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The first trip
The first Mission Rwentobo trip to Uganda, led by Gordon Miller, took place in 2014. The main purpose was to support World Shine primary school, situated in rural SW Uganda. Over 500 children attended the school , 200 of whom were boarders.
The school had a very small sick bay at the time which was poorly equipped, with nothing but a grubby mattress on the floor where sick children could rest.
We talked to Medad Birungi about creating a better sick bay but he explained that part of the vision for World Shine Ministries was to eventually create a clinic for the whole community, who had no access to health care nearby at the time.
Very few people in this community own a bike, let alone a car so this is a major barrier to good health
Connie Burgess and I realised that, in order to provide good healthcare a clinic would need to be linked to a facility with experience.
We identified Kisiizi Hospital, a Church of Uganda Mission Hospital about 50 minsup rough mountains roads from Rwentobo. This hospital is recognised by WHO for exemplary care to the rural poor.
Dr Ian Spillman, who was then the medical superintendent at Kisiizi and he agreed to take our request to the board.
The other advantage of linking with Kisiizi was that the Rwentobo community would have access to the KHIS. This means that, for a very small annual premium, families can have access to very heavily subsidised acute healthcare and maternity care.
We were delighted when the Kisiizi board agreed that clinical supervision could be provided to the clinic, with staff being trained and allocated by them.
Fundraising to build and equip the clinic began.
Continuing trips
Mission Rwentobo continued to send groups over to support the school and in 2016, whilst on a community visit, Connie Burgess found baby Pauline,who was obviously suffering severe malnutrition, in one of the dwellings
Kisiizi Hospital was contacted and the child, who was actually 18mths old, was found to weigh only 5.5kg.
Kisiizi agreed to use their Samaritan fund, which provides fees for those who really cannot afford it, to treat Pauline.
A few months later Pauline was looking much healthier having benefitted from the Kisiizi special feed formula.
Her mother was advised about good nutrition on a low income and Pauline was discharged.
If this mother had been able to access healthcare closer to home, Pauline may never have become so close to death.
This spurred us on with the fund raising for the clinic and for a similar“Samaritan” fund for the Rwentobo community.
At last the building commenced on land backing onto World Shine primary school and facing the main street in Rwentobo.
Using local builders and local techniques, the structure took form.
The opening
In May 2019, a small group of us were able to pay a brief visit to join the community in celebrating the opening of the clinic.
As the children returned to school, they now had the benefit of a small ward within the clinic where they could be treated when unwell.
This is the path which links the school to the clinic.
Mission Rwentobo havecontinued to fund improvements to the clinic, including solar power and large rain water collection tanks.
The original rather steep ramp access has been improved and outdoor latrines and acooking area have been constructed for the use of the night guard and family ofpatients who are admitted.
This photo shows the front view of the clinic and the outdoor sheltered seating to the side.
Currently...
The clinic is currently staffed 24/7 by a team of just 8 people. From left to right:
- Justus, Cleaner and porter
- Miracle, Night guard
- Martha, Enrolled nurse
- Majira, Enrolled comprehensive nurse
- Charles the clinical officer
- Brenda, Enrolled midwife
- Abel, lab technician
- Dianah, nurse assistant
Charles, the clinical officer, joined the team in November, taking over from Sarah who had been in charge for nearly 2 years. She moved on to a district hospital to help with the Covid pandemic.
Nurse Martha has been working at the clinic since it opened and previously as the school nurse. She is devoted to the community and provides regular updates and photos.
Thanks to a generous sponsor, who sadly died last year, we have been able to fund her training to upgrade to diploma level comprehensive nurse, which will extend her knowledge and skills so that she can assess patients and plan care independently.
Here she is doing a community visit with a fellow student.
One of the big successes of the clinic is being accepted by the district health officer as a suitable clinic for providing childhood immunisations.
This means that a gas fuelled vaccine fridge and regular vaccine deliveries have been received by the clinic, fully funded by the government.
A busy weekly vaccination clinic now runs every Wednesday. The corridor is used as a waiting area with doors open front and back to allow good ventilation.
Sometimes babies are seen in the covered area outside.
This very enthusiastic local health volunteer has been keen to support the clinic since his retirement. He takes the responsibility for processing the records.
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Fortunately, most mothers breastfeed their babies, which give some protection against disease and provides the best nutrition for free, so this is greatly encouraged.
Other services which the clinic provides include family planning, antenatal and postnatal care.
Long acting contraception like implants and coils can be fitted at the clinic.
Mothers are checked antenatally.
This picture is on the wall at Kisiizi hospital and shows a midwife using a sonicaid to listen to baby’s heart beat.
This slide shows the midwife receiving a doppler device so she is now able to use this to listen to baby’s heartbeat and Mum is also able to hear it.
The device was donated by a company which provides medical equipment to the GP surgery where Debbie works.
Currently the clinic is unable to provide deliveries of babies because it is not yet fully equipped to do so or to cope with emergencies.
A catholic hospital has opened recently which is closer than Kisiizi and they have agreed to accept mothers who have complications in labour, so we hope that this may be possible in the future.
However, one baby has been safely delivered at the clinic, as a mother arrived in the middle of the night in advanced labour. The midwife and nurse who helped to deliver the baby are proudly showing her off here.
Patients are also seen at the clinic for acute health issues and the busiest day is Friday which is market day so people are in the area.
Patients are triaged by the nurses and then Charles, the clinical officer is able to assess them.
If medicines are required they can be obtained from the onsite dispensary.
This slide shows Martha checking the computer system for instructions regarding medicines which are then dispensed through the window.
An excellent software system called “Streamline” was developed at Kisiizi Hospital to ensure good health records are kept and correct medicines issued.
If further investigations are required, Abel, the lab technician can take blood and run checks to aid the clinical officer in his diagnosis.
24/7 care is provided on an emergency basis when really necessary.
Patients are admitted to the small onsite wards for medical care with close family providing food prepared in the outdoor cook house and washing clothes etc, which is expected in their culture
This lady was suffering from pneumonia and needed to be admitted for a few nights. Here, Nurse Martha has taken her out for some fresh air while she is off duty.
This graph shows how the Covid-19 pandemic affected the footfall at the clinic due to restriction of movement in the country.
The increase in numbers since late 2021 reflects the lifting of restrictions but also the popularity of Charles as Clinical Officer. The culture means that people have more confidence in a male in this position, rather than a female as before.
This graph demonstrates a surge in severe cases of malaria towards the end of 2021 with some children requiring admission for 2 or 3 nights for life saving treatment.
It is thought that this was caused by lack of community outreach and health education during the long lockdown. Covid precautions took precedence over education to reduce malaria, encouraging use of mosquito nets etc.
Tonbridge Baptist Church and friends were very faithful in providing the funds for the clinic, as is acknowledged in this plaque as people enter the building.
Dr Ian Spillman was then instrumental in providing ongoing support and spiritual encouragement to the team for the first 3 years. However, he has now returned to live in the UK after 10 years service to Kisiizi.
In a recent review, the board of Kisiizi concluded that the clinic has come a long way and no longer requires the same level of support from the hospital.
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