Findings from the Uganda research team

Photo by: April ParsonsLaura Fisher, with translation help from Uthman, surveys a patient at a health center.

Photo by: April Parsons
Laura Fisher, with translation help from Uthman, surveys a patient at a health center.

“We really should be working in all 69 of these health centers,” said Kissito President Tom Clarke one night, during a casual conversation at the Ugandan volunteer house. It was a simple statement that brought about one of the biggest tasks the KHI research team has ever taken on.

We knew they needed the help, and we knew we had help to give, but what were the specifics? That is what our key researchers Laura Fisher, and Doug Dasilva, have set out to find. Instead of just giving out goodie bags of gauze and gloves, or placing incubators in random facilities, the research team will be going into all 69 facilities in the Mbale, Manafwa and Baduda districts to find out what each facility needs; everything from the types of drugs, and supplies, to water and electricity, and to possible improvements on staff and patient satisfaction.

After a lot of hard work, literature reviews, and discussions with doctors they created a three-tier comprehensive study. The first part is a massive survey, 747 questions to be exact, that asks about every single drug, supply or piece of equipment that a health center would have. The second is health worker surveys, which get both qualitative and quantitative data; how often to they work, what do they need to better perform their job etc. The third is patient satisfaction surveys. They ask the patients about their experience at the health center; whether they knew what their diagnosis was, or when to take their medicine.

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It’s been about two months and the research team is not even half way done with the baseline. Most facilities take anywhere from one to two hours to get to, and you could never complete the surveys at more than two health centers in a day (and that doesn’t include the document organizing or data entry!).

So far they have completed the entire Baduda district, and half of the Manafwa district. Although they have a long way to go, some of the statistics they have found already are quite surprising, and really tell a tale of just how much work we have cut out for us.

Data below is from 25 facilities – 4 Hospitals/Health center 4s, 11 health center 3s, and 10 health center 2s:

12% have running water from the city.

Only 60% have a functioning water tank.

That means 40% percent of facilities do not have water.

80% of facilities do not have electricity.

40% do not have nutrition patient education services

20% do not have a thermometer.

12% do not have a stethoscope.

76% do not have a measuring tape for height.

And only 24% of health facilities have access to an ambulance.

This is just the beginning of their assessment. They hope to have the surveys completed by the end of April and will then be able to give completely accurate statistics for the eastern region of Uganda.

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Virginia pastors to build church in Africa

Photo by: April ParsonsPastor Tony (left) with his delegation at the Butiru Cristco health center in Manafwa, Uganda.

Photo by: April Parsons
Pastor Tony (left) with his delegation at the Butiru Crisco health center in Manafwa, Uganda.

Almost a year ago, Tony, a pastor at New Life Christian Ministries, a church in Roanoke Virginia, decided to take a trip to Uganda with KHI President Tom Clarke. It was a trip that would inevitably change his life.

Ten months later he is on his second trip, along with five other pastors from Virginia, and they are making preparations to build a church.

“I really felt like God was calling me here,” said Pastor Tony. “There is so much good that can be done here, and I am really excited to see God’s plan for the work in Uganda.”

Pastor Tony has partnered with the Butiru Chrisco health center, only a few miles away from the KHI run Bugobero health center, as a foundation and home base for their work. At the same time, Kissito has also signed MOUs with the health center and will soon be putting our health system strengthening tactics in place.

“It’s a really great partnership,” said Pastor Tony, during a visit to the site. “Kissito will be working on saving lives physically, and we’ll be saving lives spiritually.”

In Uganda 83.9 percent of people consider themselves to be Christian, so there is always a need for churches.

The hospital grounds also have living quarters, where both missionary groups as well as health care groups will be able to stay when they come to visit.

Kissito is already working on revamping their health center, and in July of this year Pastor Tony and his group will be back to start the actual building of the health center!

Make sure to keep up with us on Facebook and Twitter!

Road to recovery; every child matters

 UPDATE 9/3: After having severe stomach pain Brian was taken to the hospital again. It was found that he has an obstruction in his lower stomach that may have been caused by the poison. They were initially going to do surgery, but he started progressing, so they opted to see if he will get better without it first.  He will be in the hospital until at least Thursday. If he has made enough progress he will be discharged by the end of the week; if he is is unable to eat whole foods he will have to get surgery to remove the obstruction. 

