OUTREACH SUMMATIVE REPORT
Within Murchison falls national game park lies many unimaginable isolated communities deeply burdened by the limited access to comprehensive, accessible, and acceptable health care services. A team of health workers from Clarke international university, inter-national medical foundation, Apar Foundation, in partnership with wild frontiers, embarked on a journey to deliver primary health care services to these remote areas of Northern Uganda. Our basic goal was to provide basic medical care and preventive care to the people living in these areas.
At 9 am Wednesday 18th March 2020, the team set off from Kampala, Central Uganda, and was received at 6 pm by wild frontiers in Murchison park, at Baker’s lodge. The team freshened up, had supper, and rested ready to kick start the clinic the next day.
The medical team helped with everything from setting up tents, rearranging, and cleaning of seats to actual clinical work.
The clinic was hosted by a resident health center II, the only one within a radius of 20km which is headed by a medical clinical officer. It also acted as our referral point for patients instilled in long term care plans.
CLINICAL REPORT SUMMARY
A total of 517 patients were seen, 76,264 and 177 on day 1, day 2, and day 3 respectively.
Of these, 195 (37.7%) were male and 322 (62.3%) were female. Once again it shows that men still lag behind in seeking health care services. The team tried to address this by requesting women to bring their husbands for checkups and health education.
Community residents of 6-40 years dominated the clinic attendance with a 55.1% percentage attendance, followed by infants and toddlers (1-5years) who all together made a 17 percent attendance, >40 years– 14.3%, and finally, babies (0-12 months) made 13.5%. More than half of the children that attended the clinic were school going. And more than three-quarters of the adults were farmers.
64.2% of the cases were communicable diseases and only 35.8% being non-communicable. It was noticed that much of these communicable diseases were preventable diseases and therefore as part of our plan, we added one clinician to the public health team to increase on the efforts to alleviate ignorance, empower patients with up to date information, practically show how the common diseases they were suffering from could be prevented in the first place. Further, all clinicians gave a one on one diagnosis-based health talk. These were all efforts to mitigate the disease burden by its roots because the community cannot afford to use a curative strategy given the weak health system and remoteness of the area. There was a notable number of zoonotic diseases. Diseases that contributed to
the non– communicable toll were mainly chronic in nature with hypertension, diabetes arthritis (different forms) topping the list. There were also notable concerns with ophthalmology, a health specialty that was not being offered by the closest health center.
Seven mothers were pregnant and instilled in antenatal care. They were given mama kits and given a comprehensive talk about safer pregnancy. More kits were donated to the resident clinic by Apar foundation to be given out on Tuesday in the ANC clinic.
- Patients don’t know about family planning and have the wrong attitude about it
- Malaria is severe in its raw form like as if these people know nothing about malaria preventive strategies
- Lack of a community-centered health strategy
- Increased desire to know HIV status
COVID-19 PANDEMIC WORKSHOP
At the start of the project, we had no idea we would conduct a workshop on COVID-19, this came in as a need we had to address on the ground, with its effect being large on the park’s staff, the anxiety together with other mental health-related conditions arising from its insurgence couldn't be left un-tackled. Just hours after dropping reaching, the president had given a directive to close all schools by Friday,
It started as an awareness campaign for the students in the nearby school before they went home, later there was a need to teach Murchison falls park’s staff on ways to mitigate the transmission of the virus with each day receiving staffs from different lodges.
We conducted a total of 6 sessions, 2 sessions each day at 10 am and 3 pm to cater for the different shifts
- Successful treatment of 517 patients and 6 corona workshops reaching out to more than 50 staff of lodges.
- Supply of reusable and single-use sanitary pads.
- Supply of bread to the school students.
- Health education of patients.
Apar Foundation: This provided bread, drugs, pads, among others.
International Medical Foundation: This provided to the camp, drugs and health workers
Wild frontiers: Host
Clarke International University: The university provided a lot including human resources; Medical Clinical officers, Nurses, Public health specialists, medical laboratory technologists.
The following challenges where faced and solutions were raised to solve them; -
- Understocking of drugs
- Covid-19 pandemic altering our estimated days of service.
- Lack of better shade for patients.
- Patients coming from a long distance to seek health services.
- Little community volunteers/ community not so involved.
