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.

Helping to Improve Maternal Health in N. Uganda

Women living in Uganda face a 1 in 35 chance of dying as a result of complications during pregnancy or delivery; that’s 134 times greater than the same risk faced by those living in the UK. (WHO, 2010: 26)

At least 16 Ugandan women die each day whilst giving birth and perhaps up to 10 times that number suffer complications that significantly affect their on-going quality of life.

In the UK, 7 children are shared between 10 adult women; in Uganda each woman has, on average, 7 children.

More than 20,000 Ugandan babies are born each year infected with HIV passed from their mother.

So maybe Ugandan women should just have less children, wouldn’t that help to solve these problems? If only it was that simple. Trying to impose our Western culture or world-view on others is not the answer; we must work with those that we want to help, to provide solutions that they will find acceptable and appropriate.

Recent research shows that more than two thirds of women who want to use modern family planning are unable to get regular, sustainable access to it. (Guutmacher, 2009)

Suubi Trust is working with local health teams throughout Uganda to help resolve these issues. In Lira, Northern Uganda, it is partnering with a local faith based organisation, Charis, to implement solutions that will help to improve maternal and child health for the poor living in the local communities.

Some of the local women who will benefit from the Maternal-Child-Health services being provided at the Charis healthcentre in Lira, N. Uganda.
Click for more photos...

These include ante-natal services in which women can access the necessary treatment to help prevent mother to child transmission of HIV and receive family planning after delivery.

We are building a Maternity Theatre that will help provide safe delivery, with emergency obstetrics care, such as c-sections, as and when needed. Friends and supporters of Suubi Trust have raised the necessary funds for this and a generous donor has offered to buy all of the necessary equipment.

The theatre will be operational by September 2012 at which time we will be seeking donor support to sponsor ANC and Safe Delivery for those local women who could not otherwise access such services.

You can read more about this project by clicking here and here.

New Life Church, Supporting Mothers in Lira

I’ve just come back from a few days in Menorca with Alan and Lyn. On Sunday I was able to give church members an update on our plans for Maternal Care at the Charis health centre in Lira. I mentioned how we are hoping to create a Safe Motherhood programme at a cost of £75 per enrolled woman. This programme will provide at least 4 ante-natal visits, treatments during pregnancy, safe delivery, post-natal care and immunisation for the baby. We hope to ensure the availability of appropriate family planning to all those that want it.

New Life Church has been collecting each week to support our work and I was very pleased to be there in person to receive their latest donation of £500.

Receiving a cheque for £500 from Alan at New Life Church

Cheque

Click here to read about their previous donation, referred to as “Scooby-Doo Money”.

Scooby-Doo money

New Life Church in Menorca recently donated another £300 to help support the development of a theatre and maternity services at our clinic in Lira, northern Uganda.

Pamela receiving cheque from Lyn

Last year when I was with Alan and Lyn in Menorca they asked me to say something about our work in Lira, which Pamela followed up with on her recent visit. Since then the church members have been giving their loose change each week.

Faith and Works

Lyn sent us the following:

New Life has certainly embraced Suubi Trust in a big way. They refer to the “Scooby-Doo money” and are so faithful to bring their loose change each week which soon mounts up to a reasonable amount. We originally pledged 50Euros per month from our change but have had other sums come in as well which have brought us to 100Euros!

This extra money came from:

  • Offering from Carol Service
  • Hermann asked for his birthday gifts to be donated
  • One of our members is the Entertainment guy at a holiday resort and had two people donate their Bingo winnings when they heard about Suubi Trust
  • Trisha asked for her birthday gifts to be donated.

Thank you so much for the funds and your continued support and promotion of Suubi Trust, we really appreciate it.

Kevin.

UK Aid as a share of National Income

In the last few weeks there’s been a lot of discussion about UK overseas aid. (on Twitter #AidReview)

DFID has just completed a thorough review of all the programmes that it supports and has announced some changes planned for the next few years.

Essentially the UK Government is committed to sharing up to 0.7% of our national income to deliver results such as:

  • secure schooling for 11 million children – more than we educate in the UK but at 2.5% of the cost
  • vaccinate more children against preventable diseases than there are people in the whole of England
  • provide access to safe drinking water and improved sanitation to more people than there are in Scotland, Wales and Northern Ireland
  • save the lives of 50,000 women in pregnancy and childbirth
  • stop 250,000 new-born babies dying needlessly
  • support 13 countries to hold freer and fairer elections
  • help 10 million more women get access to modern family planning.