You can help support Brian by donating at kissitointernational.org/donate.aspx and typing Brian in the Special Instructions box. All of the donations will go to his hospital bills and, hopefully soon, his school fees as well. 

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Sitting on the couch, drinking a mango juice box, Brian is completely engulfed in the  cartoon show on the TV. No one knows for sure, but it might be the first time he has ever watched a television show and although he can’t understand most of the English words he seems to enjoy the characters – laughing when they laugh, staring with longing when they seem sad.  He speaks Luguiso, like the majority of children from the eastern Uganda region, though since he’s been at the KHI compound, he hasn’t spoke much at all.  He understands most hand gestures, and will respond with a nod of his head when you rub your tummy like you’re hungry, or pretend to tilt a cup up to your mouth.  He seems happy enough, although his true feelings remain a mystery for now. One thing is certain though, and that is the fact that he probably never imagined he would be where he is now, when less than a month ago he was on the brink of death.

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It was a Saturday afternoon and Carolina Tovar, a KHI volunteer was working at the Bugobero health center when the police came in with a little boy. He was 11, but was so frail and malnourished, that at first glance he didn’t seem any older than 6. They said a boda driver had found him lying in the middle of the road, and took him to the police station a few miles away. When the police started asking the boy questions he was so sick he could barely talk. He told them that he was sure his mother had poisoned him. She gave him a mendazi, a staple breakfast food, and told him to stay put; she was going to the Kenyan border and would be back in a couple of hours – it had been days since then.

Brian in the hospital, about a week after he was found.

Brian in the hospital, about a week after he was found.

Often times if a father leaves his family, the mother cannot support the children on her own. When she meets a new man it’s a possibility that he will want his own children with her. Although, not acceptable in any culture, it is not uncommon to hear about a mother abandoning her children when tempted with the promise of a better life. Brian is one of those unfathomable statistics.

Christine, the head nurse at the hospital had been walking through the villages trying to find his home or even a distant relative that would be able to take care of him, or at the very least sign paperwork for him. She came back empty handed; not a single person knew who Brian’s family was.

A man from the church in the village, Mufumbo Alex, had never met Brian but decided to care for him while he was in the hospital. Weeks later you could still find him next to the bed.  He did not have a dollar to his name, nor a roof to sleep under; not a thing to offer Brian but company and love. He gave it unconditionally though, and that seemed to be enough.

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The staff at Bugobero was able to stabalize him, but after about 24 hours they decided he would need an ultrasound. In order to get one he would need to take the two hour drive to the regional referral hospital. Carolina decided she could not let him stay there alone, and the KHI team decided together that we would bring him to the private hospital to make sure he had the best care, and if needed we would pay for the cost ourselves.

He spent two weeks in the hospital, and after numerous test and x-rays it was decided that he would need surgery in order for his stomach to heal. He was so brave the entire time, braver than any 11 year old should ever have to be.

Day by day you could see the strength come back into his body. Slowly but surely he was beginning to look like a happy young adult. He was able to sit up, and then walk on his own. Kissito volunteers were bringing him porridge at first, but is wasn’t long before he was able to eat rice and beans and chicken.

Before we knew it, it was time for him to be discharged…

… and go home.

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We sat around the living room one night taking about the options for him when he left the hospital. He could stay at Bugobero for a while, but no kid (or adult even) would want to live at the hospital. He could sit at the police station until they find an orphanage for him, but he could be there for weeks or months, with no promise of food or his medicine. It didn’t take long before we realized what he had to do. When you have a house with empty rooms, and extra food every night, how could we not let him stay there?

So that’s exactly how it happened, and he’s been here almost two weeks now. He is still malnourished, and has a number of health problems, but he gets stronger every day. He is still a ways away from recovery, but is growing stronger every day.

Brian, about 2 weeks after being discharged from the hospital.

Brian, about 2 weeks after being discharged from the hospital.

We hope to find a family member, or someone in the village that knows him and will take him in for good. If not we will eventually find an orphanage that is good enough to provide for him; not just food and shelter, but education, guidance and compassion.

As much as we want him to, we know he can’t stay forever. It will be just as hard to let him go as it was to see him for the first time.  As hard as it’s going to be though, it will be worth it, knowing we changed his story, and saved his life.

