Uganda: Healthcare Implementing Partner for UNHCR at Bidibidi Refugee Settlement
120 Integrated Outreaches: Q3 2018
January 11, 2019
Naku Charles Lwanga
Summary of Activities
- Continued to provide high-quality health services to persons of concern through the Outpatient department, Inpatient department, inpatient therapeutic care, outpatient therapeutic care, community outreaches, and referral services.
- Purchased and delivered medicines to the health facilities on a monthly basis to treat patients.
- Purchased laboratory supplies to test for diseases. Medicines and testing helped save lives.
- The health project in Bidibidi received 2 new vehicles, a coordination vehicle and a funeral van, to assist in day-to-day activities of the project, as well as facilitate coordination of the programs.
- When technical issues delayed the arrival of medicine and medical supplies from UNHCR, the supply of medicines from RMF allowed the facilities to keep running and manage the patients’ conditions.
- RMF, together with other health implementing partners, held a blood donation drive throughout the settlement which involved humanitarian staff and persons of concern who were willing to donate blood. Following a call from an Arua blood bank reporting a shortage of blood at the regional referral hospital, it was necessary for us all to engage in this drive, as this location is a referral point for our patients.
- Provided a constant flow of cleaning supplies, which enabled our diligent sanitary team to keep health facilities clean. The cleanliness of RMF-managed health facilities is among the reasons why many patients prefer receiving care from us.
- Continued conducting community health outreaches to extend medical treatment and health education to the community, especially to people of concern in more distant villages of Bidibidi Refugee Settlement.
- RMF has continued to sustain a medical team at the Goboro border point, providing medical screening, immunization, treatment, and ambulance services to refugees who arrive exhausted.
- Continued to sustain medical staff that were hired to support health centers neighboring Bidibidi Refugee Settlement. This has helped reduce the constraints felt in these health centers due to the dramatic increase in population and is contributing to peaceful coexistence between the refugee and host populations. District health facilities benefiting from this program include Yumbe Hospital, Barakala Health Centre III, and Kulikulinga Health Centre III.
- RMF continued to provide HIV/AIDS testing, counseling, and ARV services and encourage all patients to practice healthy lifestyles. The team also continued to trace patients who were previously on ART and work to reinstate them on treatment. The ART clinic is growing.
- Continuously conducted HIV/AIDS prevention activities, including the distribution of condoms, moonlight counseling, testing, and sensitization. In addition, the ART clinic conducted an HIV/AIDS awareness week in the settlement as a step to fulfill the 90-90-90 policy of the Ministry of Health.
- Continued to facilitate the disease surveillance teams’ activities so that the medical department will not be taken by surprise in case of an outbreak. Any suspected samples of cholera, measles, and polio are rushed to the national laboratory for confirmation. This is partly why no outbreak was experienced during the reporting period.
- Conducted follow-ups on TB cases in the community to ensure that patients are taking their medication as instructed. Through outreaches and home visits, we are working to prevent patients developing multidrug-resistant tuberculosis (MDR-TB).
- We also conducted AFB (acid-fast bacilli) microscopy and Genexpert testing for TB at the Desert Breeze Hotel in Arua for three days, between July 9 and July 13, 2018.
- Community health officers and Village Health Teams (VHTs) were trained on community-based disease surveillance, patient referral, and health promotion strategies.
- RMF facilitated community leaders’ dialogues to help community leaders become ambassadors of good health practices. This will strengthen the preventive health initiative and thus reduce the cost of curative health.
- Continuous cervical cancer screening and education is ongoing at the health facilities.
- Continued to support government facilities with medical supplies and staff to assist with the high volume of patients referred from the refugee community.
- On August 23, 2018, a team from UNHCR visited RMF’s facilities to monitor the quality of services we provide to persons of concern in the settlement, and their remarks indicated that they were impressed by our service provision.
- RMF participated in various capacity-building trainings and refresher courses to keep them updated in the medical field, which is constantly changing.
- RMF has continued to provide respectful burial services to refugees who die in the settlement. They are buried in one place, where exhuming will be easy if loved ones wish to rebury them in their home country when peace comes.
- The Palliative Care Association of Uganda, in collaboration with Real Medicine Foundation, trained staff on the integration of palliative care (focuses on providing relief from the symptoms, pain, and physical and mental stress resulting from serious, life-limiting illnesses) into their practice. The team of facilitators returned to monitor the progress and challenges of integrating this type of care. They engaged 10 Village Health Teams (VHTs) and 5 community health officers (CHOs) from each of the settlement’s 5 zones.