Getting to 0.7% will mean an increase of some 50% in cash terms over the next 4 years.

I first came across this chart on Owen Barder’s Blog:

In his announcements last week Andrew Mitchell noted that UK Aid to Uganda will increase from £68m pa to £98m and will be focussed on these top priorities:

  1. Improving the quality of essential services, especially for the most vulnerable
  2. Supporting the recovery in northern Uganda
  3. Improving maternal and reproductive health
  4. Driving growth through training, job creation, financial services and trade
  5. Improving government accountability and transparency so that future oil revenues are spent effectively.

I am hoping that our projects in Lira and in the Makindye Division of Kampala might benefit from some of this funding, as we seem to be closely aligned on the first 3 in particular.

Advent: Day 22 Charis – IMC (Lira)

Over the last 3 years, I’ve had the great pleasure of watching our work in Lira grow and reach more and more of the people in that community with an ever-increasing range of services.

Earlier this year we relocated to a facility owned by Charis, represented by Dr. Joel at the far left in the photo above.

Since then Dr. Leonard (2nd left above) and his team have been able to extend the services to include in-patient care, particularly for young children with severe malaria. The team has expanded its maternal health services, through Yer Yotkom which is focussing on reproductive health, preventing unwanted pregnancies and preventing the transmission of HIV between mother and child and by offering safe delivery.

Next year we will build an operating theatre suite which will allow the team to perform C-sections and emergency obstetrics care. Dr. Mike, on the far right above, has committed to providing the funds to buy and install all of the necessary equipment for this. Dr. Richard and Patricia have started to raise funds in the UK to meet the cost of building the theatre.

Also pictured above with Dr. Ian Clarke is Phil Knight who will manage the building project.

Once the theatre is completed the Charis-IMC centre will be designated a Health-Centre-4, which is the small hospital category, with facilities capable of providing safe maternity services and some minor operations. Such centres usually provide service for local populations of 50,000 – 100,000. Given its population Lira should have 4 such facilities; currently there are none and the regional referral hospital is desperately overcrowded, under-staffed and lacking some essential facilities.

Advent: Day 10 Dr. Richard

Photo by VSO/Ben Langdon

This is Dr. Richard as many of us will remember him, enjoying being with the kids on Hope Ward. He made a huge difference in his time with us as a voluteer with VSO. There are more photos of him on the VSO website here.

Even after their VSO stint was finished, Richard and Patricia continued to help, encourage and support us. They came back for an extra 3 months to help us move into a larger health facility in Lira, northern Uganda and are now helping to raise funds for our maternal and child health programme there.

Here’s what Dr. Richard says about working with VSO:

“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.”

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.

Charis IMC Lira: part 4 of 5

By Clea Meynell:

IMG recognises that the success of this initiative wholly depends on a number of key partnerships and ongoing collaborations to leverage resources and support. These are as follows:

Ongoing partnerships

There are three ongoing collaborations which form the basis of this initiative. The first relates to the unique set-up which exists between the various IMG entities. IAA Healthcare provides a significant regular income, which helps to defray the clinic’s fixed costs, including e.g. staff salaries. IHK provides the overall management and supervision of the clinic, ensuring Patient Safety and Quality of Care. It also ensures reliable provision of drugs and medical consumables. IMG Construction (the team that has built and maintains International Hospital Kampala) has already been deployed to make some minor renovations to the Charis facility and this will be the team used to build the Theatre Suite once funds have been raised. By using our own internal workforce we can control costs and ensure quality and timely delivery. International Health Sciences University (IHSU) will deploy its research students and lecturers to continue inputting into baselines and evaluating the outputs and outcomes at Charis-IMC. This adds an academic and objective rigor to our planning and assessments.

The partnership between Charis-IMC and Fields of Life is another important relationship which is central to the success of this model, and one which would be furthered through the provision of financial support in constructing the operating theatre. It is due to the vision and generosity of those involved in FoL that this clinic has been established in the first place. That vision was for a community hospital serving the poor in these communities and we are now very close to making this a reality.

Dr Joel’s continued involvement brings the additional benefit of his wealth of experience and knowledge of Ugandan Healthcare. Dr. Joel is a well respected local resident in Lira and he is able to help establish the local links and partnerships with the District Health managers and senior staff at many other facilities.

