who carefully stretched out the funding from Target TB. Suddenly Gavin Esler, who was hosting the evening, announced that they were going to open the envelope to find the winner for my category.

It was a bit like the Oscars, especially as Hugh Grant was sitting on the next table. And the winner is; “Dr Richard Feinmann.” The champagne anaesthetic dramatically disappeared and from the back of the room I went up to receive our prize. I hope I managed to make it clear in my short speech that I was just a small cog in the team and paid tribute to them all but my memory is slightly blurred.

The only downside was that this was a team effort and the team could not be there. All our work was done with charitable monies and getting them all to the Hilton was not possible.

But what a great evening. Thank you BMJ.

BMJ Large

Uganda VSO Health Recruitment Film

VSO has been a great organisation for us to work with; each of the volunteers have made significant contributions to the development of our healthcare services at International Medical Group.

This video features Dr. Richard and I am so glad to hear him say that he got as much from his time here as we got from him, which believe me was massive. His influence continues through his ongoing support for our TB Lab and community hospital in Lira. We need more like him…

We are Winners!

The BMJ nominated us winners for the
Getting Evidence into Practice
award.

The TB Diagnostics Lab was the very first project that I became involved in at International Medical Foundation, back in 2007. I remember being approached almost every day by Dr. Mark Russell (a VSO volunteer) who wanted to do something for the many HIV/AIDS patients that he was needing to treat for TB. He had come across a new diagnostic method, *MOT – MODS, that had recently been used in Peru and he thought it would be perfect for Africa; and so it began.

Dr. Ian Clarke offered some space and building resources for a new lab at International Hospital Kampala and agreed that Bosco, one of the hospital’s microbiologists, could allocate some of his time to working with Mark.

I had just started Suubi Trust and agreed that we would raise the £15,000 that was needed to equip the new lab.

The lab was opened on Wednesday August 1st, 2007.

In Q4 2007, Dr. Grania, also from VSO, took over from Mark and started to work with Bosco and the IHK team to perform the clinical trail to validate the methodology and local processes. Early in 2008 this trail received a huge boost when the team secured additional funding from Target TB.

In 2009 Dr. Richard, VSO, joined the team and helped Dr. Edith and Bosco to complete the trial. In August 2009 he helped to train local volunteers, CATTS as we started Phase 2 of the programme, with a particular focus on treatment in the community.

Then in March 2011 we heard that we had been shortlisted for the BMJ award.

It’s been a great team effort. On hearing the news Grania said: “The TB team at IHK should be very proud of themselves, they have worked very hard and its great that their hard work has been publicly recognised.”

Dr. Richard and his wife Pat were able to attend and collect the award:

“This award is for all the Ugandan volunteer workers and village health workers who worked so hard with us to improve the lot of their community.  In a land where this is so much unemployment and pitiful wages this a completely different ‘Big Society’ “

This is a programme that we can all be very proud of. For me it was great to be involved at the very start. Thanks to Mark and the original Suubi Trust sponsors who helped to get us started. Thanks to Target TB for its support of the clinical trial. Thanks to VSO for encouraging doctors to come here and help.

Most of all thanks to Bosco, Edith and the Touch Namuwongo team for the daily implementation of health education, preventative measures, diagnostics and treatment, which is making a huge difference in the lives of those living with HIV/AIDs and TB.

*Microscopic Observed Technique (MOT) is a low-technology, low cost ($5) liquid culture-based methodology performed directly on sputum samples to diagnose Tuberculosis. It is simple to implement, especially in the developing world, and the programme is now run by Ugandan doctors, clinical officers, TB nurses and an increasing number of trained volunteers. This has led to increased rates of diagnosis and treatment of TB, and opening the doors to better management of TB not only in Uganda but across Sub-Saharan Africa.

Read more about this programme by clicking here.