Uganda: Panyadoli Healthcare Project
Growing Outreach and Growing Staff: Q1 2016
June 03, 2016
Summary of Activities
To improve the health status of the population:
- Provision of medicine, medical supplies, and medical support
- Support service delivery by employing medical personnel
- Support and maintain the security of the health centers by employing security guards
- Reach communities with health services through community outreaches
- Raise health service awareness through health promoters and community health teams
- Support the Health Management Information System Maintenance (staff and petrol supply)
- Maintain hygiene at the health centers to Best Practice Modern Medicine standards
- Enhance existing structures for Malnutrition Ward and Main Center
- Promote hygiene through recruitment of more compound and ward cleaners
- Upkeep and renovation of the health centers through periodic re-painting and re-plastering
- Maintain effective disease surveillance through community health services
- Maintain a high level health information system
The region has seen a significant increase of its South Sudanese refugee population which is at 49,065 as of early January 2016 according to the registration desk of OPM. By the end of December 2013, thousands of refugees started arriving in Kiryandongo from South Sudan, fleeing the conflict in their country that broke out in mid-December 2013. Because of the continued war in South Sudan, we are seeing over 170 new arrivals every day, some are coming from other refugee camps to settle in Kiryandongo.
The population of the refugee community has increased lately due to the push factors from their country including insecurity, famine, lack of reliable services etc. Currently there are over 51,000 South Sudanese refugees in the community
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Rapid Expansion of Staff
RMF had another massive recruitment in the month of January 2016 for medical doctors, social workers, IT personnel, medical workers and technicians, drivers, counselors, finance people, etc. This is a sign of rapid expansion of RMF in Uganda through financial support from United Nations High Commissioner for Refugees. Recruitment of two new hardworking, committed doctors has reduced referral cases and minimized costs that are associated with referrals. They also recruited and trained 6 interpreters and 50 Village Health Team members. Provision of RMF uniforms has greatly improved the visibility of RMF/WCF.
Cleanliness is Key
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. 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 clinics. The grounds are continuously cleaned and maintained, making it safe to walk without fear of being bitten by snakes
Referrals and Campaigns
RMF acquired two ambulances which are helping in referral cases. HIV and AIDS campaigns have been conducted and as result, many clients have turned up for testing and care. RMF initiated integrated community outreaches to enhance health service utilization. Provision of quarterly medical supplies that have kept Panyadoli Health Centers II and III, and the Reception Center Clinic running effectively, especially during the current influx of Southern Sudan refugees. Since this support benefits both refugees and nationals, it has promoted peaceful co-existence.
Change in Attitude
Erasing the stigma of modern medicine
Various capacity-building activities were undertaken as planned. Most training sessions were planned through direct implementation by UNHCR, with RMF making considerable, successful efforts to fast track implementation. Community health promoters’ (VHTs) training in disease surveillance and prevention are invaluable at a time when there are outbreaks of epidemics in the world like Ebola in West Africa. As a result, one of the trained VHTs was able to detect a suspected case of polio in Magamaga. Tests were conducted at the Virus Institute. Structures such as these are also making patients change their attitudes toward seeking health services in various health facilities in the settlement.
Counseling and Testing
Teaching about prevention
HIV/AIDS Voluntary Counseling and Testing services were provided at the center. The ART clinics have been conducted every Wednesday, condoms have been distributed, and opportunistic infections properly managed with survivors assisted and supported. Communities have been sensitized on prevention, care, guarding against discrimination and stigma, and avoiding risky lifestyles that lead to the spread of HIV/AIDS. The recruitment of an HIV/AIDS counselor has helped build confidence among the clients in need of these services at the health facility and outreach sessions. Availability of skilled midwives has increased ANC services at both health facilities; overall mothers are now seeing hope in deliveries at the facilities instead of delivering at home.
serving those far out
Preventive, community based health services were enriched with conducting outreaches through static units and enhanced by outreach for communities with limited access to the existing health units or located over 5 km from the health facilities. RMF took an integrated outreach approach with services covering immunization, HCT, ANC, deworming, condom distribution, and health education (including vital information on other cross cutting issues like gender based violence) since the community is reached with various medical services in consideration of time and cost implications. Community health promoters were trained on disease surveillance and prevention and their roles.
