RMF signed a tripartite agreement with UNHCR and the Government of Uganda to implement a health project for a period of 12 months in Kiryandongo Refugee Settlement. The health project aimed at providing primary health care support to South Sudanese refugees and asylum seekers in Kiryandongo Refugee Settlement.
As of January 2016, a total of 45,256 refugees had been registered by the OPM in Kiryandongo Refugee Settlement. However, fresh fighting began between South Sudanese forces supporting Dr. Riek Machar and those of President Salva Kiir in July 2016, and the conflict led to the displacement of South Sudanese communities to Uganda and other neighboring countries. The number of refugees registered by the OPM at Kiryandongo Refugee Settlement thus increased to 68,275 as of December 31, 2016, which signaled a 32.2% beneficiary increase from the point of the project’s design.
Despite severe constraints placed on existing structures and social services, the Government of Uganda has maintained its commitment to accommodate refugees from South Sudan. The continuous influx of refugees has been mainly attributed to the precarious security situation in South Sudan, where pockets of violence are still being experienced in some parts of the country. Hunger is also believed to be pushing South Sudanese to Uganda.
Real Medicine Foundation delivered services to the persons of concern (PoC) through established health centers, namely Panyadoli Health Centre III, Panyadoli Hills Health Centre II, Nyakadot Health Centre II, and the Reception Centre Clinic. The facility-based services were enhanced by integrated outreach activities for communities with limited access to the existing health units, those located over 5 km from the health facility, as per the Ministry of Health access standard, and besides these, activities aimed at ensuring PoC are reached with preventative services.
RMF strengthened both the curative and preventive services component of health through recruiting and involving 63 staff members, equipping the health facilities with medicines and medical supplies, providing medical equipment, and maintaining commendable hygiene and sanitation levels at the health facilities.
All of these contributed to the efficient management of the program, thereby enhancing and securing timely and quality services for the PoC.
RMF supported the extension of preventive health services from static units directly to beneficiaries with limited access to the health facilities through a cohort of 44 VHTs and 8 interpreters, together with health workers, and through support of integrated outreaches covering immunization, antenatal care, HCT, family planning, and health education.
RMF’s intervention involved the recruitment of 8 additional midwives, with the aim to reduce maternal death through antenatal care, maternity services, and postnatal care. Other services provided include cervical cancer screening, routine testing for pregnant mothers (to enhance PMTCT done by recruiting laboratory staff, and improvement of family planning services.
Maternity care ensured safe deliveries, and in case of complications mothers were referred to Kiryandongo and Gulu hospitals, while postnatal care checked the health of the mother and child, including 24-hour observation and immunization of the newborn.
HIV/AIDS services involved creating HIV awareness among the population, conducting voluntary HIV testing, and providing care and treatment for persons living with HIV. Awareness activities involved reaching out to the community and conducting health education about HIV: how it’s transmitted, how it can be avoided, pre-exposure prophylaxis (PrEP), and how to get treated and stay in care if infected. As a result, over 60,000 people were reached with HIV/AIDS awareness messages.
RMF maintained its quarterly contribution towards the provision of essential drugs. However, during the peak of a drug stock-out, additional purchases were made to cover the gaps that had been created as a result of the high numbers of patients at the health facilities. The drugs provided mainly treated the five most common diseases: malaria with 36,411 at 50%, URTI with 25,909 at 36%, skin diseases with 5,298 at 7%, UTI with 2,898 at 4%, and finally intestinal worms with 2,003 at 3%.
RMF supported the health facility with laboratory supplies and equipment, and maintained 1 laboratory technician and 6 laboratory assistants. The quality of laboratory services addressed accuracy, reliability, and timeliness of the reported test results. Laboratory results must be as accurate as possible, all aspects of laboratory operations must be reliable, and reporting must be timely in order to be useful to the health facilities.
The project has been implemented in Kiryandongo Refugee Settlement as part of the emergency response to the South Sudanese refugee influx. Health services are provided through the established health centers: Panyadoli Hills Health Centre II, Panyadoli Health Centre III, Nyakadot Health Centre II, and the Reception Centre Clinic with community-based care supporting both the refugee and host community.
Funding is provided by UNHCR to aid the influx of refugees and asylum seekers into Kiryandongo Refugee Settlement. The number of refugees is projected to increase. This is due to the political instability in South Sudan, as the cease-fire agreement signed in Ethiopia has not yielded peace as anticipated.
Real Medicine Foundation (RMF) has hired a manager who is responsible for the overall implementation and coordination of planned interventions, whereas OPM and UNHCR do oversight functions. Activities are planned, coordinated, and reviewed on a weekly, monthly and quarterly basis through coordination meetings chaired by OPM at the settlement level.
13,430 under-5 children and 2,523 pregnant mothers will receive regular vaccinations, routine antenatal care including folate and iron supplementation, and preventive treatment for malaria, 29,644 schoolchildren will receive regular preventive health education, deworming, and vitamin A supplementation through school-based health programs.
Overall, 63,072 people comprising the target population will have ready access to quality curative services through the established health units by the end of 2016.