Supporting the Kanawat Clinic in North Uganda
Project location: UGANDA, Karamoja region
Project start date: October 2013 - Project end date: October 2014
Project number: 2013-048
Beneficiary: ICAD - International Cooperation & Development Association
Since the late 1980s Uganda has been in the process of recovery from civil war and although recently it has become more peaceful and stable, the lives of hundreds of thousands of people in the north of Uganda remain blighted by one of Africa's most brutal rebellions. Certainly Uganda remains one of poorest nations in the world, with 37.7 percent of the population living on less than $1.25 a day (World Bank 2012).
It is not surprising then, that given the poor economic base of the country, that life expectancy is low, with men in Uganda usually only living until they are 48 while for women it is 51(World Health statistics 2006). However, the reality for many children is that many of them do not live into adulthood. With sixty-one out of every thousand babies dying at birth in Uganda and one hundred and thirty children out of every thousand children dying before their fifth birthday (CIA World Fact book 2012). With so many of the causes of death being preventable, early diagnosis is an essential element of health promotion and the identification of communicable diseases prevents premature deaths. This project proposal is requesting funding to purchase laboratory equipment for a health centre in the Karamoja region in northeast Uganda. This small-scale activity will make a difference to the communities living in Karamoja and will help to save lives.
Note: It is not all bad news in Uganda, in 2001, the Ugandan Government eliminated user-fees at all government health facilities. This has resulted in an 80% increase in visits, with the poorest 20% of the population accounting for half of this increase (Overseas Policy Institute 2010).
The Karamoja region in northeast Uganda
Home to about 1.1 million people, Karamoja is a harsh, semi-arid region largely inhabited by agro-pastoralists in the North-East of Uganda. The Karamoja region in the north-east of Uganda, is one of the most marginalized communities in the country and one of the least developed in the world (United Nations 2012). Now, after a decade of Ugandan military operations to disarm rival clans in the region, Karamoja has become more secure and development experts hope it can become more self-sufficient. The improved security situation has enabled the government and international community to shift the focus from emergency aid to sustainable development for the Karimojong and more recently they are trying to convince local people to settle down and plant crops (Delany 2012).
However, the districts of Karamoja continue to have some of the highest human poverty indices in Uganda (Kotido has 53.8% compared to the national average of 37.5%) and in 2008 the Integrated Regional Information Network suggested that the Karamoja region had such poor health indicators that up to 100 children younger than five were dying each week, with many of them dying from preventable illnesses. (IRIN 2008).
Kanawat Health Centre.
In this context lies the jewel of the Kanawat Health Centre, despite the poor infrastructure and lack of equipment, the Centre is run efficiently and is maintained and staffed by a well trained and highly motivated team who are held back either by the lack of, or poorly functioning, basic equipment. The Health Centre has been run for more than 35 years by sisters from the Comboni order.
The Director, Sister Roma Tecle has been responsible for the Health Centre since 2009. She is a qualified Counselor, professional nurse, with a diploma in Administrative Management. She has been educated in United Kingdom, Ethiopia and in Uganda.
Before her assignment in Kanawat, she worked as an instructor in an International Center for Comboni Sisters in Namugongo, close to Uganda Capital's city, Kampala.
The team is comprised of 43 staff members as follows:
- 2 doctors,
- 12 nurses,
- 3 laboratory assistants,
- 10 auxiliary workers
- 1 accountant;
- 1 secretary;
- 4 HIV Counselors;
- 5 cleaners;
- 3 masons;
- 2 guardians.
The Health Centre is currently funded from different sources as follows:
- 8 % of basic costs come from the Government (39 million of Uganda Schillings = 13 thousand Euros);
- 35 % from the patients and the balance from Italian donors and NGOs.
The above funding is not sufficient to fully meet the requirements of the Health Centre which covers the health needs of a population of approximately 30.000 people.
Key performance indicators of the Health Centre 2011:
- ANC new cases . . . . . . . . . . . 1,071;
- Maternity Admissions . . . . . . . . 251;
- Deliveries . . . . . . . . . . . . .. . . .252;
- BCG . . . . . . . . . . . . . . . . . . . .992;
- DPT3 . . . . . . . . . . . . . . . . . . 1,977;
- Meals . . . . . . . . . . . . . . . . . . 1,367;
- OPD new attendances 0-4 years . . . 17,208;
- OPD new attendances 5 and over . . 11,249;
- Re Attendances 0-4 years . . . . . . . . .2,193;
Total attendance 30,650
- In patients 0-4 years . . . . . . . 6,363;
- In patients 5 and over . . . . . . 2,671;
Total admission 9,034
- TB new . . . . . . . . . . . . . . . . 13;
Pregnant mothers tested for HIV . . . 1,020;
Mothers HIV positive . . . . . . . . . . . . . . . 6;
HIV counseled . . . . . . . . . . . . . . . . . 3,918;
HIV tested . . . . . . . . . . . . 4,468;
HIV positive . . . . . . . . . . . . .99;
HIV + TB . . . . . . . . . . . . . . . .1;
HIV + on CTX . . . . . . . . . . .98;
- BCG . . . . . . . . . 895;
- Polio3 . . . . . . . 2.681;
- Measles . . . . . .1.558.
In March 2012, the plight of the centre was brought to the attention of Mr. Del Moro, the founder of ICAD, by Sister Roma Tecle who in her role as Director runs the Centre. She stressed how essential the purchase of even some very basic equipment was. Such equipment would significantly affect the speed of diagnosis, the cure and prevention of diseases that afflict the general population, pre and post partum mothers, would improve neo-natal health and survival rates making a substantial improvement in overall hygiene/sanitary procedures. It is important to note that the staff at the centre have requested that the equipment be of high quality and durability and that it be purchased from a reliable source.
The prime objective of the project, which received a grant from the Nando Peretti Foundation, is to improve the delivery of care to pre and post partum mothers, children and other users of the Health Centre through the provision of laboratory equipment and the purchase of two maternity delivery beds to enable speedy diagnosis, early intervention and increased hygiene.
Specifically, the staff have requested:
No. 2 Microscope OLYMPUS Cx21 with mirror;
No. 2 Pipette variable 5.50 Microlitre;
No. 1 Laboratory weighing scales;
No. 2 Delivery beds;
No. 1 Vacuum extractor, 515 ks DeVIBLIS;
No. 1 Autoclave Benchtop, mod. 2340 mk tuthauer;
No. 1 Oxygen Concentrator.
The Kanawat Health Centre serves a population in the region of 30,000 people and the purchase of microbiology equipment and maternity beds for the clinic will improve the overall quality of diagnosis and potentially increase patients life quality in the region. Specifically,
a) The purchase of two Microscopes OLYMPUS Cx21 with mirrors will improve the screening of blood and urine, and this will positively affect the speed of diagnosis as well as the efficacy of curative and preventive measures in the Kanawat Health Centre. Effective and fast diagnosis saves lives.
b) The additional purchase of two maternity beds will improve the quality of women's birthing experience, give mothers in labour dignity and improved hygiene as well as reducing the possibility of infection to mothers and infants.