Lastly continued collaboration with the Ministry of Health, both at District and National level will be important to ensure buy-in and to feed back findings to key policy makers.

Project-specific partnerships

The portfolio of IMF projects being implemented from Charis IMC will vary over the coming years depending on project length and each project will have a range of stakeholders specific to its focus. At present there are a number of donors who are currently supporting IMF activities at Charis IMC.

The Positive Action for Children Fund (PACF) supports the new Yer Yotkom Project, a 3-year Sexual Reproductive Health (SRH) project being implemented in partnership with the National Community of Women living with HIV/AIDS (NACWOLA). The PACF is a fund set up by two global pharmaceuticals, Pfizer and Glaxo Smith Kline.

Suubi Trust helped to establish the initial charity based work at the Lira IMC. Its funds supported provision of primary care to more than 3,000 patients in the last year, initiated an Immunisation programme and helped meet the cost of some essential equipment.

Hands of Help Australia has been a long-standing donor to IMF with financial assistance being provided for two community projects, one in Jinja and one in Lira. The Aldo Project provides HIV/AIDS prevention, testing and treatment services to community members in Lira. It is a small but successful project which is due to finish in January 2010. IMF are in the process of finding funding to continue and expand this service.

Team at Charis IMC

A key gap in service provision for Lira District highlighted to IMF by the Aldo Project was the lack of CD4 machines which were functional in the District. Samples were being sent to Gulu for analysis, causing a high cost onto the patients. Therefore, IMF approached the HIPS Initiative (Health Initiatives for the Private Sector) to partner with IAA Healthcare (IMG) to cost-share on the purchase of a new CD4 machine for Lira IMC. Both parties contributed just over USD 15,000 each. This machine is now successfully installed and in operation. A pricing model has been established in which the margins charged to private and IAA pre-paid clients are used as a cross-subsidy to provide CD4 tests for our community clients at a reduced price.

Voluntary Services Overseas (VSO) have a longstanding relationship with IMG, with IHK receiving numerous VSO volunteers on a regular basis. Three such volunteers have had a considerable input into the development of the Charis IMC model. Dr Richard and Patricia Feinmann were based in Lira for 3 months working with the team to do an assessment of training needs and to develop initial ideas and potential models for the initiative. Diane Lockhart, an experienced midwife, has recently spent 3 weeks with the team up in Lira, focussing specifically on maternity services and related training needs. IMF are currently in the process of working alongside VSO to identify future roles for volunteers to be based at Charis IMC in Lira.

In the pipeline

The vision for Charis IMC is such that the collection of partnerships and collaborations outlined above will be both expanded and formalised in the future. In terms of expansion, there are already a number which are currently being developed through proposals and ongoing discussions. These include:

– Further collaboration with Target TB and Comic Relief to increase the TB-related work that Charis IMC is involved with. TB diagnosis and treatment is a particularly under-resourced area in Lira District and preliminary investigations hint at a problem which is growing, particularly in the urban areas of Lira Municipality.

– As mentioned above, there is a need to find additional funding for the HIV/AIDS related work undertaken in Charis IMC. The IMF team are in the process of approaching a number of donors, namely Civil Society Fund and the Global Fund to fill this gap.

– Recent conversations with the UK Department for International Development (DfID) were particularly positive and there was a great deal of cross-over between the approach described here and their current thinking for support to Northern Uganda, particularly concerning maternal health.

In the long-term IMF is considering the idea of creating a consortia of donors and other stakeholders so as to formalise these relationships and to leverage further resources. This would facilitate easier marketing of the various initiatives involved in Charis IMC and would hopefully attract new interested parties.

Charis IMC Lira: part 3 of 5

By: Clea Meynell

The target population will be the communities surrounding Charis IMC. Initially the idea is to extend service provision to all residents within Ojwina and Central Divisions in Lira Municipality, thereby covering 62,100 (59%) of Lira Municipality residents. Charis IMC is located in Bar Ogole Parish of Ojwina Division.

This document shows a table which outlines the target population by parish:

The current bed capacity of the facility stands at 24 beds and the aim is to have one ward (12 beds) dedicated to post-operation care (6 beds) and post-natal care (6 beds) whilst the remaining 12 beds will be for in-patients (largely women and children) admitted from the outpatient and community based clinics.