- No record-keeping strategy instilled prior
On 13th January 2020, Clarke International was invited by the administration of Refuge and Hope International to conduct a training exercise on Sexual Reproductive Health and Rights. This took place at the offices of Refuge and Hope International found in Kansanga, Ggaba and the training was done by Ms. Alimah Komuhangi, a lecturer under the Institute of Public Health and Management and the coordinator of community engagements at CIU.
The focus of this exercise was mainly on sexual health, sexual rights, reproductive health, and reproductive rights. The aim of this training was to equip the staff members of Refuge and Hope International with information so they can guide their students and families better on matters of sexuality, sexual and gender-based violence and practicing safer sex.
Community engagements are an integral part of our core values and as an institution that puts emphasis on making a difference in society, we are excited to kick start the year by giving back to the community that has continually supported us throughout all the years of our existence.
On 17th April 2019, Clarke International University was invited to conduct Cyber security awareness training at Refuge & Hope International (RHI). RHI is a US registered faith -based nonprofit organization born out of desire to serve and assist people affected by war and conflict.
Clarke International University (CIU) is privileged to have partnered with MOBIKLINIC -Uganda, a health organization that aims at increasing access to healthcare services in rural areas. Other partners were Tec. Uganda and Malongwe health center. The medical camp was held on the 22nd. 02. 2020 at the Catholic church field in Bulyasi, Kinoni village, Najjembe division, 5km away from the nearest health facility. Farming is the main source of livelihood for people in Kinoni village. CIU team was led by Ms. Komuhangi Alimah and was directly involved in diagnosing and treating medical conditions, dispensing and health education.
From a total of over 200 patients that turned up for the medical camp, 193 prescriptions were identified randomly and analyzed. Results revealed that 68.4% (132/193) of the patients were female. The highest proportion of 42.5% (82/193) of the patients was below the age of 18 years, followed by 22.3% (43/193) that were above 50 years. Patients that turned up presented with the following conditions: upper respiratory tract infections (16.5%), malaria (7.8%), urinary tract infections (7.8%), peptic ulcer disease (7.3%), fungal infections (3.6%), pelvic inflammatory disease (2.6%), and Pneumonia (2.6%). Orthopedic conditions were common among patients over 50 years: 3.6% (7/193) mainly osteoarthritis, myalgia and Gout. Among the referrals made were a total of 4.7% (9/193) that presented with signs and symptoms of diabetes and hypertension, 2.1% (4/193) that presented with signs of depression, 1case of incomplete abortion, 1 case of scrotal hernia, 2 cases with HIV/AIDS, 1 case with Hepatitis B virus, 1 case with mastitis and 2 cases of pregnancy to continue attending ANC services at the nearest health facility.
Face to face interviews with 10 patients that were conveniently sampled was conducted. The purpose of the interview was to attain their perception regarding the services offered. Overall, patients were satisfied with the services offered, especially the laboratory services and medication. They also noted that were no delays, they never had to wait for long hours before getting the service. However, there was a concern regarding the time the medical camp closed. Patients were still coming in for healthcare services but they were not able to register.
“I am very grateful for the time you took off to travel to our village to take care of our health needs. I have not been feeling well for the past 4 days, when I heard that you people are coming over, I was delighted. I got all the drugs prescribed, I even came with my wife and children and they got medicines. We are very happy. We hope you continue with this kind of initiative. I request next time you start early so that by the time you leave all patients are seen,” (BKN1) One of the patients reported.
Since the majority of the health concerns in Kinoni village are communicable diseases, it poses an opportunity for health initiatives to focus on general hygiene, vaccination, safer sex practices, and nutrition while offering health education. In addition, a community like Kinoni with a population structure where the majority are unproductive would benefit from initiatives that strive to bring healthcare services closer to the people. In that regard, CIU pledges to continuously create a difference in the health of the population through health education, research and community engagement.
Many thanks go to Mr. Andrew Ddembe of MOBIKLINIC-Uganda for granting CIU the opportunity to give back to society through community engagement. I thank CIU management, the Dean School of Public Health, the registrar, Mr. Lwanga Alex and the students from the Institute of Allied Health sciences for making the medical camp a success.
By Komuhangi Alimah
By Alimah Komuhangi
ACRO engineering works limited and El Bueno technologies in partnership with Clarke International University (CIU), Kampala International University, Dental Access, AIDS Information Center Uganda, Marie Stops Uganda and Glenmark annually organize the medical camp.