Uganda: Panyadoli Healthcare Project

Mental Health Department Supporting 688 Patients: Q4 2017

March 18, 2018
Naku Charles Lwanga and Alphonse Mwanamwolho


Summary of Activities

  • RMF procured and delivered sufficient medications and medical supplies to the Panyadoli Health Centres. These were delivered on time throughout the reporting quarter.
  • RMF procured and delivered sufficient cleaning supplies and tools, maintaining a highly motivated, well-equipped team of cleaners who continued to keep the health centers clean and neat.
  • Provided sufficient laboratory supplies so that patients requiring laboratory services are tested accordingly.
  • Provided sufficient stationery and printing supplies for the program, mainly to support the data department.
  • Conducted special trainings on TB and HIV/AIDS treatment and management.
  • Conducted an in-house special training for the cleaners on medical waste management.
  • Continuous Medical Education (CME) sessions were facilitated for all staff working in the health facilities, so that team members keep sharing and increasing their knowledge.
  • Provided mentorship of medical workers and VHTs in the comprehensive management of HIV based on the new guidelines.
  • All patients that came to the health facilities received treatment, and those whose conditions were beyond the capacity of the health facilities were referred accordingly.
  • Integrated services that benefit both refugees and the host community were continuously provided. For example, RMF’s surgeon works certain days at the nearby district hospital.
  • The mental health department is improving and its client load continues to grow.
  • Salaries, wages, and top-up allowances for all RMF staff members were paid in a timely manner. This kept the team’s morale high.
  • Conducted staff meetings to keep the team well coordinated.
  • Conducted an end-of-year party for staff members and partners to celebrate our joint work and accomplishments.
  • Maintenance and repair were promptly performed for hospital equipment, furniture, water sources, generators, etc.
  • The health facility was maintained and cleaned, ensuring that the compound, wards, offices, common areas, and the entire facility are hygienic and conducive to healing and working.
  • Strengthened data collection and processing in all health centers of the settlement by ensuring that every health center has an RMF staff member in charge of data.
  • RMF continued to facilitate integrated community outreaches (including malaria prevention, immunization, safe birth, HIV/AIDS, and disease surveillance outreaches).
  • Continued tracing patients on ARV treatment and following up with those who have defaulted so that they can be restarted on ART.
  • Continuous immunization of all under-5 children living in and around the settlement was implemented through the health facilities and outreach activities.
  • Organized World AIDS Day celebrations, as well as 8 days of activism. During the celebration, additional awareness of HIV/AIDS was created.
  • Facilitated the disease surveillance team to strengthen disease surveillance activities in the settlement and surrounding areas
  • Medical screening of new refugees at Kiryandongo Refugee Settlement was effectively performed during the reporting period.
  • Facilitated UNHCR and partners’ coordination meetings both in the settlement and regional offices, helping to promote cohesiveness in operations.


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Results &

Accomplishments


  • Extending Services

    Creating an Impact

    The ART clinic is continuously creating an impact and extending services to the people of concern. Presently, we have 631 clients on ART, of which 230 are refugees and 401 are nationals. The ART clinic is implementing the new government policy of testing all patients who come to the health facility for HIV/AIDS and enrolling all HIV-positive clients on treatment. By the end of December 2017, the clinic was treating 101 children under 14 years of age (40 boys and 61 girls) and 42 children under 5 years of age (18 boys and 24 girls).

  • Immunization activities were conducted at both static and outreach points.

    Immunization Coverage

    Continuing to Improve

    Immunization coverage continues to improve. For instance, BCG coverage was at 94.5% by the end of December 2017 and polio coverage was 97.7%. Overall, immunization coverage stands at 96.2%.


  • New Mental Health Department

    688 Mental Health Patients

    RMF’s new mental health department has progressed tremendously, continuing to expand its capacity to serve more clients. By the end of the reporting period, the department had extended support to more than 688 mental health patients: 249 in October, 242 in November, and 197 in December 2017.

  • Dr. Robert treating an expectant mother in the Maternity ward expansion, newly constructed by RMF

    Reproductive Health Services

    Continued Improvement

    During the reporting period, RMF continued to improve reproductive health services. For instance, antenatal care and attendance were recorded at 92% against the UNHCR expected standard of 100%.


  • RMF Creating Awareness

    Increased Access to Contraceptives

    RMF has increased access to contraceptives. As of the previous quarter, coverage was rated at 63.2%. At the close of 2016, access and use of contraceptives was rated at 54%. This has been achieved because of the increased awareness RMF is creating.


  • New and Effective Tests

    Improving Laboratory Services

    The laboratory now offers a wider range of tests and performs them effectively. These include:

    • hepatitis B
    • hemoglobin estimation
    • blood grouping
    • urine gram stain
    • urinalysis
    • stool tests
    • ZN stain.
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Background

& Objectives

Background

The Panyadoli Health Centres, located in Kiryandongo Refugee Settlement near Bweyale, Uganda, provide healthcare services to over 100,000 refugees from Kenya, South Sudan, DR Congo, Burundi, and Rwanda, as well as members of the host community.


Objectives
  • Provide medicine, medical supplies, and medical support
  • Support the Health Management Information System Maintenance (staff and petrol supply)
  • Maintain hygiene at clinic to Best Practice Western Medicine standards
  • Enhance existing structures for Malnutrition ward and main center
  • Provide cooking materials such as charcoal stoves, saucepans, utensils, etc.
  • Upkeep and renovation of the health center through periodic re-painting and re-plastering.
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More

Photos

Click to Enlarge
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Numbers

Served

A total of 21,670 outpatients were treated during the fourth quarter of 2017.

