Help for Hospitals in Uganda visit report July 2018

This is my 10th year of regular visits to Uganda. It has been an exciting journey of personal learning and observing continuous change and development.
The new expressway from Entebbe to Kampala
To take an obvious example, many roads here have been immeasurably improved in the last 10 years
As for healthcare, progress is often a bit slower and rather less obvious. However, there has been very real change, not least at Kamuli where my Ugandan medical career began. It is fair to say that the infrastructure we have helped to create there means it is barely recognisable compared to my first visit.
I’m delighted to report that the main focus of this visit is a major milestone in the transformation of a second hospital. Freda Carr, Ngora was once a leading hospital in rural Uganda but has since suffered a sad decline. It is in a much worse state than Kamuli was when I first visited. But all that is about to change. Once again, this is due to the combination of working with colleagues on the ground in Uganda, generous donations from those at home and support from Rotary. August 3rd 2018 sees the formal launch of a project to refurbish the maternity ward and the operating theatre and erect a water tower.
Project launch by Rotary Clubs of Kampala Central and Kumi
Work begins   

Interestingly FCNH was founded in 1922 by a Briton living in Nairobi in memory of the 12 yr old daughter he had lost. Here is a picture of the early beginnings – the first doctor doing an early outreach clinic.

Bristol eSSC 2018

Once again Bristol University has sent 4th year medical students to Kitovu and Villa Maria hospitals which provides the students with a unique experience and the hospitals with a welcome financial boost. There are plans to extend the visits to a third hospital next year.

Over the past seven years I have worked closely with a Ugandan, Dr Rogers Kabuye, who has been my cultural and technical guide and mentor. Without the benefit of his intimate knowledge of local healthcare, we would have achieved very little. Rotary Doctor Bank have recognised his contribution to our work by awarding him a Paul Harris Fellowship. This is Rotary’s way of recognising outstanding service. It was presented recently at a meeting of the Rotary Club of Kampala Central.
As you are still reading this, thank you for coming with me on this journey. Your support and encouragement have kept me going and there is still so much more to do.
Jim McWhirter, July 2018

To receive regular updates, send an email to jimhmcw@me.com

Developments at Freda Carr Ngora Hospital

Our next major project is at Freda Carr Ngora Hospital for which a Rotary Global Grant application has been submitted recently.

 

A building refurbishment programme will upgrade the maternity ward and operating theatre and construct a water tower.

 

A Rotary Vocational Training Team (VTT) of UK doctors, midwives and paediatricians  will visit every 6 months over the next 3 years to teach essential lifesaving skills to healthcare staff and students at the Nurse Training School.  The VTT has just returned from its second planning and assessment visit during which training was given to 213 people.
You can read more about the VTT at https://www.rotary-ribi.org/districts/page.php?PgID=679420&DistrictNo=1090

Teresa Dawkes Visit to Kamuli Mission Hospital August 2017

This was my fourth visit to Uganda and my second with the Rotary Doctors Bank previously having spent time at Villa Maria Hospital. Prior to my visit to Kamuli, I was dismayed to receive the news that following, an inspection the X-ray Department had been closed by the Ugandan Atomic Energy Council (AEC). The Medical Superintendent, Dr Andrew Muleledhu, e-mailed with a list of requirements, mainly radiation protection issues, that needed to be met before the Department could be reopened. This then gave me a good focus for my trip and enabled me to do some preplanning and research before I left home.

They have been unable to employ a qualified radiographer at Kamuli due to lack of funds and the inability to attract staff to such a rural location. They therefore employ Joseph as a layperson to take and develop the X-rays. He has received minimal training in radiography positioning but no training in the principles of radiation protection. I was also told that theirs is the only functioning X-ray department in the district and if it is out of action patients have to go to Jinja which involves at least a 3 hour round trip. This is obviously not an option in an emergency.

Positioning a patient

Joseph positioning a patient

When I arrived at the hospital I was made to feel welcome and was impressed by the helpfulness of the staff. I was pleased that they had built an X-ray screen for staff to stand behind when taking the X-rays. The Department had therefore been reopened by the AEC but was due for a re-inspection in a month following completion of the other recommendations. One of these involved establishing a new Darkroom, which was at present very inconveniently in another building amidst a lot of rubbish. With help from the carpenter, electrician and a team of strong men we cleared and cleaned a room within the Department and set up a new Darkroom.

