Uganda: Healthcare Implementing Partner for UNHCR at Bidibidi Refugee Settlement

Creating Solutions

Refugee Settlement

An emergency interagency meeting was convened by the UNHCR and OPM (Office of the Prime Minister) in Kampala, at the OPM’s offices. Among the resolutions adopted during the meeting, was one dispatching a Joint Assessment Mission to Uganda’s West Nile region to find a place where this new influx of refugees could be settled. Partner organizations (including RMF) who would be able to support different sectors were encouraged to join the mission. Upon our return from West Nile, the Joint Assessment Mission resolved to settle the new influx of refugees at Bidibidi Refugee Settlement in Yumbe District. Within this context, RMF was selected as the main UNHCR Health Implementing Partner, complemented by IRC for reproductive health, ACF and Concern Worldwide for Nutrition, and of course the UNHCR.

Service

From the Ground Up

Pagirinya Transit Centre was now very congested, and existing refugee settlements were filled with numbers exceeding their capacity. All services were exhausted, and fear of a disease outbreak, such as cholera, was running high. It was necessary to open Bidibidi Refugee Settlement within a very short time, increasing the pace of work, decision making, and accurately identifying priorities, especially priorities that would be lifesaving.

What must be kept in mind is that Bidibidi started as fields and thickets, and every service had to be built from the ground up.

Additional Facilities

Increasing Capacity

Since refugees had been settled far from the Reception Centre where the health facility was located, it became necessary to establish another health center closer to where people were living. This called for additional personnel, medical and cleaning supplies, furniture, and office supplies. In order to bridge the gap, RMF Uganda had to use its already stretched resources to purchase more hospital supplies and hire additional manpower. Currently, Bidibidi Refugee Settlement is divided into 5 zones, and as of early October, Bidibidi’s 3 zones are occupied by a population of 131,352 refugees. Zone 4 and Zone 5 are to be opened at any time now, because the influx is increasing. Bidibidi Refugee Settlement was originally designed/estimated to accommodate 100,000 refugees, but with new areas opening, its estimated capacity is 180,000.

Growing Presence

Recruiting Staff

The number of RMF workers in Bidibidi increased from 22 to 39, and our team per this October now includes 41 members:

1 RMF Medical Coordinator
2 Medical Officers
2 Nursing Officers
7 Enrolled Nurses
5 Clinical Officers
6 Midwives
1 Laboratory Technician
2 Laboratory Assistants
2 Data Clerks
4 Interpreters
2 Guards
6 Cleaners
1 Accountant

Providing Care

Despite Adversity

Despite the fact that RMF has not yet received any funds from UNHCR, we are performing our duties as the main Health Implementing Partner:

• Curbing an early cholera outbreak in Bidibidi Refugee Settlement
• Establishing additional services including birthing services
• Providing medication, medical supplies, and cleaning supplies to sustain the health project
• Providing medical equipment (hospital beds, mattresses, delivery beds, examination couches, etc.)
• Providing a temporary incinerator
• Excavating a placenta pit
• Providing stationery (to work as medical forms) for patients
• Supporting patients who are referred to the regional referral hospital in Arua through financial facilitation of the patient and the caretaker
• Conducting consistent health outreaches to provide health education and prevention

Challenges

Working Solutions

Referral Mechanism
RMF quickly initiated a collaboration with Yumbe Hospital so that cases requiring surgery or other specialized treatment can be referred to Yumbe Hospital. Through this collaboration, RMF Medical Officers provide professional services to Yumbe Hospital, and Yumbe Hospital provides RMF with unlimited access to their facilities for the benefit of refugees.

Ambulance Services
RMF (with permission from UNHCR) relocated one ambulance from Kiryandongo to support Bidibidi. This has been critical in saving the lives of people of concern. Since one ambulance was not sufficient, UNHCR relocated another ambulance from Arua operations (under MTI) to the Bidibidi Refugee Settlement.