Ojama Medical Health Centre – Under Construction

Ojama Medical Health Centre – Under Construction

Ojama village has a population of about 8,000 inhabitants. Situated 24 kilometres from Soroti town, health care in the village is currently non-existent although in Serere twelve kilometres away, there is a limited public health facility and maternity services are available.

It is not uncommon for someone requiring a blood transfusion to have to access the hospital in Mbale (98 kms away) as Soroti Regional Hospital more often than not, has no blood supplies available. Health services we take for granted are not available within the public sector – ultra-sound, some X-rays, can only be accessed in private medical clinics which are out of financial reach of most patients. An ECG for example, costs 50,000/- UG (approximately 60 UK pence) but most people in Ojama earn less than $1US per day!

Currently, there are no qualified doctors in Ojama: nationally there is 1 health worker to every 2000 and in Ojama, Denis and Catherine are the two health workers. When Denis qualifies in 2012, he will be the first qualified doctor for a population of about 7,500.

Above: Denis, Catherine and young Baby Po

Catherine and Denis have begun the construction of a Health Centre with the intention of providing a comprehensive range of facilities: the building has so far been erected with spaces for an examination room, a laboratory, dispensing room, injection room, community meeting space and a resting room. At a later stage, land they already own at the back of the centre will provide for a maternity unit and in-patient facilities with a fully equipped theatre.

Interior of the clinic, as of February 2010

Maternal mortality rate in the whole of Uganda stands at 200:100,000 women and this high figure is due to poor anti-natal care; lack of awareness about the importance of delivery in hospital; rudeness of health workers who frighten many pregnant women away and men who don’t support their wives: women are expected to perform all their normal chores including digging and planting of crops while pregnant. There is a high incidence of pre-eclampsia, while pre and post-partum haemorrhage is common.

There are numbers of clearly defined diseases common amongst the village population.

In children, the major problems include malaria, diarrhoea, vomiting and anaemia.

Poor hygiene results in cholera and worm infestation and pneumonia is common as a cause of admission to hospital.

There is an incidence of Burkett’s Lymphoma among children.

Most mothers do have their children immunized.

While HIV is an issue in Ojama, public campaigns and constant education provided by Catherine in the Serere clinic has resulted in most mothers “declaring” their status and accessing anti-retroviral medication. The new rate of infection is stable although every week, the clinic shows up one or two new cases.

Amongst adults, the primary diseases are Malaria and lifestyle diseases such as diabetes; raised blood pressure and, as with the children, due to poor hygiene, worm infestation.

Sexually transmitted disease is very common, especially among women who are infected by their male husband/partners who, on the whole, are reluctant to attend the existing health centre in Serere.

Alcoholism and cannabis use cause a high level of domestic violence.

Cancer of breast and cervix is common.

Unsafe water - which the majority of the population is forced to use - is the major harbinger of Cyclops organism and a cause of corneal ulcers. HIV infection is the cause of glaucoma.

Many of the diseases prevalent in the community are a result of ignorance caused through poverty. A major focus of the clinic under construction will be the development of outreach programs to combat this.

In addition it is hoped that funding will make possible the acquisition of two neighbouring pieces of land on which SECODEI (Serere Community Development Initiative) would develop a co-operative chicken farm using high quality stock and employing modern farming methods to increase output and income – creating a sustainable economic venture for the community, together with a citrus fruit orchard producing quality fruit that could be sold to restaurants in Kampala and beyond.

Recognising the hardship for families who live below the poverty line, Denis and Catherine are planning, together with the Village Savings Scheme already established, to develop a private health insurance scheme. It is likely that this scheme would encourage each family to pay some 15,000/- annually, entitling them to access the medical services of the community health centre. Limited financial support will also be available once the clinic is finished and running, from the Government of Uganda who offer a small fee for each immunization undertaken.

Denis feels that the current construction will become a workable space as soon as the flooring, windows and doors are fitted, possibly with the addition of some plastering to the walls and purchase of equipment. There also need to be eco-system toilets constructed at the back. The waste from those toilets will eventually be used as fertiliser for the nearby farming projects it is hoped to establish.

(Since my return from Uganda, generous donors in the UK contributed £1000 and this has already enabled the purchase of doors and windows for the clinic and for the floor to be laid. Further donations approaching £10,000 would ensure ceilings, construction of the eco-system toilets and construction of the maternity facility and purchase of equipment. This would bring forward the date when this clinic would be completely viable and servicing the needs of up to 7,500 individuals, although Denis will not be able to be the doctor until he completes his medical course! In the interim period, the clinic would operate as a health centre, managed by Catherine, with full medical services being rolled out when Denis qualifies.)