Uganda: Healthcare Implementing Partner for UNHCR at Bidibidi Refugee Settlement
Promoting Behavior Change Towards HIV/AIDS: Q4 2017
March 25, 2018
Alphonse Mwanamwolho and 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.
- Throughout the reporting period, RMF purchased medicines to treat patients and laboratory supplies to test for diseases. Medicines and testing helped save lives.
- Food supplements were procured to support the nutrition program.
- During the reporting period, RMF purchased other hospital supplies to support the program, including furniture and waste receptacles.
- 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.
- 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.
- 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.
- Continued managing highly motivated medical and support staff teams to provide optimal care to the patients.
- Selected medical staff members were taken for special training on management of TB cases.
- Recruited new staff members to replace those who left the team during the reporting period.
- Salaries and wages for RMF-supported staff were paid in a timely manner, which helped keep staff members motivated.
- 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.
- 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.
- 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.
- Boosted the HIV/AIDS awareness program in the community; awareness was promoted among school going children during the reporting period.
- Actively organized the World AIDS Day celebration for the entire settlement. Prior to the celebration, 7 days of activism were conducted. Voluntary testing and counseling (VCT) was carried out.
- 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.
- 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 district laboratory for confirmation. This is partly why no outbreak was experienced during the reporting period.
- 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.
- 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).
- 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.
Utilizing Health Facilities
More than 150,000 Medical Consultations
Health facility utilization is progressing. From October to December 2017, RMF carried out 168,800 medical consultations, treating 109,429 refugees and 59,371 nationals. 52,596 people (42,179 refugees and 10,417 nationals) were admitted to the inpatient departments at RMF medical facilities with different conditions.
ART Clinic Growing
Encouraging Safe Lifestyles
The ART clinic established by RMF in Bidibidi Refugee Settlement is growing steadily, and additional patients are reached through outreaches and RMF-supported health centers outside of the settlement. During the reporting period, 91,752 clients were tested for HIV/AIDS (70,038 refugees and 21,714 nationals). 53 tested HIV-positive. During counseling sessions, all patients are encouraged to practice safe lifestyles, and those who are HIV-positive are encouraged to enrolled in ART.
Partnership with UNHCR
Funds Entrusted to RMF
RMF is building a relationship of strong trust with UNHCR. For instance, IGAD funds given to UNHCR for implementation of HIV/AIDS and TB related activities in the refugee settlements of West Nile have been entrusted to RMF for implementation. RMF was entrusted with these funds because of our visibly exceptional performance; UNHCR has confidence that the work will be completed and well done. 962,957 condoms were distributed through community outreach and the STI clinic.
Partnership with Direct Relief
During the reporting period, RMF Uganda’s team also coordinated and received two donated consignments of medicine: one from Direct Relief International and another from World Children’s Fund. These additional medicines helped support program operations immensely.
Nutrition Program for Mothers
Benefiting More Than 550 Mothers
RMF’s work in Bidibidi Refugee Settlement also is attracting more partners who have offered contributions to the refugee program through RMF. For instance, Convoy of Hope is funding a nutrition program for pregnant and lactating women (PLW) through RMF. Currently, over 577 mothers are benefiting from the program (281 in Zone 1, 150 in Zone 3, and 146 in Zone 4).
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
Click to enlarge
The Construction of Four Permanent Health Centers
Continuing to Expand Services
The construction project includes 4 permanent health centers, each with 4 buildings: An Outpatient department, Maternity ward, General ward, and staff house. Each health center will include a pit latrine with 6 stalls and each staff house will include a pit latrine with 2 stalls. The construction also includes 6 bath shelters for patients at each site and 2 bath shelters for staff at each site.
Orthopedic Department Opened
Success in 6 Months
Due to the increased number of cases requiring an orthopedic expert, RMF opened an Occupational Therapy/Physiotherapy department in Bidibidi Reception Health Centre III so that all orthopedic cases can be handled within the settlement. Since the establishment of the department 6 months ago, the department has registered the following successes:
Physiotherapy & Orthopedic Services
3,522 patient consultations were provided during the department’s 6 months of operation, with an average of 147 consultations weekly, 587 consultations monthly. *11,280 consultations were provided during the department’s 6 months of operatio*n, with an average of 470 consultations weekly, 1,880 consultations monthly. Patients presented with fresh fractures, both closed and open. 67% were closed (simple) fractures and 33% were open (compound) fractures.
Cases of Head Injury
180 head injuries were seen during the department’s 6 months of operation, of which 60 were open head injuries successfully referred to Arua Regional Referral Hospital. The most common causes of head injury were domestic and gender-based violence, falling from a height (especially among children), and traffic accidents (especially among boda [motor bike] cyclists.