Value for Impact

International Hospital Kampala, IHK, is the largest, and some say best, private hospital in Uganda.

In 2010, IHK gave 2.5% of its income to support the work of the group’s foundation, International Medical Foundation.

As we continue to support IMF in 2011, and beyond, we are keen to ensure:

  1. that savings are made where possible, without impacting the quality of the care being provided,
  2. that all of our programmes deliver value for money,
  3. and most importantly that these programmes maximise the impact being made for the communities and people being served.

Kevin.

 

Hope Ward Annual Report 2010

By Jemimah Kiboss:

In the 11 months to the end of November 2010 Hope Ward admitted 227 patients for a total of 2,730 bed-nights.

This year, funds raised for Hope Ward amounted to UGX 89.4 million (~£25,000); 43% of these funds came from our corporate sponsors – Bead for Life, Mvule Trust & Narrow Road.

Most (80%) of the Hope Ward expenses amounting to approximately UGX 459 million (~£130,000) were paid by International Medical Group.

Please click on the image below to download the annual summary report which has some further financial details and a few patient stories.

The Overall Aim of Hope Ward is to

cater for the underprivileged in need of high quality complex treatment, who would otherwise not afford this much needed and often life saving care. We intend to do what we can to alleviate the suffering and improve the quantity and quality of life of our patients.

We have some spare capacity in Hope Ward and with additional funding we could help many more needy people in 2011. Please support us in whatever way you can.

IMG – Doing Business as a Means of Development

Suubi Trust continues to support the work of International Medical Foundation, IMF.

IMF, one of four companies within International Medical Group, is the group’s NGO (registered charity) providing a wide range of charitable health services to the poor ranging from community based health education, preventative services including family planning and ART, TB diagnosis and treatment, complex medical and surgical procedures and oncology. IMF receives funding from a variety of sources including international donors, businesses in Uganda and UK, individual supporters from around the world, Suubi Trust and from International Hospital Kampala, IHK, its largest donor.

IHK, is the largest private health service provider in Uganda and has gained an enviable reputation for the safety and high quality of the care provided. This is reflected, for example, in its successful performance of 29 open heart surgeries in the last 3 years and the specialist trauma and intensive care provided to the victims of last year’s bombings in Kampala.

IAA Healthcare is Uganda’s leading provider of pre-paid health schemes, with 40,000 members being served in IHK and at 9 health centres across the country.

International Health Sciences University, IHSU, is now in its third academic year with 600 students of nursing, health management and public health.

IMG is one of Uganda’s larger employers, with more than 750 staff. It generates income from its pre-paid members and those patients paying cash for service. IMG is not government or donor funded and as such is an excellent model of private business as a means of development.

You can read more about IMG here.

Hope Ward Cancer Charity

We will be posting over the next week or so some patient stories and information about cancer care being provided to our Hope Ward (charity) patients.

Introduction

The word “cancer” in Uganda brings thoughts of death, confusion, and stigma. People feel hopeless and impotent with nowhere to turn. The Hope Ward Cancer charity was founded in 2006 as a response to the great needs of underprivileged cancer sufferers in Uganda. Since the Hope Cancer charity launch, complex cancer care for the vulnerable has been delivered to hundreds of destitute children, orphans, widows and refugees who have received sponsored, lifesaving cancer treatment.

The cancer unit is led by a London trained, Ugandan based, Consultant Oncologist‐ Dr. Helena Nam ‐ and four internationally trained chemotherapy nurses.*

People treated from January‐November 2010

In the first half of the year, UGX54 million for Hope Ward patients was received and UGX110million was spent on essential treatments, including the cancer service. The shortfall has been met by IHK on a cross-subsidised model e.g. IHK provides facilities free of charge and meets salary costs for the nursing team, in addition to the purchase of some of the necessary treatments.

Approximately one third of the patients treated were children, many of whom would have lost their lives or suffered terribly, without treatment. Some of their stories will be posted on this Blog later. Many of our female patients have breast cancer. One third of the patients were suffering from Kaposis Sarcoma which is a cancer that is AIDS ‐ related.