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We may not be able to save the world, but as the quote goes “Whoever saves one life saves the world entire,” and because of the compassion of Mufunbo Alex, the staff at the hospital, and the KHI team – Brian has the entire world ahead of him.

To stay up to date with Brians recovery visit us on Facebook and Twitter. Or, if you want to sponsor Brian, you can donate directly to him by simply typing Brian in the Special Interest box. All of the contributions will go to his hospital bills and his integration back into a normal life.

Doctors dedicated to sustainable change

In the operating room at the local regional hospital Dr. Judy and Dr. Mark Gustafson worked side by side, on a mother who had just given birth to a baby girl. Dr. Judy, an anesthesiologist and Dr. Mark, a gynecologist were in the O.R. for about two hours with the mother and child. They spoke of the story with mixed emotions.

The mother had been in labor for hours, possibly surpassing a full day. When it was finally her turn in the operating room the lack of supplies almost delayed the delivery again. Luckily, Kissito has a supply stock, and Tyler, the supply chain coordinator, was able to retrieve some of the necessary items and bring them to the hospital.

Dr. Mark Gustasfon during a c-section at Mbale Regional Referral Hospital

Dr. Mark Gustasfon during a c-section at Mbale Regional Referral Hospital

They were able to do the delivery through a caesarean section, but the baby came out with the umbilical chord wrapped around his neck, and was not breathing. The operating room only had one oxygen mask and it was needed for both the baby and mother.

Dr. Judy kind of chuckled at the level of intensity her and her husband felt during that moment in the operating room. Mark was taking care of the mother while she was taking care of the newborn.

“I need the oxygen now!”

“NO! I need it now!,”  they urgently called out to each other, trying to make sure both patients were able to breathe.

After about ten minutes the nurse looked at Judy and the baby and said “I think now we pray”. Judy did not give up though, and a few minutes later the baby finally started breathing on its own.  Even after the surgery they could hear the baby in the next room. The nurses were shocked. “Can you hear it? The baby’s crying, the baby’s crying!” they exclaimed, joyful and astonished that the child had made it.

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It was a completely different setting than the one you would find in Virginia, at the Carilion Roanoke Memorial Hospital where Judy practices, or the Lewis Gale Hospital where Mark is located.

In the U.S. facilities are spotless, sanitation is mandatory, medical supplies are always present, and protocols are followed with care and precision. Unfortunately, in East Africa, none of this is true.

The biggest disparity they noticed between U.S and the East African health facilities was the lack of training. Instead of intense schooling, most of the medical staff members receive on the job training.

According to Dr. Judy there are three main components that need to be addressed, in a particular order:

  • Training
  • Equipment and Supplies
  • Protocol

They are all intertwined, but the latter cannot work without the former.

Mark and Judy are being included in addressing these issues and are in the process of designing protocols and training programs for the healthcare workers.

Their first trip to Uganda only lasted two weeks, but they have already planned a return trip in April, to do more in-depth training , and to help put protocols in place!

Their education programs, along with all of the donations from their hospitals have the ability to single-handedly change a hospital, and possibly even a culture.

It’s not always easy to find doctors willing to stay in less than comfortable conditions, and work in less than practical environments. It’s even harder to find doctors willing to come back time and time again.

Drs. Judy and Mark however, are a rare gem and we are so glad to have them as part of the KHI team. Knowledge is truly the most important donation you can give, and we are incredibly grateful for their dedication to the sustainability of the education given to the people in Eastern Uganda!

To stay up to date with all of our initiatives visit us on Facebook and Twitter!

Volunteer Memoirs – Interview with Lillian Alexander

Lillian Alexander with a mule in Duna, Ethiopia.

Lillian Alexander with a mule in Duna, Ethiopia.

Dates of volunteer work: January 3, 2012-January 20, 2012

Tell us a little bit about yourself: I grew up in the small town of Cabot (where the cheese is made!) nestled in the foothills of Vermont’s Green Mountains. I am currently a senior at Harvard College.

What made you want to do volunteer work in Africa? Before volunteering with KHI in Ethiopia, I had spent eight weeks in rural Uganda working for a child malnutrition program. While I have always loved traveling and exploring new places, my experience in Uganda cemented my passion for global health and helping others. As soon as I returned home from Uganda, I was already itching to return to Africa to continue developing my interests.

