April 2012 – Jim McWhirter

This is my seventh visit since I began volunteering for Rotary Doctor Bank in 2009 and it has proved a very worthwhile adventure!

Previous visits have been spent working on the maternity ward at Kamuli which was a challenging but rewarding experience.

On my last two visits I met a local doctor (Dr Rogers Kabuye) who now spends his time helping mission hospitals cope with the multitude of problems that beset them.
I decided to devote this trip to visiting eight of these hospitals to see the problems at first hand and try to work out what we can do to help. Dr Rogers was my guide, mentor, companion and driver.
We covered 1400 miles in two weeks on roads ranging from first class to ghastly. We did two 10 hour bus trips and Dr Rogers drove the rest in his car. His driving skill was tested when he faced an imminent head on crash with an overtaking vehicle. His timely swerve not only avoided the two oncoming cars but also an innocent cyclist on the roadside!

These hospitals face common problems:
Remote location
Poor rural subsistence farming catchment areas
Very limited financial resources with diminishing Government grants and limited ability and willingness of patients to pay user fees
Problems attracting and retaining staff
Inconsistent donor support for capital projects and very rarely any donor support for recurrent expenses

So how can they begin to cope?

A difficult truth is that the fewer resources you have, the more efficiently you must use them to perform effectively. Unfortunately those with the least resources are rarely the most efficient!
Dr Rogers has produced his own locally developed, computer based management system. He provides hardware, software, installation, training and support. This provides the data necessary for the hospitals to understand how they are performing. Armed with this knowledge and his guidance, they are able to implement systems and procedures to increase income and limit expenses. In this way they can achieve stability on a day-to-day basis. Dr Rogers is a real modern day Robin Hood. As well as helping rural hospitals which are his first love, he supplies businesses in Kampala with management systems. This allows him to subsidise the service he gives hospitals which are similar to the one he worked in at the start of his career.

So how can we help?

Even hospitals that are managing to cope financially day-to-day have great difficulty saving anything for capital or unexpected costs. Those that are just beginning to realise that they need to improve in order to cope, often cannot get started without a bit of help.

Dr Rogers helps those hospitals which show their willingness to recognise their need for change by approaching him to install his system. He does not need to advertise – good news spreads fast. Last year we funded this system for Kamuli at their request and it is beginning to bear fruit as I saw on this visit. I have agreed that we will fund the supply of hardware to a further seven hospitals who are all keen to get started on the road to improvement and self-sufficiency. All this will cost about £7,000. The hospitals will show motivation by paying for the software and Dr Rogers will provide free on-going support. Thus a small investment will, in time, produce a real improvement in patient care.

Last, but not least, the relationships built up will develop as time goes on with visits from volunteers and capital donations into a fuller continuing collaboration.

I miss the challenge of hands on care for patients at Kamuli and the friends I have made there, but I believe we can save more lives in the long run by concentrating on helping all these hospitals to become self-reliant.

Thank you all for your care, concern and support.

Jim McWhirter
May 2012