Why this Project is Important

Potential Long Term Impact

Because VSO's volunteers pass on skills that stay in the communities, hundreds of colleagues and students and thousands of patients benefit long-term. Vitally, local medical practitioners feel encouraged to remain in their countries.

Project Message

"The clinic that I joined has changed beyond recognition. Thirteen people have become forty Ugandans. In 2007 we tested more than 3000 people for HIV, including more than 900 pregnant women."
- Dr Paul Williams, VSO volunteer, Bwindi, Paul started his VSO placement in 2006.

Who is Running This Project

Contact

Emma Kendon,
Direct Marketing Fundraiser
VSO
317 Putney Bridge Road
London, SW15 2PN
United Kingdom
-4402087808200
Email:

Project Sponsor

VSO

Organisation

Learn more about VSO and the project team.

Where this Project is Located

Country

This project is located in Uganda and can also be found under Health.

For more information about Uganda, read the Human Development Report on Uganda or the Wikipedia entry for Uganda.

When this Project was Updated

Last Updated

This project was last updated on October 08, 2008.

Date Added to GlobalGiving

This project was added to the GlobalGiving project catalog on August 22, 2008.

Latest Update from the Field

Updates from 2 VSO doctor volunteers

By Emma Kendon - Appeal Fundraiser, October 08, 2008 08:20 AM

We've had two updates from volunteer doctors working in Uganda, Paul at Bwindi Community Hospital in its rural forest setting, and Unni at Mbarara University in Kampala. Nurse trainer Duncan's update is on its way too so I'll add his news when I have it as well as some overview from Sarah in the Uganda VSO office.

So, Paul's news. Firstly, if you haven't read the background document for this project, you might like to (there's a link further down our appeal page). Paul has been volunteering in Uganda with VSO for over two years, achieving extraordinary successes, and working phenomenally hard together with his colleagues at the hospital. His updates give a real flavour of achievement together with the challenges. These include problems the patients present, issues of access, damage to property etc, but also familiar human achievements and challenges amongst the staff such as taking on a new skill and responsibility and feeling a protective resistance to change.

Anyway, here he is himself:

“It is sometimes hard working in an environment like Bwindi, and also hard to convey in writing just how difficult it is. 6am to 7am is a precious time, as I’m uninterrupted and can catch up with thoughts and work. This morning I’ve used that time to write.

Yesterday a lot of things happened. I began the day at 7am with a breakfast meeting with the Project Manager to discuss all of our current construction projects, plan for the installation of power in the hospital, chase up the lack of progress on the new maternity ward, review plans for drainage and reject a design for a mortuary because it is too expensive. I learnt that the Administrator wants to be away next month, when I was planning a fundraising trip to the US. I then met with the HIV/AIDS team at 9am for the weekly get-together for the part of the hospital that I have clinical responsibility for.

I then spent several hours doing ward rounds on all of the children and the adults (although we only have about 20 inpatients at the moment, there are some complex cases), managed a complicated delivery, oversaw an HIV & AIDS clinic and supervised three medical students. In between I can remember the following things that drew me away.

I was told there was no O negative blood for a young man with a massive spleen who needs a transfusion, and our laboratory attendant said that we could not get any. I organised sending someone off on the bus to Mbarara 5 hours away to get some today.

A fuse blew on the x-ray machine, and we have a visiting radiologist and radiographer here to train some of our staff. A team is leaving at 7am this morning to travel to the Tea Factory in Butagota to try to get another fuse or to fashion something from there so that we can run the service today.

Crops were burnt in a field adjoining the Hospital and the fire got out of control, threatening the children's ward. The night watchmen and the drivers all beat the fire back with branches (or fanned the flames!)



Batwa pygmies broke through the window in the children's ward kitchen and stole all of the milk prepared for the malnourished children. Someone had been asked to put locks on the windows 8 weeks ago but had forgotten.

A support supervision visit happened from JCRC, the organisation that provides us with HIV & AIDS drugs. We discussed the sustainable funding of our HIV and TB outreach programme. They cannot help, but they reviewed a proposal to the Elton John AIDS Foundation that I have written that I am touting about to other organisations. We also discussed new guidance from WHO (World Health Organisation) on treating all babies born with HIV with antiretroviral drugs, how much support we should be giving to Government units, training opportunities for our staff and plans to develop a CD4 testing service (blood test which measures the immune system's strength after a diagnosis of an HIV infection) here in Bwindi.
The clinician on duty for the night went off to a burial of a boy in his village who had been burnt to death in a lorry accident at the weekend, but he did not arrange cover. Protracted negotiations took place with another clinician who asked me to "put a request in writing" for him to cover the work.
We have a cash flow crisis as our finance manager has been off looking after her sick daughter and has not left adequate information, so I have real difficulty in making any decisions about expenditure. It is 4 days to pay day and I’m uncertain if we have enough money for the staff. I think we probably don’t.
The company that provides us with drugs from Kampala is not responding to email requests for an order, and our secretary is not able to get them to send us the information.

