Refurbishment of the maternity ward, operating theatre and water tower at Freda Carr Hospital, Ngora, has been completed. The project was handed over to the hospital on 31st August 2019. The work has been led by the Rotary Clubs of Reading Matins in the UK and Kampala Central in Uganda. The $216,500 cost was supported by a Global Grant from the Rotary Foundation with contributions from 9 Rotary Clubs, 5 Rotary Districts, Rotary Doctor Bank GB&I and WASRAG.
The main purpose of this visit to Uganda has been to check on progress of the building work going on at the Freda Carr Hospital at Ngora funded by a Rotary Global Grant.
We are refurbishing the maternity ward and the operating theatre and constructing a walkway between them so that mothers can be wheeled on a trolley in comfort before and after caesarean section. In addition we are erecting a new water supply tank to replace the present one, as its foundations are giving way.
The pictures below illustrate the buildings’ condition before we started work last August and the current state now:
Work is expected to finish in the next couple of months. The project also includes equipping the wards internally and sending regular vocational training teams to improve the quality of care delivered by staff.
Our main ongoing project over the past seven years has been to help rural mission hospitals become self-reliant through improving their management. This support has been extended to 24 hospitals across Uganda. Previously we have focused mainly on financial management. The current phase of development is to enhance the systems to cope with recording all the patients details and so generate good quality medical data which will not only help the hospitals but act as a valuable resource for health care planning and research.
To this end, we made contact with the UK based Medical Research Council which has an office in Entebbe. The Chief Operating Officer, Susanne Rupp, kindly visited Naggalama hospital to see our work in operation. MRC has long experience of research in Uganda and will help us to develop our system more effectively.
David Robertshaw joined me for the first part of my visit. He has wide experience of computer management and may be able to help us with our future development.
We also met Prof J Meirion Thomas, a senior semi-retired surgeon who worked in Uganda in 1979 and is considering coming back again to help.
We are very grateful for the help so many give us.
It was very good to hear that the staff loan scheme we have been supporting at Kitovu hospital over the past four years has produced many benefits for their staff. Some practical examples are detailed below.
Hospital staff achievements using loans from the scheme
Start-up of personal income generating projects: Staff have invested in construction of rentals, crop farming like planting coffee, maize, banana plantation, poultry, piggery, cattle, general merchandise, mobile money business etc.
Mukasa Harriet a nurse with ART programme of the hospital got a loan from the scheme and bought a chunk of land from which she currently grows crops for home consumption as well as selling. Her dream is to use one part of her land to construct her home and the other part for crop farming and poultry:
Hospital Records Assistant-(Mukaisenje Jovanice) managed to put up a retail shop as her income generating project using the loan she got from the scheme. In her kiosk, she hired an attendant who works tirelessly to prepare breakfast, break tea while also selling beverages, consumables and milky products. Her business has managed to pay back the loan, and she is reaping from the investment. Her future plan is to expand the business by getting another loan from the scheme:
Hospital Secretary (Nassali Prossy) has managed to buy a plot of land and put up a personal house from multiple loans she got from the scheme. Her dream is to say goodbye to renting by use part of her house as her home and the other part as rentals for hire so that she can save from paying her rent as well as earn some extra income from her tenants
Staff have accessed loans from the scheme for school fees for their children at primary, secondary and tertiary institutions.
Staff Mambu Miriam (A social worker) is one of the scheme members who has benefited by accessing school fees loan from the scheme for her children:
Salary Accountant (Ms. Nakavuma Annet) with her five children strives to educate them at Broader Vision nursery & primary school Kawoko-Kampala through accessing school fees loan from the scheme. She highly appreciated the contribution of the scheme that if it were not the scheme, probably her children would not be schooling:
Staff have accessed loans for their own fees while at upgrading level tertiary institutions especially enrolled nurses who upgrade to registered status as well as for further courses like public health etc.
Hospital Community Mobiliser (Kizza John Baptist) is grateful of the financial support extended to him through accessing loans from the scheme. He says that after the untimely death of his guardian & brother in a motor accident, his education was in a mess. But with the help of the hospital scheme he has managed to complete a degree in community psychology from Mutesa I University:
Deputy Senior Nursing Officer (Sr. Catherine Nakajiri) is currently undertaking a degree in public health from Mbarara University of Science and Technology. Her basis of tuition are the multiple loans she gets from the hospital scheme:
Home improvement: Many staff have secured plots of land, renovated their houses, and constructed homes for their families.
Rev. Sr. Maria Goretti Namuwulya(Hospital Administrator) is so thankful of the contribution of the scheme towards the development of her home. She got multiple loans from the scheme from which she managed to construct a home for her parents & relatives.
Hospital anaesthetist (Ms Josephine Kayondo) has managed to renovate her house as well as constructing rentals from the finances she has borrowed from the scheme. She says that the scheme has enabled her achieve her dream of becoming a landlord with over 10 tenants who pay her an extra monthly rental income.
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.
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.
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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
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.
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.
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.
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.
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!
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
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.
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
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 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