Uganda

Project Background:

The Panyadoli Health Center, located at the Kiryandongo Refugee Settlement in Bweyale, Uganda, provides healthcare services to over 60,000 in the region including 41,000 Ugandan IDPs, Bududa survivors, and Refugees from Kenya, Sudan, Congo, Burundi and Rwanda which are the main target population; we saw an influx of 10,000 new Ugandan IDPs in October 2010 and another 15,000 joined the Kiryandongo Resettlement Camp at the end of May 2011.

In 2009, Real Medicine Foundation in collaboration with UNHCR and the Office of Prime Minister initiated a center-wide upgrade to restore the function of the center to best practice western medical standards. Since then we have completed many building and service upgrades and continue to resupply medicine and medical supplies to the clinic every month.

Photo: Medicine supplies arriving at the Panyadoli Health Clinic

Project Objectives:

• 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.
• Unblock the pipes in some of the building at the health centre
• Renewed renovation of the health centre, i.e. painting and plastering

Summary of RMF/WCF-sponsored activities carried out during the reporting period under each project objective: 

• RMF provided the Panyadoli Health Center with medicines and medical supplies, and covered existing gaps during this reporting period.
• A Child Malnutrition Survey was carried out across the Kiryandongo Settlement and in the Panyadoli clinic at RMF’s request by the staff of Panyadoli during the week of Feb 13^th-19^th (Full results below)
• Three ward cleaners and two ground keepers sponsored by RMF are reporting to Dr. Simon Opieto, head of the Panyadoli Health Center. The grounds are groomed regularly and the cleanliness and hygiene of the wards and offices is well maintained. 
• Continued maintenance of water pipes and solar pumps.

Results and/or accomplishments achieved during this reporting period: 

• The coordination of medicine supplies to the health center continues to make a significant difference to the community and maintains the center’s treatment capacity and overall reliability. 
• The Child Malnutrition Surveycarried out during the week of Feb 13^th-19^th, showed a total of 28 cases of children with malnutrition, with 10 cases of Severe Malnutrition that require special treatment and expensive therapeutic food supplies not currently available at the Panyadoli Health Center.  The survey results and consultation with medical staff at Panyadoli has shown that the clinic would need approximately $30,000 a year in therapeutic food supplies and medicine to manage both the Severe and Moderate cases. The full report on these children, and the associated medicine and supply costs can be found further down the page.
• Due to the continued high levels of patient flow from the increased Ugandan IDP population the medicine consumption continues to be high. Inflation also continues to drive the increase of costs of medicine and supplies.
• The wards are kept clean, and equipped with medicines and supplies; this is a joint effort of RMF, the Kiryandongo local government, and the UNHCR. 
• The grounds are continuously cleaned and maintained, making it safe to walk around without fear of being bitten by snakes.
• The Solar Powered Water Pump is functioning successfully, providing clean running water to the clinic wards and offices, greatly increasing the hygienic conditions of the health center.

Number served/number of direct project beneficiaries: 

• During the month of January, 1,518 patients were treated at Panyadoli Health Centre out of which 567 were male, and 951 were female.
• During the month of February, 1,326 patients were treated at Panyadoli Health Centre, out of which 471 were male, and 855 were female. 
• During the month of March, 1,442 patients were treated at Panyadoli Health Centre, out of which 513 were male, and 929 were female. 
• No deaths in this reporting period.

RMF Uganda: Panyadoli Health Center Malnutrition Survey of Children under 5 years old

The following survey was taken at the Kiryandongo Settlement in Uganda by RMF staff during the week of February 13^th-19^th, 2012.  From the below table, children numbers 1 through 10 are suffering from Severe Malnutrition, while the rest are more moderate cases under supplementary feeding.  Panyadoli Health Centre currently has an average of 10 children each month with severe malnutrition that are unable to be treated properly due to lack of supplies.  In the past, UNHCR provided the therapeutic food products and the health centre used to see far more than 10 children a month when the community was aware the food supplies existed.  UNHCR discontinued this program and many of the other support programs at Kiryandongo in the past two years.

In order to properly treat cases of Severe Malnutrition, the health centre needs the following therapeutic milk and food products for the dietetic treatment:

• F100 milk Lo
• F75 milk Lo
• Plumpy nut
• Posho.

After initial treatment of Severe Malnutrition, the following supplementary foods are required:

• Beans
• Ground nut
• Rice
• Simsim
• Seed of vegetables for demonstration farm.

The ratio of Refugees with Malnutrition to Nationals seen at Panyadoli Health Centre is 2 to 1.  In total 22 children were discovered with Malnutrition and of those, 10 had Severe Malnutrition.

Annual Budget for support of both treatment of Severe Malnutrition and Supplementary Feeding

This assumes that the number of children treated will be higher than the 10 average that the clinic is currently seeing once the community is aware of supplies.

• F100 milk Lo: 900,000 per carton x 5 x 12 months is 54,000,000 or $23,000 for one year supply.
• F75 milk Lo: 25,000 per tin x 10 x 12 months is 3,000,000 or $1,300 for one year supply.
• Plumpy nut: 100,000 per carton x 5 x 12 months is 6,000,000 or $2,600 for one year supply.
• Posho: 75,000 per bag x 12 months is 900,000 or $400 for one year supply.

After initial treatment of Severe Malnutrition, the following supplementary foods are required:

• Beans: 180,000 x 6, or 1,080,000 or $500 for one year supply.
• Ground nut: 300,000 x 3, or 900,000 or $400 for one year supply.
• Rice: 300,000 x 4, or 1,200,000 or $550 for one year supply.
• Simsim: 300,000 x 3, or 900,000 or $400 for one year supply.
• Vegetable seeds for demonstration farm – lump sum, or 200,000 or $90.

Total Budget for one year = 68,180,000 or $30,000

Success Stories

Kimono Esther is 23 years old and a resident of the Bududa Ranch area that is allocated to internally displaced persons. She arrived at the clinic ill and was diagnosed with severe malaria. Her treatment included a Quinine IV, Coartem, and Paracetamol. She recovered over the course of three days and was discharged in good health.

Langwil Sabina is 35 years old, HIV+, and a resident of the K cluster allocated to refugees. She was diagnosed with severe malaria and pneumonia. Her treatment included Coartem, Septrin, Paracetamol, and Quinine IV. She improved quickly.

Adong Milly, 20 years old and a resident of the N cluster at Kiryandongo allocated to refugees, was diagnosed with severe malaria and is known to be HIV+. Her treatment consisted of three doses of Coartem-4, a Septrin prophylaxis, Paracetamol, and three doses of Quinine IV. She has improved quickly, responding to medication very well.

Janet Nyatoo, 35 years old and a resident of the “ranch two” section of Kiryandongo allocated to refugees, was diagnosed with severe malaria and a cough. Her treatment was based on three doses of Quinine IV 600g 8’, three doses of Paracetamol 1g, and Septrin. She spent three days in the admission ward and is to be discharged soon as her health has improved substantially. She is grateful to the nurses for the intensive care given to her, and for the availability of the drugs at the health center.

John Oryem, 28 years old and a resident of cluster K allocated to refugees was diagnosed with pneumonia and malaria. His treatment consisted of an IV of X-pense 2mu 6’ for 24 hours, three doses of Coartem- 4, a tablet of Diclofenac 100g; he was discharged after 3 days of treatment.