US-Ugandan collaboration breathes life into local maternity services

This is a follow-up piece to September blog entry "Covering Ground in Kisozi."

On October 14th, armed with a simulation baby and a wealth of educational media, Dr Ernani Sadural and Professor Jared Kutzin traveled from the US to the E&E Health Clinic in Kisozi, Uganda, a facility operated by Dutch-Ugandan NGO Hope Alive Uganda. Excitement in the run-up to the US team’s visit had been running high and the team, accompanied by Hope Alive Uganda co-founder and Kisozi village representative Eddy Mpoya and managing director Simon Peter Oullo, hit the ground running.

The trip was originally conceived early in 2012 by Nabuur volunteer Kirsti Shields working with Rochester NY-based non-profit Journeys of Solutions. It's purpose was two-fold: to train local clinicians in essential life-saving techniques as well as to help assess ongoing needs and identify directions for future growth. The team focused its efforts during the first part of the week on key training needs identified during pre-trip discussions with the E&E clinic staff. Priority was given to teaching critical life-saving techniques such as infant resuscitation and management of breathing difficulties in infants and children. The team brought materials from the US needed to implement an internationally endorsed program called Helping Babies Breathe, and also trained local clinicians in cervical-cancer screening techniques. An add-on visit to the nearest hospital, 48 km away, enabled Dr Sadural to extract a commitment from senior OB/GYN Dr Charles Balloga, that he would help treat any women identified as at-risk by the cervical cancer screening.

The second part of the week focused on identifying ongoing and future clinic needs and trying to understand the day-to-day difficulties faced by the Ugandan team in treating patients in a low resource remote village setting. Several basic but pressing needs were prioritized: a refrigerator with a thermostat in which to store vaccines for children, a fire extinguisher, a spotlight to provide illumination when suturing birthing lacerations and a supply of oxygen for patients with respiratory ailments. The biggest priority identified by the team was the need for a reliable ambulance service to transport critical patients to the nearest hospital – a staggering 48 km away in the town of Jinja.

Currently, patients requiring emergency care must travel down 40 km of unpaved rough dirt road. By car, the journey takes a full hour. Frequent rain makes it virtually impassable for weeks at a stretch. At night, the lack of lighting creates lethal conditions. There’s a clear need for an ambulance – but currently no funds with which to buy one. A strategically engineered motorcycle ambulance might be a solution - ether way, the need for a reliable, safe means of transportation was identified by all staff as critical.

The trip was rounded out by a tour of the local schools and a rousing musical performance by the children of St Mary's primary school before the US-team headed home – at least, for now. “We’re looking forward to working together with HAU and E&E center on further training programs and hope to return next summer with more medical volunteers,” said Dr Sadural. “I believe we can really help the E&E medical center become a first rate primary care facility.”

The response of staff at the Kisozi clinic was equally optimistic. “Valuable training was provided,” says Esther Haaisma, E&E Clinic Director. “It’s given the clinic a great boost. Thanks to Dr Sadural’s visit, we can help save more lives now. We can help more people.”

Mission achieved.