Old darkroom

Old Darkroom

New darkroom

New Darkroom

Another major concern, which came to light whilst I was there, was the inability to produce a diagnostic X-ray of a spine, abdomen or pelvis. This was due to a piece of equipment called a grid being missing from the X-ray table. Luckily I managed to locate one on an old piece of equipment in a storage cupboard and with help from the electrician extracted it and cut it to size. We then managed, with the help of some sticky tape, to put it into the X-ray table. This now means that patients do not have to have a trip to Jinja to obtain a diagnostic X-ray.

Grid

Grid

I brought with me from the UK new lead aprons, thyroid and gonad protection as well as X-ray cassettes, which require a lower dose of X-rays to produce an image. I also spent time establishing new exposure factors.

Joseph modelling a new lead apron

Joseph modelling a new lead apron.

I would have liked to have spent longer at the hospital and hope to revisit as I feel that Joseph although excellent at chest X-rays would benefit from some teaching on radiographic technique for other parts of the body. I also feel that it would be of benefit to the nursing staff to receive some basic training on the safe use of radiation, as there seemed to be a lot of confusion on this.

My other area of concern is the developing of the X-ray films, which are “wet developed” at present. This involves manually immersing the films in the chemicals. This is not only a hazard to Joseph as the chemicals contain carcinogenic substances but also the quality of the X-ray suffers due to inconsistencies in the process and the fact they are then hung on the railings to dry! I am therefore hoping to find a small automatic film processor for Kamuli; similar to the one I took to Villa Maria.

My 17year daughter accompanied me, on my visit, and we would like to thank everyone at Kamuli for their friendliness and making us feel so welcome. My daughter spent time in a local primary school and was also invited to spend time on the wards shadowing a doctor and spending time with the student nurses. She is now considering a medical career!

Teresa Dawkes.

August 2017.

Help for Hospitals in Uganda visit report July 2017

On this visit Bristol University asked me to accompany 20 of their 4th year medical students and four of their tutors on their visit to Kitovu and Villa Maria hospitals. This is the fifth year in which Bristol has sent students for a three-week study period in Uganda. The hospitals receive financial support in return for hosting the students who receive a fascinating insight into a completely different medical and social environment.

 

 

Most of them gave a blood donation, many for the first time.

 

In addition to financial support, Bristol sent a large amount of useful medical equipment

While at Kitovu I was able to review our projects there. The staff loan scheme goes from strength to strength and is a great help for staff recruitment and retention, which are always major problems. We have given loans which this scheme uses as working capital and they have always been promptly repaid.
Another loan, now repaid, was used to complete the x-ray department which will shortly be fully functional, including a CT scanner which is a rarity in a mission hospital.

They are in the process of building a new ward with single rooms. Our loan has enabled completion of the ground floor and patients will be using it in the very near future. A second floor will be built in due course as funds become available.

Our next big project is the refurbishment of the maternity ward and operating theatre at Freda Carr Hospital, Ngora, in north eastern Uganda which is a poor area.
Planning for this is progressing well in cooperation with the Rotary Club of Kampala Central and we expect to submit an application for a Rotary Global Grant this autumn. The vocational training team which visited from Rotary District 1090 this spring was enthusiastically received. We are optimistic that we can initiate a major transformation in this rundown hospital along the lines of the work that succeeded so well at Kamuli in the past. The buildings to be refurbished are shown below:
Maternity ward Operating theatre:

   

This project will greatly improve the lives of mothers, babies and surgical patients in this area.

Jim McWhirter July 2017

Support for Ngora development continues

This year has seen strong support for the proposed Rotary Global Grant to refurbish the maternity facilities at Freda Carr Hospital, Ngora in eastern Uganda. The grant will also include regular visits from the Vocational Training Team which visited this hospital in April for the first time.

