Global Health Educators
Program Report from Uganda Trip - Spring 2016
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| The Nile River, Murchison Falls, Uganda |
Travelers: Mark Gustafson MD, MPH, Judy Gustafson MD, MPH, James Drougas MD, Raven Sullivan, and Brooke Parker
Vision:
Improve women and newborn health in the developing world.
Mission:
Improve the health of communities through educational teaching programs and sustainable interventions.
Goals:
• Improve maternal and newborn health.
• Strengthen medical care at the level of the health center.
• Improve community health through educational and sustainable interventions.
Below is just a brief report on what we tried to accomplish during our most recent visit. Our intent for this trip was to evaluate programs that have been initiated on previous trips and present just a couple new topics that were specifically requested by the Ugandan medical staff and community leaders during our last visit in October 2015.
Magale Health Center Level 4 - Health System Strengthening
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| Dr. Drougas (right) working with Dr. Lukia in Magale, Uganda |
Surgical and Anesthesia Mentoring: Dr. Sr. Maria Goretti was transferred to Tororo to act as administrator to multiple health centers with Dr. Lukia now acting as the new physician for Magale HC4. Dr. Lukia assisted Dr. James Drougas and Dr. Mark Gustafson in multiple surgical cases that were chosen to help improve her surgical skills including Ob/Gyn and general surgical cases.
Skills Training Workshop for Medical Staff:
A hands-on workshop was conducted with new training topics including suturing, airway management, spinal anesthesia, and IV placement. Clinical health officers, midwives, and medical staff from several health centers attended these training programs.
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| Ursula, midwife, teaching patients and family about temperature monitoring |
Newborn Warming: The program was initiated by the PA Students from Jefferson College of Health Sciences in October 2015. Upon return the midwives were continuing to monitor newborns for hypothermia although they had run out of thermospots (stick-on crystalline thermometers). The midwives will continue with the thermospots donated from VT and temperature monitoring charts posted on the walls near each patient bed.
Virginia Tech Engineering Students’ “Baby Pod” Evaluation:
The engineering students at VT in Blacksburg, VA requested an evaluation of their “Baby Pod,” a simple device designed to prevent heat loss that could be made with local resources. A prototype was taken along with staff surveys to determine acceptance and feasibility in a low resource setting. Of the 10 midwives who attended the trainings, all provided comments and positive feedback and hope to incorporate this type of device for their newborns at risk for hypothermia.
Continuing Medical Education: New topics were introduced including management of wounds, hand hygiene, and an exclusive breastfeeding program for a minimum of 6 months. Although mothers breastfeed their infants, there are many superstitions and misunderstandings leading to supplementation with contaminated water resulting in early newborn diseases and death. Time was spent trying to understand the cultural challenges facing mothers and the ability to implement an exclusive breast feeding program as recommended by the WHO and the Ugandan Government.
Ultrasound Training: Demonstrations and teaching programs were presented to the staff. An ultrasound machine was then presented to Magale Health Center to assist with diagnostic imaging. Sister Aligonda is the new acting head of the medical staff and will continue these training programs as well as assure the safety of the Sonosite ultrasound machine. Appreciation goes to all who donated toward the purchase/renovation of two ultrasound machines through the Sonosite Soundcaring program.
Antenatal Clinic: Prior to delivery, four antenatal visits are recommended by the Ugandan government. To encourage mothers to attend these clinics, “Mama Kits” were given to mothers who were near delivery and had attended all 4 antenatal visits at St. Angela’s HC4 in Magale, and Gamatui HC2 in Sipi Falls. Pictoral teaching materials developed by GHE were given to the clinic staff and the “Mama Kits” were donated by mercyformamas.com. GHE is hoping to work in collaboration with “Mercy for Mamas” to improve maternal and infant care.
Community Health Programs - Manafwa District
Bubulo East Traditional Birth Referral Agents, BETBRA
Traditional Birth Attendants assist more than 50% deliveries in rural Uganda. To help improve maternal and infant health, GHE has been working with community health leaders and midwives to form a new organization, Bubulo East Traditional Birth Referral Agents.
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| BETBRA leadership shown in the photo in front of their new sign |
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| One of several health Centers visited by GHE |
The referral program was initiated by leaders in October 2014 and now the organization has 390 active members in less than 2 years. Their goal is to improve education among their members and encourage referrals to the 13 health centers in the Manafwa District as well as becoming recognized by the Ugandan Government as a community based organization. Of note is that all leaders and members of the organization are unpaid volunteers. The t-shirts are purchased in Uganda through GHE donations. The leaders then sell these t-shirts to members at a very nominal price that then goes toward expenses of running their programs including communications, office supplies, and collection of data from the health centers.