At various points during the day I gave an anaesthetic and performed a surgical toilet on a man who had the tip of his nose bitten off the night before, I talked with the family of an old man who had died in the night and worked with our IT people on introducing a computer database for our HIV service I sat with the midwife to help her with her data collection for the organisation that supports our Prevention of Mother to Child Transmission services. I reviewed a child with severe dehydration, a man admitted with a ruptured liver, saw a young girl who has juvenile rheumatoid arthritis and is suspected to have TB (although I am initially managing her for pneumonia) and tried to work out if the scan really showed an ovarian tumour in the lady in bed 3 with abdominal pain.

After dark I sat with the clinician who agreed to cover, and tried to review some of the cases that he had admitted in the last 3-4 days, giving him constructive criticism. I finished work at 9pm and had some food whilst opening and responding to some of my emails (another 43 today...) before reading the paper online and going to sleep.

Best wishes

Paul”


You see how Paul refers to fundraising in the US. He is looking for large donations from wealthy individuals for the Hospital, and you will see below Unni is doing something similar for his placement. Your and my donations to send the volunteers go a long way, as these specialist doctors/trainers double up as managers and project fundraisers. Costing about £5 a day - how about a really imaginative Christmas present! I’m certainly buying my friends some Uganda healthcare volunteer days each.

Over to Unni, or to give him his full title – you should understand the calibre of the VSO volunteer! – Dr Unni Wariyar OBE, Senior Paediatrician:


“Uganda is a great country but the health care system is well behind the progress made in this field in developed countries. It is even worse for the sick and very small and vulnerable babies. There are no specialists here and no specially trained nurses either. I am trying to start a facility to care for the newborn ill babies at a basic level in the "regional referral hospital" and "Medical school". I am looking for some resources to buy equipment to warm the area to care for them and some basic monitoring and treatment facilities.

The University is committed to this development and will work in partnership with the local community and Voluntary Service Overseas (VSO) and the donor to ensure a successful outcome.

The hospital was set up as a regional referral hospital in 1950. It became a teaching hospital and was incorporated into Mbarara University of Science and Technology in 1989. The hospital serves a large rural area of south western Uganda comprising of the districts of Mbarara, Isingiro and Kiruhura.

The University management team are committed to developing the hospital to meet the needs of the very deprived communities served by the hospital but lack funding for any development.
There is a large paediatric patient turnover – approximately 7000 patients per year – and the majority of admissions are newborns or toddlers. The paediatric unit accounts for 53% of hospital admissions but has only 15% of the beds. The admission room is not adequately set up for its purpose. The space and basic equipment are inadequate. Babies are kept with other patients with communicable diseases increasing the risk of mortality and morbidity and this needs to change.

The hospital serves a population of 1.4 million people. The largest community served by the hospital is the town of Mbarara with a population of 80,000. The remaining population live in small rural villages where subsistence farming is the main occupation. Some of the villages with good infrastructure are relatively prosperous but the majority lack basic water and electricity and people live in extreme hardship. Half the population are children.

The infant mortality rate is around 15% with the main diseases of malaria, bacterial infections, HIV and malnutrition placing a heavy burden on the children. Ignorance is a major factor in these diseases. In this region many children in the villages suffer malnutrition because of the lack of essential nutrients in their diet.

Cultural practices have led to small farm plots of around a few acres. If current trends continue the land use will de-fragment further leading to problems. The average family has around 7 children with about half surviving to adulthood. There is an urgent need for basic equipment for the care of newborns. It is currently not possible to administer oxygen appropriately to babies, protect them from hospital infections and to keep them warm.”


There is no room here for the end of Unni’s report, but it can be accessed in full via www.volunteerlinking.org.uk

I hope this has been helpful in giving you a VSO volunteer’s-eye-view of the nuts and bolts of development work in health and in Uganda. The next update will give quite a different view, so do please come and visit us again, and don’t forget to make a Christmas present of some VSO valuable time.

Thank you very much for your time too!

Emma
VSO

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