Results &
ACCOMPLISHMENTS

Integrated Outreaches
No Disease Outbreaks
There were 120 integrated health outreaches conducted during the reporting period, during which, no disease outbreak was experienced. This is an indication that the surveillance team is working effectively and preventive measures are getting stronger.
Health facility utilization is progressing, and the health status of the population is improving, as indicated by the decreased number of consultations during the reporting period. From July to September 2018, RMF carried out 63,558 medical consultations in Bidibidi Refugee Settlement.

Nutritional Support
Sharing Good Practices
Food supplements were procured to support the nutrition program, that is steadily growing and saving lives. Thanks to support from LDS Charities and Convoy of Hope, pregnant and lactating women (PLW) have been especially helped. RMF conducted follow-ups on nutrition cases in the community to monitor patient’s progress after discharge and avoid relapse.
We held a health and nutrition coordination meeting at the main OPM office on July 19, 2018. The purpose of this meeting was to monitor the nutrition progress in the settlement and share good practices about timely and adequate reporting on nutrition.

World Breastfeeding Week
August 8, 2018
RMF and Nutrition Implementing Partners came together to celebrate World Breastfeeding Week at the Bidibidi Reception Centre in Bidibidi Refugee Settlement. During this event, RMF’s nutrition team facilitated activities such as cooking demonstrations and sensitization of the community—especially mothers—on demonstration gardens and engaging in positive, affordable nutrition practices to improve food availability.

Managing Immunizations
Children and Young Adults
Participated in the Child Days Plus (CDP) activities for the mass vaccination of children and young adults within the refugee settlement and of nationals from the host community as they visited the settlement.
MF continued to facilitate and manage routine immunization exercises in zones 1, 3, and 4 of Bidibidi Refugee Settlement. All the under-5 children arriving at the settlement are also immunized. This is a strategy to secure the future of these children, which is threatened by deadly diseases. The program was carried out at both outreach and static points.

RMF Receives Resources
In-Kind Donations
RMF’s Bidibidi Refugee Settlement program received an in-kind donation of a 40-foot container full of fruit juices from Agros on the recommendation of World Food Programme. Through RMF staff and other implementing partners, it was distributed to refugees and nationals within the settlement. Fruit juice is a good source of vitamins A and C, and the donation helped boost refugees’ nutrition.
RMF also received an in-kind donation of midwife kits from Direct Relief International (DRI) during the reporting period. These kits supplemented the equipment sets at Bidibidi Refugee Settlement health centers and helped ensure that each midwife has sufficient tools to perform his or her job at an optimal level.

Promoting Safe Motherhood
Antenatal, Maternity, and Family-Planning Services
All RMF-managed health facilities continued to provide antenatal, maternity, and family planning services, thus promoting institutional deliveries and safe motherhood, as opposed to village-based deliveries.
We have been able to achieve safe motherhood targets, thanks in part to the dignity kits provided by UNHCR and distributed by RMF at the health facilities during delivery.
We successfully conducted 417 deliveries during the reporting period, with the proportion of deliveries attended by a skilled health worker at 91%.

Background
& Objectives
Background
Since 2009, RMF has been working to help the people of South Sudan recover from decades of civil war, which destroyed much of the country’s infrastructure and healthcare system. RMF initiated, co-founded, and continues to support the Juba College of Nursing and Midwifery, supports the Juba Teaching Hospital, and in December 2014, became the UNICEF implementing partner for malnutrition treatment and prevention in Jonglei State and the greater Pibor Administrative Area. Even after renewed fighting broke out in July 2016, RMF’s in-country teams have continued these programs. RMF has also been providing health services, school support for children, and vocational training to South Sudanese refugees in Uganda’s Kiryandongo Refugee Settlement since 2008, and was appointed UNHCR Health Implementing Partner in 2014.
To accommodate the large numbers of South Sudanese refugees fleeing to Uganda (between July 1, 2016 and September 21, 2016, there were 163,540 new arrivals), the Ugandan Office of the Prime Minister (OPM) and the UNHCR, in partnership with RMF and other organizations, opened the new Bidibidi Refugee Settlement on August 5, 2016. Bidibidi is located near the South Sudanese border in the Yumbe district of West Nile, Uganda, and has the capacity to support 180,000 refugees. Bidibidi is being built from the ground up, and during August 2016, 31,902 refugees were relocated to the settlement. Real Medicine Foundation is the main UNHCR Health Implementing Partner for Bidibidi Refugee Settlement, and between August 5, 2016 and August 31, 2016, 5,331 patients were treated at RMF’s health clinic.
Objectives
- To provide residents of Bidibidi Refugee Settlement with high quality primary health care
- To maintain easily accessible, fully staffed, fully stocked health clinics
- To provide referrals to secondary and tertiary care centers when needed
- To provide health education and early detection through health outreaches
- To provide support to Yumbe District Hospital

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Photos
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Numbers
Served
July-September 2018
Total number of medical consultations: 63,558
- Refugees: 53,262
- Nationals: 10,296


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