Uganda: Panyadoli Healthcare Project
Improved Immunization Coverage and Reproductive Services: Q3 2017
December 20, 2017
Naku Charles Lwanga and Alphonse Mwanamwolho
Summary of Activities
- RMF procured and delivered sufficient medications, and medical and laboratory supplies to the Panyadoli Health Centres. These were delivered on time throughout the reporting quarter.
- RMF procured and delivered sufficient cleaning supplies, which enabled the team to keep the health centers clean and neat.
- Continuous Medical Education (CME) sessions were facilitated for all staff working in the health facilities, so that team members keep sharing and increasing their knowledge.
- All patients that came to the health facilities received treatment, and those whose conditions were beyond the capacity of the health facilities were referred accordingly.
- Integrated services that benefit both refugees and the host community were continuously provided. For example, RMF’s surgeon works certain days at the nearby district hospital.
- RMF boosted the mental health departments by strengthening community outreaches in order to reach other psychological cases that have been neglected in the villages.
- Follow-up and tracing of patients on ARV treatment were increased.
- Salaries, wages, and top-up allowances for all RMF staff members were paid in a timely manner. This kept the team’s morale high.
- Additional staff members were recruited to support the data management department and the ART clinic.
- Sufficient stationery and printing supplies were purchased to support the data office.
- Maintenance and repair were promptly performed for hospital equipment, furniture, water sources, generators, etc.
- The health facility was maintained and cleaned, ensuring that the compound, wards, offices, common areas, and the entire facility are hygienic and conducive to healing and working.
- Signposts were purchased to increase the visibility of the project.
- RMF continued to facilitate integrated community outreaches (including malaria prevention, immunization, safe birth, HIV/AIDS, and disease surveillance outreaches).
- Continuous immunization of all under-5 children living in and around the settlement was implemented through the health facilities and outreach activities.
- Medical screening of new refugees at Kiryandongo Refugee Settlement was effectively performed during the reporting period.
- Promoted and enhanced teamwork through departmental and general meetings.
- Facilitated UNHCR and partners’ coordination meetings both in the settlement and regional offices, helping to promote cohesiveness in operations.
Implementing Government Policy
Testing for HIV/AIDS
The team started implementing the new government policy of testing all patients who come to the health facility for HIV/AIDS. Presently, we have 1,519 clients on ART, of which 210 are refugees and 1,309 are nationals. The ART clinic treats 110 children below 14 years of age (41 boys and 69 girls).
Rise in Patient Numbers
New Staff Members Hired
Health seeking behaviors have improved among people of concern. This is evidenced by the rise in patient numbers. The improvement is due in part to referrals made by community health workers within the communities. RMF recruited some new staff members for the ART clinic and data department, thus reducing the challenges of long working hours and client wait times.
Improved Immunization Coverage
From 60% to 96%
We have been able to sustain improved immunization coverage. By the end of 2016, the immunization coverage was rated at 60.1, but by end of September 2017, RMF has been able to stabilize the coverage at 96.
No Maternal Deaths
Improved Reproduction Services
Reproductive services have been improved. For instance, during the reporting period ANC attendance was recorded at 91% against the UNHCR set standard of 100%. RMF has been able to* promote safe motherhood* by ensuring that highly motivated midwives are available at the health facility, who handle their work with love and passion. Throughout the reporting period, no maternal death occurred.
Access to Contraceptives
RMF Increasing Awareness
RMF has increased access to contraceptives. *The coverage is rated at 63.2*. At the close of 2016, access and use of contraceptives was rated at 54. This has been achieved because of the increased awareness RMF is creating.
Introducing New Laboratory Tests
Elevating Laboratory Status
New laboratory tests introduced by RMF’s laboratory team in the previous quarter were sustained during the reporting period. These new tests include hepatitis B, hemoglobin estimation, blood grouping, urine gram stain, urinalysis, stool tests, and ZN stain. The Infectious Disease Institute’s plan of elevating the status of the laboratory to a regional hub laboratory is still underway.
The Panyadoli Health Centres, located in Kiryandongo Refugee Settlement near Bweyale, Uganda, provide healthcare services to over 100,000 refugees from Kenya, South Sudan, DR Congo, Burundi, and Rwanda, as well as members of the host community.
- Provide medicine, medical supplies, and medical support
- Support the Health Management Information System Maintenance (staff and petrol supply)
- Maintain hygiene at clinic to Best Practice Western Medicine standards
- Enhance existing structures for Malnutrition ward and main center
- Provide cooking materials such as charcoal stoves, saucepans, utensils, etc.
- Upkeep and renovation of the health center through periodic re-painting and re-plastering.
Click to enlarge
Identifying and Treating Depression
Harriet Akite is a 24-year-old mother of two. She is a South Sudanese refugee living in Kiryandongo Refugee Settlement, and she suffered from a major depressive disorder secondary to PTSD for the last two years without treatment. However, due to interventions in mental health by RMF, Harriet’s depression was identified and diagnosed. In January 2017, she was enrolled in psychiatric care, including both medication and therapy. Harriet’s treatment was managed by the Mental Health department at Panyadoli Health Centre III until July 2017, when she was confirmed as a mentally stable patient and qualified to be off of medication to date. Harriet is now living normally and happily with her family. She started a small business from her home, maintains a kitchen garden, and is taking care of her children, which she was unable to do on her own in previous years.
Bringing Back her Smile
Nyakwir Atem is a 10-year-old South Sudanese refugee girl who was admitted to RMF-supported Panyadoli Health Centre III in Kiryandongo Refugee Settlement with symptoms of a bacterial infection. Although Nyakwir received treatment, her condition showed no improvement. She was referred to Kiryandongo Hospital for further management; however, her condition grew increasingly worse despite 10 days of hospitalization and receiving various antibiotics. Nyakwir’s parents were losing hope of her getting any better.
The young girl’s stomach was distended and painful, and with persistent fevers, she lost her appetite and was wasting away as the days passed. On one of the follow-up visits by an RMF medical doctor, he decided to take Nyakwir to the Operating Theatre, where they would investigate the probable cause of her agony. The operation was successful, and based on findings from the procedure, which were consistent with abdominal tuberculosis, he decided to start her on TB (tuberculosis) treatment. Since Nyakwir had also become malnourished due to her prolonged hospitalization and loss of appetite, she was also started on therapeutic foods for malnutrition—she had lost about 5 kg of her weight in one month.
One week after the start of this treatment, the young girl’s condition had improved tremendously, and you could see the feelings of satisfaction and relief in her smiling parents’ faces and the brightness of Nyakwir’s face. It was a happy moment when she could sit and hold a conversation with her parents, which had not happened in the previous couple of weeks.
Nyakwir was later discharged from the hospital and continued with her medication from home, which she periodically picked up from RMF’s TB clinic. About a week ago, she finished her six-month course of treatment and has now gone back to school, attending classes happily with her friends. Her father is also happy that his daughter recovered very well and is now back in school.
Thank you to our team of health workers, who fought tirelessly to bring back the smile on Nyakwir Atem’s face and that of her father.