* The specialist nurses have received chemotherapy training from India and UK – We are grateful to lead nurse trainers from Kent and Canterbury NHS who provide ongoing medical education (Wendy Hills and Jane Orwell).

Bomb survivor’s slow and bumpy road to recovery, four months later

Sadly, Francis died at the weekend, may he rest in peace. The item below was one of his last interviews.

>>>

Posted at: http://bit.ly/dmLQWn

By RACHEL KABEJJA:
Posted Thursday, November 11 2010 at 00:00

Francis Semwogerere after two months in hospital. INSET, Semwogerere on arrival at the hospital after the bomb blasts. PHOTO BY RACHEL KABEJJA

It is exactly four months since the twin bombs went off in Kampala. About 80 people were killed and others left with severe injuries among whom is Francis Semwogerere, an IT engineer with Hunger Free World. While many of the injured victims could have left hospital and are recovering from their homes, Semwogerere is almost just starting his medication. He had his major surgery on September 27, 2010 and has two more to go; one operation to remove the sharp metal from his spinal cord and the other to rectify the damaged lung.

According to Dr Patta Radhakrishina, a surgical gastroenologist flown in from Apollo Hospital India to perform the operation, this surgery was aimed at having control on Semwogerere wind and food pipes. These were damaged by the metal which cut through the neck to the spinal cord. The damage made his breathing difficult and the food and saliva, instead of going to the stomach, started flowing to the lungs hence damaging one of them.

During the operation, a new food pipe was created and stitched to the neck. This was to help him feed before he gradually learns to feed on his own in about a month hopefully. “On his arrival at Kampala International Hospital (IHK), we thought he had one injury in the neck,” says Dr T. Prasandan, director of the Cardiac Centre at IHK. “However, we later realised that he was losing a lot of blood and had breathing difficulties.

His oxygen levels were also going down and his limbs were paralysed. That is when we performed a scan and X-ray to examine the exact problem. The results showed that he had a metal in his spinal cord and we did an emergency surgery to put a tube into the breathing pipe to stop blood from flowing to the lungs.”

The fateful day
Mr Semwogerere’s wife, Grace Nassanga, a midwife at Nsambya Hospital, says her husband left home at about 7:30p.m. to go and watch the final World Cup match. “He is a football fan but watches almost all his matches from around home. I didn’t know where he was watching the match from but when I heard about the bomb blasts, I called him. This was at about 11p.m. The person who picked the phone told me that he had an injury on his arm. I thought it was a lie. I asked the person who answered the call to tell me the truth and he reaffirmed his statement.”

“When, I arrived at the hospital and found him gasping for breath, I couldn’t believe it, I was so shocked and more so that the doctors, on his arrival at the hospital, thought he had only one injury so they were supporting his neck while blood was flowing out of him. Later, they realised that it could be more than one injury so they took him to the scan and X-ray to find out the exact problem.”

About how he ended up at Kyadondo to watch the match, Ssemwogerere says; “I was driving from Nakawa to town but the traffic jam seemed unbearable that is why I decided to go to Kyadondo Rugby Club. While there, I heard a blast, and in my attempt to flee the area, I fell down in a trench. When I turned to look, my neck was bleeding. Then a certain O.G of mine assisted me to get transport to AAR but they (AAR) couldn’t handle my condition so they referred me here (IHK),” says Semwogerere. This is all he remembers about the incidence which has changed his life.

His wife says; “He did everything in his power to give us the best care. I have consoled myself with prayers and accepted the situation although I regret why he went there.” “I can’t wait for him to be discharged from hospital because our five-year-old daughter asks for her daddy every day. I tell her that daddy is in hospital but will return home shortly.”

After surgery
The doctors are hopeful that he will recover since he is responding well to treatment but he will face some challenges. A formerly able bodied man, full of life, a career and family to take care of, Semwogerere may never walk again as his lower limbs are completely paralysed. He may also have difficulties controlling his bowels. He needs more support from family and rehabilitation after surgery. He had emotional disturbances (like the fact that he can’t provide for his family) but will hopefully be better after the two operations that are yet to be performed on him depending on his progress after each operation is done.

Francis undergoes another procedure in his fight for survival.