How did you get involved with Kissito? I had worked with the Initiative to End Child Malnutrition (IECM) through the Massachusetts General Hospital’s Division of Global Health and Human Rights in rural Uganda during the summer of 2011. Due to IECM’s incredible success in establishing a comprehensive inpatient and outpatient malnutrition treatment program, KHI asked us to come to Ethiopia and help to build a similar program. I was fortunate enough to be invited on the three week trip with IECM to Ethiopia.

What program did you work with? I worked with the KHI team in Duna Woreda in Hadiya Zone.
What was your role as a volunteer while in Ethiopia? While in Ethiopia, I worked with the KHI team on a variety of different tasks and no day was the same as the last. Sometimes I would drive around to different health posts with a KHI employee to train the community health workers in the malnutrition assessment and treatment protocols. Some days I would work alongside the KHI team from sunrise to sunset helping out with the mass screening of children as well as pregnant and lactating women. Other days I would be cleaning and decorating an empty room at a health center to be turned into a stabilization center for malnutrition patients requiring inpatient care.

What was the most memorable moment you had while volunteering? One of the most memorable moments from the three weeks I spent volunteering with KHI in Ethiopia was our last night in Duna before traveling to Addis to fly back to the U.S. We had decided to have a big celebration with a bonfire where we cooked an entire goat! I still remember sitting around the fire eating, laughing, and singing with the KHI team. They were some of the kindest, most passionate people I have ever met. Fortunately, I have been able to stay in touch with most of them, and they still inspire me with their dedication to helping others and improving KHI to the best of their abilities.

What was the hardest thing you had to experience? One of the most difficult moments of my time volunteering in Ethiopia was having to turn away mothers who had come to a mass screening day expecting to walk away with a sack of fortified corn soya blend. On that particular day, we had screened over 500 women and children, exhaustively working long after the sun had set by the dull light of our cell phones. There were still about 30 mothers waiting to receive their small food rations when we ran out of corn soya blend. We had no choice but to pack up our supplies and head home, with promises to return in the morning with more rations. The looks on these women’s faces was heartbreaking. Many of them had walked several kilometers toting one, if not two or three, babies and young children, only to stand in line after line beneath the blazing sun for hours without food or water. Despite our commitment to return the next morning, I felt so guilty and helpless as I hopped into KHI’s car to drive home to the warm dinner that awaited us, while these women had long distances to walk in the pitch dark with their children, only to return home empty-handed and exhausted.

What was the most rewarding experience? One of the most rewarding experiences of my time volunteering for KHI was creating a stabilization center out of a dingy old room at a health center that had been previously used for storage. I remember spending an entire Saturday at the health center scrubbing the walls and floors of the soon-to-be stabilization room, then decorating it with colorful stickers of zoo and ocean animals as well as detailed posters to remind caretakers of the treatment protocols. We managed to find spare mattresses, sheets, and blankets, which we used to set up about five beds for malnutrition patients. Needless to say, the beds were quickly filled.

Happiest memory of the trip: One of the happiest memories of my three weeks in Ethiopia was finally seeing one of our inpatients smile. She was a three year old girl who, accompanied by her mom and younger sister, had been admitted to the Bure stabilization center. Every time we visited Bure, I would pick up a ball or some stickers and try to play with her. But it was clear that she was so weak and in so much pain, that she hardly reacted at all. However, that didn’t stop me from trying to engage with her whenever I would visit. I noticed her finally starting to improve, little by little. On one of our last days in Duna, I was playing a hide-and-seek game with her when she finally cracked a smile. Though it was small, her smile made my day as I knew it had huge implications for her overall health and well-being.

One tip you would give to a potential volunteer: Soak in every moment of your experience. Whether you’re volunteering for two weeks, two months, or two years, it will go by so quickly. Take advantage of everything and leave with no regrets. Make friends with the KHI team, they are some of the most amazing people you will ever meet.

Sum up your trip in ONE sentence: My time in Ethiopia was truly one of the most challenging, yet incredibly rewarding experiences of my life.

You too could be a KHI volunteer. Visit our website to find out how, and become our friend on Facebook and Twitter, so stay up to date with all of Kissito’s initiatives.