A final report from Uganda

We started our mission in Uganda at the beginning of 2014; now we have handed it over to the local authorities. A report:

The hospital has been founded in 1934 in Lwala, a place north of Lake Kygoga. At that time its primary purpose was the reduction of infant mortality. Today, malaria is the major cause of death in this region. In 2014, the 100-bed hospital with a catchment area of 103.700 people was in dilapidated condition. When we initially started the project in Lwala, there was a massive lack of professionally trained staff, medication, medical equipment, sanitary facilities, reliable electricity supply as well as a water system.

That’s when we started with the renovation of the operating room, the delivery room as well as the quarantine-station for tuberculosis. We installed a new water pipe system, which guarantees the hospital’s continuous water supply. In dry season, rainwater tanks provide the needed water for the ambulance, the laboratory as well as the delivery room ensuring that these spaces can be cleansed at all times. A hand operated well provides the source of drinking water for several hundred locals. As part of our work in Uganda we also established a reliable system of waste disposal, repaired sanitary facilities, and introduced a cleaning day. In the event of a power failure, a generator provides the supply of electricity guaranteeing that technical devices can continue to remain in operation and blood reserves can be cooled properly all around the clock. Additionally, the pharmaceutical warehouse has been equipped with medicine and the hospital has been endowed with beds, thermometers, blood pressure monitors, mosquito nets and other basic devices.

At the same time we were also able to significantly improve the technical equipment: we installed an ultrasound scanner in the new examination room, the delivery of medication now proceeds on a regular base and instead of maintaining several small places for dispensary service within the hospital zone, we built a large warehouse in which all the medication is stored and distributed from. The refrigerator in the warehouse is connected to the electrical supply via a solar panel, thereby ensuring that medication is held at the required temperature even in the event of a power failure.

To ensure that help reaches people as quick as possible, doctors of different medical disciplines were sent to Uganda at the very beginning of the project to assist and also to train local representatives. The children’s ward was in particular need of urgent assistance, thus nurses and midwives were exceedingly committed to help here. They were quickly able to implement what they learned and fortunately this has led to a noticeable decrease of childbirths deaths and infant mortality rates. Over the course of the project, gynaecologists, nurses and paediatritians worked in Uganda.

Unfortunately, there are still many problems in the region when it comes to drug prescriptions. Antibiotics are prescribed incorrectly and pills coming with a “placebo effect“ are sold at high prices on the black market. As a consequence, malaria patients often only come to the hospital when they are already in a near comatose state so that strong antibiotics and blood transfusions are the only possible treatment. As blood glucose meters are too expensive for most people in the region, diabetes can also not be handled alone. Therefore, in cooperation with an internist, we established a consultation hour for diabetes patients in order to be able to specially respond to individual cases. As a general educational resource, we organized health care training courses for the entire population, and in cooperation with a nutritional scientist we provided information on healthy nutrition and diet.

Thus, over the course of the last two years we were able to improve a lot: Through intensive controls in terms of documentation, hygiene, organization and order management, the plant and -work process became reliable and consistent. Staffing has been improved and adjusted to the individual requirements and a shift system has been established.

Today, patients are coming to the hospital by mini busses, motor bike taxis “Boda-Boda”, by taking their friend’s or family’s car or by foot on a daily basis. Several small villages have come into existence within the hospital zone. With 1.500 treated patients a month, the hospital still lies below its capacity, however, it has the potential to accommodate up to twice as many patients and thereby guarantee independent financing in the future.