Uganda: Healthcare Implementing Partner for UNHCR at Bidibidi Refugee Settlement
Participating in Mass Polio Campaign: Q3 2017
January 01, 2018
Alphonse Mwanamwolho and Naku Charles Lwanga
Summary of Activities
During this reporting period RMF:
- 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.
- Delivered mass polio immunization services to the refugee and host communities during community integrated outreaches.
- Recruited additional staff members (both medical and non-medical) for health implementation in Zone 3, which was handed over to RMF in July 2017. Over 172 staff members were recruited and have started working.
- Throughout the reporting period, RMF purchased medicines to treat patients and laboratory supplies to test for diseases. Medicines and testing helped save lives.
- RMF 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.
- RMF actively supported World Breastfeeding Week. During this event, lactating mothers were taught best breastfeeding practices, cooking demonstrations were conducted for lactating mothers, etc.
- Treatment was provided to all patients that came to the health facilities. Patients with conditions that could not be handled at the health facilities within the settlement were referred to district and regional referral points, respectively.
- RMF 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.
- Staff in the EPI (expanded program on immunization) department were given a refresher course to acquaint them with the new guidelines for EPI.
- All RMF-managed health facilities continued to provide antenatal, maternity, and family planning services, thus promoting institutional deliveries and safe motherhood. 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.
- RMF continued facilitating an outreach program within the settlement. This is to ensure that health services are extended to people of concern in more distant villages of Bidibidi Refugee Settlement.
- Community health officers were given special training to empower them with community mobilization skills.
- 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.
- An incinerator and placenta pit were constructed at Bidibidi Reception Health Centre III. They have been sanctioned for use, thus achieving the minimum required standards of a health facility.
- Facilitated the disease surveillance teams’ activities so that the medical department will not be taken by surprise in case of an outbreak. Suspected samples of cholera, measles, and polio were rushed to the district laboratory for confirmation. This is partly why no outbreak was experienced during the reporting period.
- RMF has 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.
- Continuous cervical cancer screening and education is ongoing at the health facilities. Those patients testing positive are referred to the regional referral points for further management (cervical biopsy for histology and cytology).
- 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.
- RMF has maintained a highly skilled, dedicated medical team thanks to the prompt payment of salaries and wages, as well as RMF mentorship.
- 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.
Supporting New Mothers
World Breastfeeding Week
RMF actively supported World Breastfeeding Week. During this event, lactating mothers were taught best breastfeeding practices and cooking demonstrations were conducted for lactating mothers.
Utilizing Health Facilities
Treating 55,552 Refugees
Health facility utilization is progressing. From July to September 2017, RMF carried out 62,837 medical consultations, treating 55,552 refugees and 7,285 nationals. 2,518 people (2,158 refugees and 360 nationals) were admitted to the inpatient departments at RMF medical facilities with different conditions.
Mass Polio Campaign
Immunized against Polio
RMF participated in a mass polio campaign titled “Uganda Supplementary Immunization Activities,” during which 29,278 children were immunized against polio in zones 1, 3, and 4 of Bidibidi Refugee Settlement. This includes 29,220 children under 5 years of age and 58 above 5 years of age.
Physical Therapy Provided
- 1,260 patient consultations were provided, with an average of 124 patients daily.
- 85 children with cerebral palsy were assisted, 448 neuritis cases were assisted, 122 women with sciatica, 333 cases of spondylosis were handled, and 272 cases of back pain were registered.
- In addition to drugs and passive and active appliances, physical therapy and exercises are provided.
1,613 Consultations Provided
- 1,613 consultations were provided, with an average of daily attendance of 65 clients.
- 187 children with clubfoot were assisted, 121 cases of genu varum were assisted, 72 cases of genu valgum were assisted, and 443 cases of fracture malunion were assisted.
- 97 amputees that need artificial limbs have been identified.
- 230 cases of fresh fractures and dislocations were handled, and 463 need assistive devices.
Diagnosing Unassisted Children
- 23 children assessed were diagnosed with autism. However, most children who seem to be at risk of autism have not been assessed by Early Childhood Development Centers (ECDC).
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.
- 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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Controlling the most Serious Illness: Malaria
Yokani Hakim is a 10-year-old boy who weighed 8.4 kg when he arrived on September 10, 2017 from Goboro border point (an entry point for refugees from South Sudan). RMF’s medical team identified Yokani and saw that his condition was concerning. After assessment, he was referred to the main nutrition point in Bidibidi Refugee Settlement: Bidibidi Reception Health Centre III.
RMF’s nutrition team, headed by Nutrition Officer Ronald Byandala, found on examination that Yokani was suffering from malaria, and his condition included lack of appetite, edema grade 3, limbs unable to flex, general pallor of the skin, and sparse, silky depigmented hair. He was diagnosed with SAM (severe acute malnutrition) and edema (marasmus and kwashiorkor) with < -3SD of the Z-score.
According to his mother, Ajone Sarah, Yokani was always left in the house because he could not walk, and at 10 years old, he could not even talk. Yokani was admitted for inpatient therapeutic care (ITC) and started on antimalarial treatment. He was also started on Formula 75 (F-75) during the stabilization phase. After 2 days, his treatment was changed to Formula 100 (F-100). Aside from nutritional therapy, the team also had to provide ambulation of the limbs to enable Yokani to walk.
Within 4 days, the edema had subsided, and Yokani’s appetite had returned. He was also able to sit, as well as play with fellow children in the ward. Real Medicine Foundation was able to control the most serious illness. On discharge, Yokani weighed 8.7 kg. We enrolled him in outpatient therapeutic care, and he was transferred to Imvepi Refugee Settlement in Arua District under Medical Teams International for further management of acute malnutrition. The team allowed Yokani to travel to Imvepi because that is where his parents had been given a plot of land to settle.