By Dr. Prasandan:

It is over two and a half months since Francis has been suffering from the bomb blast. He had deteriorated for the last two weeks with the normal left lung also getting affected from the secretions coming from the right lung, which was getting all the secretions coming down through the abnormal connection from the esophagus/food pipe that had developed from the injury.

He was back on life support with ventilator for the same reason for over 2 weeks.

He underwent an extensive surgery on Monday to overcome the problem of the esophageal leak into the right side of the chest. By this 5 and half hours long procedure, his stomach was mobilized and lifted up behind the chest bone/sternum, into the left side of neck and was connected to the Esophagus/food pipe.

This extensive operation was performed by a surgical team led by Dr. P. Radhakrishna, Consultant  surgical Gastro-enterologist from Apollo Hospital, Chennai, India. The team included IHK surgeons, Dr.Moses Galukande and Dr. Sam Rackara. The surgery was successful and his condition is stable though still critical. If everything goes well, he will be able to have some liquid food by mouth sometime next week- first time since he suffered the injury.

He, still on a ventilator, expressed thanks to all the doctors and staff who visited him in the ICU yesterday, the morning after surgery.

He has a total of 9 different tubes connected to his body and was trying to smile in spite of the pain he was going through!

Let us hope that he will survive this critical time too and will be able to lead at least a near normal life with his family.

Grace and Sasha visiting Francis

Francis – clinical status as on 13th August, 2010.

Dr. Prasandan sent this update on Friday:

>>>

Francis is still in a critical situation, though some problems have got settled.

The important problem that looks settled is the air leak, which was causing swelling all over his body and face. Also, he has become more stable lung wise and is mostly off ventilator for over 5 days. He had breathing problems last night and needed ventilator support for a few hours. His left lung is OK and right lung is also partially working. He is needing very low support of oxygen since morning and is breathing by himself.

He is still paralyzed below chest. Can write and communicate. Both upper limbs are OK.

Francis after recent surgery

We took him for a CT Scan of chest and neck a week ago. At the same time we did a barium swallow study to assess the status of Oesophagus. They were very informative.

The CT Scan of neck – shows shadow of metallic shrapnel within the spinal cord at the Vertebral level T1, or at the junction of chest and neck. The neuro-surgeons here are of the opinion that it should be removed by surgery and are confident of doing the operation. But he is still not stable for that major surgery.

The CT Scan of chest showed what we expected – the problems with the lung and pleura.

The Barium meal study was done principally because we found that food from his stomach was coming out through the right chest tube. The film clearly shows the barium contrast leaking from the neck (Oesophagus) to the right Pleural cavity/chest. This means that there is a communication between his Oesophagus (Food pipe ) and right chest cavity.

After seeing this, we had to stop giving him feeds through naso-gastric tube and had to start on Total Intravenous (parenteral) nutrition, which is very expensive and having its own risks too. The ENT surgeons and Cardio-thoracic surgeons in this country are not operating on Oesophagus regularly and hence not coming forward to do a surgical correction. Also, it is very risky to operate on neck unless one is experienced and confident. (as it has a lot of vital structures in small area).

Oesophagus is routinely operated in many other countries, including India. So, I had contacted Dr.Radhakrishna P., senior consultant surgical gastro-enterologist in Apollo hospital, Chennai, India, who is a friend of mine. He had advised to do Esophagoscopy, locate where the leak/defect is and close it directly with a covered/metallic stent. We cannot do this as we do not have experts who can deploy Esophageal stents (stent is not available also) here.

So, he advised to do an alternative of surgery to insert a tube into lower part of intestine (feeding Jejunostomy) to give him food, so that he can survive and another surgery in the neck- Esophagostomy/ opening of Esophagus out, so that saliva can be diverted from going down to the chest. The defect can be repaired later when he is more stable. This will improve his chest also.

Dr. Moses has done the feeding jejunostomy 3 days back. But 1 day after the surgery, he vomited greenish(bile containing ) Fluid, which started coming through the chest tube also. This has improved and we have started giving liquid food through the feeding jejunostomy tube.

Esophagostomy is yet to be done.