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Success

Stories

Par Puok and her baby

Par Puok

Giving Relief to a Worried Mother

Par Puok is a South Sudanese mother living in Cluster B of Kiryandongo Refugee Settlement. She walked into Panyadoli Health Centre III with her 1-month-old baby, who was having difficulty breathing, in addition to a cough, fever, and nasal flaring for three days. The baby was diagnosed with bronchial pneumonia and tested negative for parasites. The baby was given ampicillin, gentamicin, hydrocortisone, and paracetamol. Over the following three days, the baby showed great improvement: its breathing normalized and it can breastfeed well. The mother, who came in with a lot of anxiety, is now able to smile and appreciates the services rendered to her baby.

The South Sudanese community has a special attachment to RMF, as RMF employs some South Sudan refugees. The most well-known is a South Sudanese clinical officer named Rebecca, who has created linkages between the South Sudanese refugee community and RMF. Rebecca practices RMF’s values in the way she delivers quality services to the people with love, respect, and dignity. Par Puok says, “We pray for RMF to continue bringing good people to service refugee, and we pray for the long live RMF and take over all services to refugees.”

Nyanial Kong

Nyanial Kong

A Healthy Baby Boy Delivered

Nyanial Kong is a 28-year-old South Sudanese national living in Cluster N of Kiryandongo Refugee Settlement. She was brought to the Panyadoli Health Centre III Maternity ward on a boda-boda (motorcycle taxi) during the night. Nyanial was in labor, and by the look on her face, she was suffering from a lot of pain. The midwives admitted her and monitored the progress of her labor with the help of a pantograph. After twelve hours, she gave birth naturally to a baby boy weighing 3.2 kg. She received Panadol, amoxicillin, ferrous sulfate, and Pitocin after delivery. Nyanial seemed to be healthy, but the midwives insisted on monitoring hers and the baby’s condition until they were certain that mother and son were ready to be discharged.

Nyanial is grateful to the medical team for being kind to her and making sure she had a safe, normal delivery. She says she is still enjoying the kindness of the midwives and clean environment of the new Maternity ward.

Denis Mwaka

Denis Mwaka

Changing the Perception of Panyadoli Health Centre

Denis Mwaka is 44 years old, and Kenyan by birth. He has been a refugee in Kiryandongo Refugee Settlement since 2008, and he has seen Real Medicine Foundation grow in its scope of service delivery. He is glad to share why he treasures RMF and its staff, which makes him always return to Panyadoli Health Centre III whenever he is sick.

Recently, RMF’s ambulance brought Denis to Panyadoli Health Centre III from his home in Magamaga. He was semi-conscious and had lost sensation on the left side of his body, coupled with difficulty in breathing. His caregiver explained that Denis fell ill at night and was home alone when he had collapsed. When his caregiver came to check on Denis, he saw that he had collapsed and called the ambulance straight away. The RMF ambulance did not disappoint; in a few minutes it had arrived.

The team at the facility considered Denis’s case an emergency, and he was admitted to the adult male ward, where he was diagnosed with meningitis. Denis is also a known HIV patient who is on antiretroviral drugs. He was given ceftriaxone, fluconazole, dexamethasone, and paracetamol, and he has been in the ward for 8 days. Since then, he has showed great improvement, and he can walk and talk again. Generally, Denis’s clinical condition has greatly improved, and he is due to be discharged.

When Denis recovered, he started telling us that he used to see RMF as a one-man show: Naku Charles Lwanga (now RMF Country Director, Uganda). He saw Charles do a lot of things at Panyadoli Health Centre, like buying drugs, painting wards, etc., changing the perception of Panyadoli Health Centre, which had been known as “half dozen health center” because each time a patient went there for treatment, he or she would be given only a painkiller or one of half a dozen basic medicines that could not cure the disease the patient was suffering from.

As the community saw RMF improving the health center, Denis worried how RMF could sustain this with only Naku Charles Lwanga to lead the way, though Charles was well known as a good man. Each time RMF recruited new staff, this brought hope and a smile to Denis. He saw RMF expand its services to an ART/VCT clinic and met very good people with the right attitude. He says he felt stress free and his sickness was no more. Denis was enrolled in the ART clinic, where he was “given the best service he could need and never missed prayer for RMF to grow in service.” His prayer was for RMF to take over Panyadoli Health Centres and Kiryandongo Refugee Settlement health centers as a whole, and he says he is seeing it happening as IRC has already withdrawn from the settlement with its reproductive health services, leaving room for RMF to expand, and he is happy for that. Denis saw his dreams come true when he saw operating theatre built by RMF. He had always worried how he would reach Kiryandongo Hospital if he needed an operation, but now he sees that the service will soon be brought to Panyadoli Heath Centre III by RMF. He says, however, that he is the happiest because RMF serves all people. The expansion of the Maternity ward leaves him all smiles; though he is not a woman, he is glad for the women in a clean environment like the new RMF ward. Denis got better and started moving from one medical staff member to another, thanking them and saying, “RMF healed me.” He has been so overwhelmed by RMF’s services and our staff’s positive attitude that he has been praising RMF as much as possible.

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Mourning the Loss

Grief & Tragedy

Caroline Tukugize, the well-loved RMF program manager for Kiryandongo Refugee Settlement Caroline Tukugize's Funeral

Untimely Death of Caroline Tukugize

RMF’s Global Family Mourns

The program faced a shock due the death of Caroline Tukugize, the well-loved RMF program manager for Kiryandongo Refugee Settlement. She died shortly after undergoing a successful C-section to deliver twins at Paragon Hospital in Kampala.

RMF, OPM, and UNHCR team members traveled to Tororo in Eastern Uganda to attend Caroline’s burial. RMF continues to send financial support to help provide for her newborn twins.

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