In March 2016, the GHE travelers were welcomed into 6 of the 13 smaller Health Centers that refer into Magale HC4. BETBRA teaching Materials were left with clinic staff and official T-shirts were presented to active members of the newly formed organization. The T-shirts provide recognition to the people who are committed to improving maternal and newborn health.
Video below: A typical warm welcome from one of the 6 health Centers visited on March 5, 2016
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| Patrick demonstrates the use of a handheld magnifier |
The leadership of the TBRAs also organized the “Albinism Awareness Program,” that had been initiated in October 2015 with the help of Jefferson College of Health Sciences in Roanoke. The program included in 4 health centers with multiple Ugandans with Albinism attending the program. Delivery of hats, sunglasses, handheld magnifiers, and Albinism handouts were left at the health centers for continued education of the health center staffs and communities.
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| Albinism education draws many members at their community Health Center |
St. Angela’s Schools
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| The Older Nuns get fitted for reading glasses at St. Angela's convent in Magale, Uganda |
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| (Above) The reading chart used to help determine strength for glasses |
Vision Project: This project was also initiated in October 2015 with the PA students from Jefferson College. The teachers at the school created the “Vision Impairment Committee,” composed of 5 teachers at the primary school. This most recent trip included a review for the teachers about vision testing for both near and far vision difficulties. The committee received certificates for being part of the committee along with more glasses for reading and distance vision. Shortly after the visit with the vision committee, the teachers from the primary school tested teachers in the secondary school and fitted 8 with reading glasses. More reading glasses were fitted for the older nuns at the convents and left behind for the program to continue. Sincere thanks to all of our friends and family who donated glasses for this program.
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| (Above) Sister Claudia uses the chart to determine correct lenses for her older brother, Joseph, and his wife, Olive |
Orphan Program At St. Angela's School:
With the generous donations received during Christmas in December 2015, the headmistress of the school, Sister Claudia, purchased large quantities of rice and beans along with fabric to make uniforms for the many children living at St. Angela’s School. Sincere thanks to everyone who helped with this program.
Pen Pal Programs:
One class at St. Angela’s school was delighted to receive pen pal letters and copies of Charlotte’s Web sent by Marcy Wells’ second grade class from Preston Park Elementary school in Roanoke VA. We are returning with letters written by the Ugandan School Children. Hope they enjoy!
We are also bringing back letters from 20 High School students in Magale requesting penpals from Roanoke, VA.
Sipi Falls, Uganda
After spending a week in Magale, Uganda, the group traveled to Sipi Falls to present a training program for midwives and birth attendants at the Gamatui Health Center 2. Billy Wauyo, the representative from “Mercy for Mamas,” traveled from Kampala to present Mama Kits to mothers who attended the trainings and to meet with the GHE travelers to start a collaboration for training programs for mothers, birth attendants, and clinic staff in Uganda.
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Billy Wauyo, representative from Mercy for Mamas, presents "Mama Kits" to mothers participating in the GHE training program in Sipi Falls, Uganda
Dr. Mark Gustafson presents the GHE teaching program to the participants at Gamatui HC2 in Sipi Falls, Uganda. |
The Sipi Falls Convent hosted the team for 2 nights. In addition, one evening was spent with Sister Claudia’s brother, Joseph, a coffee farmer in Sipi Falls. Several members of his family traveled to Sipi to share in the authentic Ugandan meal and evening with the representatives from GHE.
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| Sister Immaculate, the "dancing nun," also head mother of St. Angela's Convent in Magale, Uganda |
The generosity and hospitality of the Ugandan people is truly remarkable. This was my 8th trip to Uganda and it felt like coming home. Again we were fortunate to be hosted by the nuns in convents near 2 health centers. This association with the convents has provided us with safe food and lodging, a convenient place to stay in close proximity to the health centers, the benefit of learning the culture first hand, and most importantly making us feel appreciated and loved. The nuns living and working at the convents, schools, and associated health clinics devote their lives to caring for their community and visitors regardless of religious beliefs or affiliations. Their ability to laugh, sing, and dance despite their challenging conditions is always an inspiration.
Sincerest gratitude to all those who make GHE possible,
Love to all who make this possible,
Judy
Judy Gustafson MD, MPH
Program Director
Global Health Educators
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