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

 

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.

Shortlisted for BMJ Group Awards

We are pleased to note that the TB project at IHK has been shortlisted for this year’s BMJ Group Awards under the “Getting Evidence into Practice” category.

Thanks to Dr. Richard for making the submission.

TB is a significant health issue in Uganda and our project, supported initially by Suubi Trust and then by Target TB, has implemented a new TB Lab and completed a clinical trail for the MOT/MODS diagnostic method. You can read more detail about this in the submitted report by clicking here.

Essentially this method enables the team to diagnose TB in about 7-10 days at a cost of just $5. This compares to either the gold standard MGIT test which can cost up to $70 per test or low cost methods that can take about 40 days for a result.

Our thanks to VSO for it’s support over the last few years, first with Dr. Mark who got us started and then Dr. Grania and Dr. Richard who between them managed the clinical trial and the integration of the TB Lab into IHK’s community based health programme Touch Namuwongo.

Read our other Blog posts about this project by clicking here.