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January 2023 report: Evaluation of Acheru work, and Christmas Party pictures

I recently received the following from Acheru. Prepared by our orthopaedic clinician Buyinza Ronald, it is an evaluation of the work which I find both encouraging and disappointing. The disappointment stems from our hopes when we established this work that over time the need for our intervention would diminish - this has not happened. There has of course been development of health services, but against that is a growing population and the continued failure, for whatever reasons, of so many disabled children to be brought for treatment. I am however encouraged to see the results of the work done by the Acheru staff and their efforts to get into areas not previously reached. It seems strange to us, looking at the work from a distance, that areas which seem relatively close to large towns and medical facilities are in effect still remote and isolated, with children still being denied treatment due to the same traditions or fears which we encountered at the outset.

The Acheru staff are clearly aware of these factors and continue to explore the most effective ways of developing the work.

Report about patients and our work:

Greetings from Acheru staff and appreciation to our donors for facilitating the Acheru budget. We are looking forward to ending the year successfully.

Ebola outbreak in Uganda:

As you see on the international news, Ebola broke out in the central region of Uganda and covered some districts of Kassanda and Mubende. The government of Uganda together with the Ministry of Health put those two districts in lock down for 6 weeks, the school term was also shortened and this has helped limit the spread.

Ebola put fear in the public as we had already seen what happened during the COVID-19 pandemic. The outbreak first affected the health workers in the above districts. As for Acheru, we put measures in place to prevent the spread of the Ebola Virus. All our staff took precautions; screening of our patients was done and we also stopped our patients who were coming from the affected districts and also the surrounding ones as they were at risk. Some of our patients who come from the affected districts had to have their follow up appointments deferred.

Health of our patients:

Our patients are doing well as they get whatever care and treatment they need. Despite high food prices, our patients and care takers have been able to be sustained with feeding schedules as per the nutritional guidelines. We usually have around 10 to 15 inpatients receiving post-operative care, ongoing therapy and other kinds of management.

State of the economy:

Even in developing countries like Uganda we have an economic crisis as most of the people are below the poverty line. Some people cannot afford transport to bring children for review appointments, treatment, or assessment and this is reflected in the monthly statistics as we record around 200 patients seen in a month. We are receiving much less from patients' contribution towards surgeries and other services.

Patient clinics have done well with continuing referrals for surgery. Costs for surgery have risen (though still heavily subsidised by CoRSU) but families have tried to contribute. Patients are also referred to the Children's Surgical Hospital at Entebbe.

Northern Uganda:

We have a limited turn up of patients from the North due to transport costs and the planned changes in our work presently being discussed with government representatives there with a move to a different location anticipated.

Outreach in Kayunga:

We had an outreach at Kamuli UMEA primary school in Kamuli village, Nazigo sub county of Kayunga district on 16 November 2022 organized with our partners International Needs Uganda and we assessed and diagnosed 53 patients who were treated or referred.

Outpatients in Physiotherapy:

The main condition treated is cerebral palsy with at least 100 sessions per month. The Ebola outbreak has caused fear from the patients and carers to share equipment during therapy; some patients are not keeping appointments. However, the number of new patients is increasing due to sensitisation on world Cerebral Palsy Day, and a community outreach program in which the physiotherapist actively participated and referred patients to the unit.

Inpatients in physiotherapy:

This involves mainly post-operative patients and some cerebral palsy patients from distant districts are admitted for a while to educate families about rehabilitation and treatment. Acheru had a cerebral palsy day on 20th October, 2022 where we hosted many children with CP problems. We had a health talk from some of our partners and Noah's Ark Children ministries sensitized the mothers on nutrition. We had a feast and then gave a package to every family who attended the party.

Report compiled by Buyinza Ronald, Orthopaedic Clinician.

In the run up to Christmas, a number of parties were held to bring together former patients and families and help promote Acheru's work. A leisure day was organized for the staff as a thank you for their work, and to help them identify as team members.

Minakulu Christmas party

Staff leisure day