Nigeria

Lagos State: While Coker/Aguda is still in need of a long-term health care center, RMF has chosen to implement its first Primary Health Care Project in Gure, Baruten, L.G.A. Kwara State, a rural area of extreme poverty where there is a dire need for more comprehensive health care. Central to RMF’s success is leveraging existing clinics, familiar with the local demands, yet requiring support to fully optimize its function and leverage its presence.

After a thorough review of the situation in Lagos State and surrounding areas, we determined that the Gure, Model Health Care Clinic was better suited for the RMF Model and our assistance would address a larger rural population in dire need of outside assistance.

Strategically, we felt that our model could be easily and successfully implemented in this region and then scaled back to Lagos State as originally intended, and Calabar, Cross River State where needs have been identified and interest is high for RMF participation.

Kwara State (Gure Project):

Overview: As outlined in the last report, we were able to create a partnership with the Gure Model Health Care Clinic, which is located in the Baruten local government area (LGA) in Kwara State. Gure is in the south-west of Nigeria (about 3 hours north of Lagos) and borders the Benin Republic on the West. The Gure Clinic serves the entire Baruten LGA as well as people from the Benin Republic. The population to be served is approximately 150,000. It is a primarily rural area with little access to health care. The clinic faces several major challenges including: fatalities from easily treatable diseases due to lack of adequate treatment. The most common ailments in the area include: malaria, musculoskeletal pains, gastrointestinal disturbances and ulcers, respiratory tract infections, hernias.

April Health Week:

Dr. Ejughemre Ufuoma who is the overseeing physician at the Gure clinic organized a health week (4/13 – 4/17) where he invited visiting doctors to assist in providing free basic surgeries and health care to the impoverished residents of the area. His goal was to spread awareness of the health treatments available at the clinic and avoid preventable deaths. He heard about RMF’s operations and requested aid. Real Medicine provided organizational support and financial support for medicines and equipment for the week.

The health week was a huge success (see the schedule below and attached images). It raised awareness of non-traditional healthcare services at the clinic, 290 people received free treatment and we also brought surgeries for the first time to the area! In detail: A total of 290 cases were attended to, 5 were surgical cases involving herniorraphy:

• Malaria-80
• Antenatal-30
• Respiratory infections-25
• Surgeries-5 Herniorrhaphies
• Musculoskeletal Pains-60
• Gastrointestinal/ulcers-40
• Others- 50

Kick off ceremony	Crowd gathers at clinic
Patient being treated	Patient with child awaits treatment

Next Steps: The clinic is still in dire need of long-term support. Particular issues include overstretched facilities including lack of surgical and medical amenities, doctors and other medical staff, inadequate staff training and poor communication network. RMF staff is scheduled to visit to carry out an extensive needs assessment of the clinic and its surrounding areas to determine the highest leveraged approach to providing solutions to this community.

The Needs Assessment will include:

• Clinic health management information system/record keeping.
• Medical inventory and dispensary procedures, etc. to ensure level of standards and transparency.
• Preparations of MOU with local and national authorities outlining RMF’s long term support in the following areas:
• Communications: Procurement and installation of a repeater to improve GSM signal strength within the hospital, facilitate communication within and outside GURE as well as Internet access through the GSM connection.
• Clinical upgrade to improve hygiene: (painting, mattresses, mosquito nets, electrical work, etc.)
• Supply medications (fill gaps in supplies from government)
• Supply some medical equipment, to be determined
• Bore Holes for drinking wells – needs assessment to be done
• Staff Training – consideration of continuing education support/training
• Maternal Care/ Midwifery – consideration of continuing education support/training
• Homeopathic Malaria Treatment Support

Another potential partnership is with the Nigerian Youth Service Corps, (NYSC), an organization that supervises Nigerian college graduates’ mandatory yearlong service all across Nigeria. We are presently setting up a system to recreate our partnership in Gure across Kwara State and the rest of Nigeria.