Hospitals Operated and Supported by Kissito Receive #1 Hospital Rankings for All of Uganda

There are currently 14 referral hospitals in Uganda, and 154 health center IVs in Uganda. It was just announced by the Ministry of Health during the National Assembly Review Meeting that sat at Africana Hotel in September 2013.

uganda_mgaletraining2 Ministry of Health ranks the health centers and hospitals based on their Annual Assembly Review meetings and through their field officer’s situation analysis Kissito’s Mbale Referral Hospital and Bugabero Health Center IV have received the highest grading, from #60 last year (2012) to #1 this year 2013, of all the health center IV’s or hospitals in the entire country of Uganda.

In Uganda there are 70 health centers IV’s and 1 Referral hospital that Kissito operates or supports. One type is called a Health Center IV, a health center that typically serves around 150 – 250 patients per day with a cachement population of around 400,000 people. Kissito supports the closest referral hospital, Mbale Regional Referral Hospital in Mbale, District. Mbale serves around 500 – 1000 patients per day with a cachement population of around 4,000,000 people or 14 Districts in Eastern Region in Uganda.

“While this latest grading for two of our 70 supported health centers and hospitals shows tremendous progress, Kissito believes this is only scratching the surface. This is a marathon for these communities and Kissito plans to support it with everything they have. We won’t rest until all 70 are graded number 1 and then we will build more because that is what the people of Uganda deserve”, said Tom Clarke, CEO of Kissito International.

mAmbulanceBugabero Health Center IV three years ago was a down trodden clinic whose operating theater was closed, and the only services being provided were distribution of minimal medications and referral services to the larger hospital in Mbale. Prior to Kissito’s involvement in operations Bugabero served around 20 patients per day. Since Kissito offered support and operational services, Bugabero now averages 250 patients per day. The difference is in the services being offered. Since Kissito has been involved Bugabero has served 110,169 patients, 2,015 surgical procedures have been performed, 1,011 babies have been delivered, and 1,227 children under five have been rehabilitated and treated.

Mbale Regional Referral Hospital in Eastern Region, Uganda is supported by Kissito. Between 2011 and 2013 with Kissito’s involvement 149,333 patients have been served, 23,485 surgical procedures have been performed, and 10,576 babies have been delivered, and 1,312 malnourished children have been rehabilitated and treated.

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.

Don’t forget to subscribe to our blog! And make sure to stay up-to-date with the research team, as well as the rest of our volunteers 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.