As well as many private donations, the following have contributed:
Rotary Club of Cardiff West and Distict 1150    £1000
Harpsden Village Rotary Club and Roundwood Park School   £2000
Rotary Club of Thanet and District 1120   £12,000
Rotary Club of Marlow    £1000
Rotary Club of Reading Matins and District 1090   £17275
Rotary Doctor Bank Great Britain and Ireland    £27,300

We are profoundly grateful for the support we have received from everyone.
Planning for the project in partnership with the Rotary Club of Kampala Central is now in the final stages and submission to The Rotary Foundation for approval is anticipated this autumn.

Rotary Club of Marlow donate £1,000 to Ngora

The Rotary Club of Marlow have donated £1,000 to the Global Grant for refurbishment of the maternity ward at Freda Carr Hospial, Ngora, in Eastern Uganda

Rotary Vocational Training Team visits Freda Carr Hospital, Ngora. April 2017

In April 2017 Rotary District 1090 sent a team of a doctor and two midwives to Freda Carr Hospital, Ngora, to train hospital staff and students at the School of Nursing and Midwifery in lifesaving skills for mothers and babies. This is the first 1090 VTT visit to Ngora which is set to receive ongoing visits as part of a Rotary global grant funded project to improve facilities and services at the hospital.

 

Two new loans for Kitovu Hospital

Two more loans are helping Kitovu Hospital. The Medicaudit Foundation has given support to the scheme which gives staff loans so helping them and improving loyalty and retention.

Rotary Doctor Bank has given a loan to help build a new ward as shown in the picture

January 2017 – Jim McWhirter’s visit

Those of you who have been reading these reports since 2009 will have noticed that they have changed significantly over time. Early reports were full of the emotional impact of seeing human suffering at first hand and the culture shock of coping with the very limited resources available to help.

Inevitably one becomes accustomed to seeing these things and latterly reports have concentrated on our efforts to make longterm improvements. Although improving the efficiency of hospitals is critical to saving the lives of mothers and babies, it doesn’t make such good reading as details of practical work on the hospital wards.

On this, my 15th visit, I have been deeply disturbed once more.
Uganda is a green and pleasant land thanks to two rainy seasons each year following the spring and autumn equinoxes.
Last year the September rains failed with severe consequences for rural subsistence farmers, the community that most of our patients come from and the bulk of the Ugandan population. There are food shortages, increased prices and many are down to one meal a day in the rural areas. In field after field the maize crop has died as shown in the pictures:

Hopefully the rains will come again this spring and set them on the road to recovery but if they don’t, it will be very serious. It is easy to overlook how vulnerable these poor countries south of the Sahara are to changes in climate and how we cannot take well established historical weather patterns for granted.

On the project front we are seeking to repeat the successful programme we implemented at Kamuli in a much poorer setting in Eastern Uganda. We hope to refurbish the maternity ward at Freda Carr Ngora Hospital (pictured above) and send a Vocational Training Team to boost education at the nurse training school, all with the help of a global grant from Rotary. We are receiving strong support from the Rotary Club of Kampala Central and the Uganda Protestant Medical Bureau.

One of the great joys of coming to Uganda is the opportunity to meet the most incredible people. I have previously mentioned the Kamuli anaesthetic officer who works literally 24 hours a day, 365 days a year and Dr Maura Lynch of Kitovu, a nun and surgeon who celebrates 50 years in Africa this year. Both of these are still working in their 70’s. On this trip I met an 80 yr old ophthalmologist who has been 52 yrs in Africa, still works full time and spends two weeks each month travelling all over Uganda taking his surgical skills to remote communities. His name is Keith Waddell of Ruharo hospital and he is photographed with his team on an outreach journey. Between them, these three remarkable people have 151 years of service. I feel I live an incredibly lazy and self indulgent existence!

Author donates £1155

IMG_7213

 

Ivan Linton of Co Antrim, N Ireland, has very generously donated £1155 being the proceeds from a book he published last year about the area where he lives. We are very grateful for his support.

 

 

 

Jim and Tessa McWhirter were presented with the cheque by Ivan and his wife Florence at an event in Cullybackey hosted by Liz Hoy and Elizabeth Boyd of the Cullybackey Historical Society.

Elizabeth Boyd, Ivan Linton, Tessa McWhirter, Liz Hoy, Jim McWhirter and Florence Linton

Elizabeth Boyd, Ivan Linton, Tessa McWhirter, Liz Hoy, Jim McWhirter and Florence Linton