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
14,316 total (6,165 males and 8,151 females)
There were 11 deaths reported, dying of Anemia, HIV/AIDS, Malaria, and one of poisoning.
Through the RMF-VHT system, Innocent was found in one of the distant clusters of the Kiryandongo Refugee Settlement, far from the Panyadoli Health Centers. He is 2 years and 7 months old. When we found him, Innocent was very sick and living with his mother in the village. He was being treated with local herbs instead of being brought to the health centers. Most South Sudanese insist on treating illnesses with herbs, and if not identified early, many end up reaching health centers when they are close to dying, and this is what would have happened to Innocent. Thankfully, the RMF-VHT found Innocent early and brought him to our health center to be treated.
Innocent tested positive for malaria and was also malnourished. RMF’s doctor put Innocent on IV Gentamycin, IV X-pen, IV Artesunate, outpatient therapeutic treatment, and Plumpy Nut (RUTF – Ready-To-Use Therapeutic Food). Innocent was given F75, F100, which helped bring him to life again. His mother was excited to see Innocent playing after just a few days, and felt guilty for not bringing her son in for treatment earlier. She apologized to the medical personnel, and confessed, “If I had not been brought here, my son was going to die. May God bless RMF as organization and its workers for this help.”
Achol was brought to Panyadoli Heath Center III and was diagnosed with malaria and malnutrition. She was treated with IV Ringer’s Lactate, IV Gentamycin, IV X-pen, and IV Artesunate, and showed great improvement quickly. She was also put on F75, F100 and super cereal. Achol improved thanks to our medical team at the health center and the follow ups that have been put in place to closely monitor patients in their communities. Achol gained weight and her appetite also increased, showing signs of great improvement. Since it’s rainy season, malaria sensitization is urgently needed in the community to help residents understand the importance of precautionary measures like mosquito nets.
Fatuma was diagnosed with Severe Acute Malnutrition (SAM) and malaria. The child had a fever with chest pain, coughing, and vomiting. Her mother, who is a Ugandan, says her child started having a fever, and then the sickness escalated to the level where her child could no longer eat. After one week of treatment, Fatuma greatly improved, gained weight, and regained her appetite. Fatuma’s whole body looked burned (another symptom of SAM), and the child required a second week of treatment. Fatuma stayed for one week in the therapeutic center, was given 75% Milk and started improving further.
In the Kiryandongo Refugee Settlement, most children who struggle with SAM do so because of poor feeding habits practiced in their homes. Superstition persists, and some parents believe their ailing child is suffering from witchcraft or a bad spirit, and they do not want to bring them to the health center because they are ashamed that their children are being attacked by the bad spirits of ancestors. Fatuma and her mother were victims of this superstition. Fatuma was very ill when she was found by a community VHT and rushed to the health center.
Fatuma’s mother could not believe the improvement that her daughter showed under our care. She explained that her community believes that if you treat a child with modern medicine who has been attacked by bad spirits, the child will die instantly. Therefore, the community avoids modern medicine as much as they can if they believe a child is being attacked by bad spirits. Fatuma’s mother was counseled that it was not a bad spirit attacking her daughter; it was severe malaria killing the child. Fatuma’s mother felt she needs to sensitize her community with the support of medical workers. She was assured of medical workers’ support during outreaches to sensitize the community. Before saying that a bad spirit is attacking a child, first bring the child to a health facility to rule out a disease. Fatuma’s mother embraced the idea and is now an advocate for her community. RMF does not only give medicine, but also helps communities through counseling and sensitization. Many more community beliefs are discovered when RMF and medical staff interact with patients.
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