Dr.Edward (ICU in-charge) was suggesting to get surgeons from abroad to operate on Francis and settle the problems. We are still looking for options. Family was also asking about this possibility. Getting a surgeon from India also is not very easy.

He is maintaining good blood pressure and pulse. Urine output /kidney function is good and is looking forward with hope! So is the family.

Child gets life saving brain surgery in Hope Ward at IHK

This from The Observer; Written by TREVOR ARIHO, Wednesday, 28 July 2010 18:32 .

Joy and Bwine are a humble couple that loves their son Mathew Ayebare (Pictured) deeply and have done their best to take care of him.  Mathew is a little over two years old and has been in and out of hospital since he was a year old.

Joy noticed that Mathew at nine months did not seem to respond or behave like her other two children. However, she did not read too much into it at the time. When he made a year, Mathew started getting seizures. When he was taken to hospital, they were told he had epilepsy and he was started on treatment.  But the seizures did not stop.

The anxious young parents took Mathew back to hospital where he had a CT scan that revealed bleeding in his brain. This is when they learned that their son had a very complex and rare congenital defect known as arteriovenous malformation. An arteriovenous malformation (AVM) is when there is abnormal connectivity between arteries and veins.

www.brain-aneurysm.com says that most brain AVMs present with a brain hemorrhage (severe headache, nausea, vomiting, and collapse/loss of consciousness). Instant death rate is believed to be at about 10% for first-time hemorrhages from a brain AVM, and this is about the same as the instant mortality rate for first-time brain aneurysm ruptures. Many AVMs present with seizures, and some present with neurological symptoms (paralysis or sensory disturbance) due to the mass of the blood vessel tangle causing direct compression of brain tissue.

Joy and Bwine desperately needed a “miracle” for their son.  They were referred to Dr. Hussein Ssenyonjo who agreed to perform the operation. However, it would be a very complex operation with a long stay in Intensive Care after the operation. The family could not raise money to have the surgery done and; so, they approached Hope Ward at International Hospital Kampala.

Hope Ward is a charity ward at the International Hospital Kampala that partners with various companies, organizations and individuals to provide complex medical treatment for the very needy in Uganda. Sponsors include Bead for Life, Muvule Trust, Stanbic Bank, MTN, Narrow Road, Hwan Sung, Suubi Trust, Bless a Child Foundation, IAA Health Care and the International Hospital Kampala (IHK).

Mathew was admitted to Hope Ward and had a successful surgery at IHK. His family was only asked to contribute Shs 2m out of a total of Shs 6.2m.  The International Hospital covered 30% of the  bill and does the same for all Hope Ward patients. The balance was covered by donations from Hope Ward supporters. Dr. Ssenyonjo waived his fee and his only concern was saving Mathew’s life.

Before surgery, Mathew had a 10% chance of living but his future is much brighter now.

Written by TREVOR ARIHO
Wednesday, 28 July 2010 18:32

Bomb Victims: Patient Updates from IHK

International Hospital KampalaHere’s the latest update from the clinical team about those 7 patients still admitted at IHK.

1. Sustained fracture of his right femur and multiple perforations in his intestines. Pain is controlled. Can take oral feeds. Steadily improving.

2. Had abdominal surgery. Pain controlled, he can eat and move out of bed. He is much better. Getting nightmares and sleeplessness. Put on medication. Slept better last night. Much better.

3. Had abdominal surgery. Pain controlled, he can eat and move out of bed. Marked improvement. Has shrapnel in his pelvis. Surgeon to determine need for surgery.

4. Severe head injury. Still unconscious but responds to pain by opening eyes. Had fever free night. Some improvement.

5. Had abdominal surgery. Pain controlled. She can eat and move out of bed-much better. Broken finger operated 2 days ago.

6. Sustained head injury. Her sight is steadily improving. Power in her arms is also improving. May need surgery to remove shrapnel form her skull. Surgeon to determine.

7. Sustained spinal, neck, airway and esophageal injury. Got air leakage to the skin and body swelling. Body swelling has reduced markedly and can move his arms. Patchy sensation in the legs. Will need surgery to close the hole connecting his airway and esophagus and to remove the shrapnel in the neck when he is stable.