Uganda: Panyadoli Healthcare Project

Project Goals:
 
Upgrade and maintain the Panyadoli Health Care Centers at a high level of hygienic and operating standards.

Project Objectives:
 
Health status of the population improved through:

• Provision of medicine, medical supplies, and medical support
• Support service delivery through employing medical personnel.
• Supporting and maintaining the security of the health centres through employing security guards.
• Reaching communities with health services through community outreaches
• Raising health service awareness through health promoters and community health teams
• Support of the Health Management Information System Maintenance (staff and petrol supply)
• Maintenance of hygiene at health centers to Best Practice Modern Medicine standards
• Enhancement of existing structures for Malnutrition Ward and Main Center
• Promotion of hygiene through recruitment of more compound and ward cleaners.
• Upkeep and renovation of the health center through periodic re-painting and re-plastering
• Maintaining effective disease surveillance through community health services
• Maintaining a high level health information system  

Summary of RMF/WCF-sponsored activities carried out during the reporting period under each project objective:

• RMF provided the Panyadoli Health Center III with medicines and medical supplies, and covered all existing gaps during this reporting period, including a continued increase in the quantity needed due to the new influx of South Sudanese refugees (now 120/day). Medical supplies were also provided to Panyadoli Health Center II and the Reception Centre Clinic.
• Supported important events for the refugees programme.
• Facilitation to attend UNHCR and partners’ coordinating meetings both in the settlement and regional offices, helping to promote cohesiveness in operations. 
• In July 2014, RMF signed a tripartite Agreement with the United Nations High Commissioner for Refugees (UNHCR), and Office of the Prime Minister (OPM) for RMF to be the official Implementing Partner for health at the Kiryandongo Refugee Settlement for UNHCR/OPM for three health centers and a large community outreach program.
• Recruited and inducted new staff members to support and accomplish core tasks for the project: Pharmacy Assistant, Pediatric Nurse HIV/AIDS, HIV/AIDS Senior Counselor, Community Health Assistant, Head of Finance and Administration, and Finance Assistant.
• Facilitated staff on mission: accompanying patients on referral, coordination meetings and routine supervision.
• Conducted massive immunization and HIV/AIDS awareness campaigns.
• Support of 6 interpreters, and 80 Village Health Team members for community outreach.
• Procurement of proactive gear for cleaners and security officers.
• Sustained water supply at Panyadoli Health Centre III.
• Continued maintenance of water pipes and solar pump at Panyadoli.
• With additional funding from UNHCR, RMF is able to buy supplementary drugs to individuals with complicated rare cases; the drugs needed for these patients are costly and cannot be easily found in the health centers.
• Six ward cleaners and four groundskeepers sponsored by RMF groomed the grounds regularly and made sure the cleanliness of the wards and offices was well maintained. 

Results and/or accomplishments achieved during this reporting period:

• Continued provision of medical treatment and other health services to patients and quarterly provision of medicines and medical supplies have kept Panyadoli Health Centre III, II, and the Reception Centre Clinic running effectively especially during the current massive influx of South Sudanese refugees.
• Successfully conducted the physical verification exercise with UNHCR, and RMF received a positive report from UNHCR.
• As a result of paying salaries to the ward and compound cleaners, the sanitation of the health centres has been excellent. Both wards and compounds are clean.
• The grounds are continuously cleaned and maintained, making it safe to walk around without fear of being bitten by snakes.
• The Solar Powered Water Pump is continuing to run successfully, providing clean running water to the clinic wards and offices, and greatly increasing hygienic conditions of the health centers
• Broken windows and doors for all wards were replaced.

Number served/number of direct project beneficiaries (for example, average number treated per day or month and if possible, per health condition).

• 11,576 patients were treated during the 3^rd Quarter of 2015.
• During this quarter; 5,014 were male patients and 6,562 were female. 
• 5 deaths were reported this Quarter, patients dying of SAM, Anemia, Malaria, and HIV/AIDS.

APPENDIX B
 
Success Stories
 
Nyeguar Lilyliy is 6 years old, a refugee from cluster K in the settlement. She was alone in the house when she was identified by the RMF VHT leader of that cluster and was diagnosed with severe malaria. Lilyliy was rushed to Panyadoli Health Centre III where she was admitted in the IPD.  Due to the high levels of malaria found in her body, she was put on Quinine IV, Ampicillin IV, Diclofenac IM and Panadol tablets.  At the time of her admission, Lilyliy was weighing 15kg but this has changed as she has now increased weight by 5kg to 20kg. She is very grateful to the RMF staff for treating her well and with a great attitude.

We are working on sensitizing our refugee patients to have access to preventable measures like mosquito nets. Some are given mosquito nets and do not use them. Some families receive one net and adults take advantage of that instead of protecting the young. Nyeguar Lilyliy did not have a net in her home for prevention.  She is grateful since she recovered well, was treated well and at no cost. 

Aber Esther is a one year and 3 months old girl who was diagnosed with pneumonia, presenting with cough, chest pain, and fever.  She was put on IV X-pen IMU, IV Gentamycin 40mg, IV Hydrocortisone plus Panadol Tabs.  The RMF medical person attending to her realized that she was not responding to treatment and put her on Vitamin A 100,000 IU and IV Chloramphenicol 250;  Esther started responding very well to this medication.  Esther currently is being followed up on weekly on her progress.

Mathew Chang is a 2 year old boy, a refugee from cluster G.  Mathew is the third born in a family of 5. Mathew’s mother says that she found him collapsed on the floor and not breathing well, and then rushed to the health centre where the RMF doctor received her and her child was admitted. Tests confirmed the boy’s diagnosis of severe malaria. Mathew was put on IV Artesunate 40mg, IM Diclofenac 30mg, rectal Diazepam 2.5mg plus Panadol tablets.  Mathew would not have reached this stage of malaria if the mother had noticed early that he was not feeling well, monitoring his temperature.  The RMF medical team has noticed that some South Sudanese refugees are reluctant to go to a health facility.  In their opinion, going to a health facility is a very last resort. The RMF medical teams, through outreach programmes, are committed to sensitizing the communities to go to health facilities as early as they don’t feel.  When Mathew was well again, there was a big, grateful smile on his mother’s face.

Walter Ogenrwoth is 8 months old, a Ugandan IDP, and was diagnosed with pneumonia after his mother brought him to the health centre. He was put on IV X-pen, IV Gentamycin 40mg, Vitamin A 100,000 IU plus Panadol tablets. Walter responded well to the medication that was given to him.