Kitgum Town

Kitgum Town
Kitgum Town

Sunday, April 20, 2014

Strong Leadership

Dr Charles travelled on buses for about 18 hours across the country to be part of our Yotkom Uganda Directors meeting here in Kitgum.  He is staying 24 hours then hopping back on the bus to return to Mbarara where he is doing post graduate study in Internal Medicine.  His studies are being partly sponsored by Yotkom and a Government scholarship he won. His new skills will be of great use in the Kitgum community.
We had a lot of things to discuss at our meeting and there was a real spirit of unity and excitement for the future. We can see real growth occurring and so many answers to prayers  . We know we have challenges but we are determined to do our part to build strong foundations and be effective in all areas of health outreach and to be fully transparent and accountable so donors can know that the funds they give are going  directly to the areas of need.
Yotkom has a residential plot in a quite part of Kitgum, purchased in 2003
We have our title deed in hand now, securing the land
Estimated cost to build $30,000AUS
We would like to build a small duplex with two x 2bedroom units on this site, suitable for long term rental and short term guest house use. This structure would provide income for the project and save us paying for accommodation when short term teams arrive.
Meanwhile our main focus is on commercial land  on the main road in from Gulu which we purchased six months ago . We have plans drawn up to build a Primary Health Care Clinic on this site with Reception area, three consulting rooms, emergency room, small operating  theatre, overnight stay ward, Pharmacy, Xray, Ultrasound and Pathology services.
commercial land for Clinic
We are still awaiting approval from authorities to visit the Nodding Syndrome community we have targeted for an outreach project. We hope to go on Tuesday but appreciate your prayers on this matter.

Thursday, April 17, 2014

Medical Matters

The focus of the Yotkom project is to assist in delivering better quality health services and improving access of the community of Northern Uganda to this care.
The Bregma Clinic we are assisting sees many cases of broken bones or Orthopaedics. This can be due to events such as children climbing trees, pedestrians being hit by bikes, motorcycles , cars, trucks or buses ! The roads are quite dangerous.
Yesterday while I was in the clinic we had several patients attend with fractures, ranging from a fractured jaw as a result of a punch, to broken arms in children and a frail elderly gent with a broken hip from a fall. The clinic is able to Xray and apply plasters  and splints to most fractures. Those which are displaced from their normal position can be reduced into alignment by the doctors while the patient is given a light anaesthetic through IV.  Dr Vincent particularly enjoys providing this sort of care.
Having diagnostic equipment such as an XRay machine and Ultrasound on site can make such a difference to the accuracy of diagnosis and level of care which can be provided.
The staff here are really missing their ultrasound machine which requires repair but will cost about $1000 and currently this is not in the budget. Consequently the centre is operating below its capacity.
Fractured Hip
Young boy has light anaesthetic while fractured elbow is put back in place
Over at St Josephs Hospital, there is a need to improve the Ambulance service and do more inservice training of the staff involved in delivering emergency care . Andrew met with the Medical Superintendent and other hospital staff, including Augustine, one of the Ambulance drivers to look at ways we can have input. We are hoping to be able to have Pat Holdsworth, an experienced   Paramedic from Brisbane spend time here in October and assist with this area of need. We are requesting donor funds  or donated equipment be sent in the container this year to assist with fitting out the ambulance which is currently bare . The outpatient department may also benefit from setting aside  a designated area for managing emergency cases and stabilising them.
St Josephs Ambulance
interior of Ambulance
St Josephs Hospital OPD/Emergency Dept
with Dr Pamela, Medical Superintendent and Obstetrician

Tuesday, April 15, 2014

Reflections from Neil Shuker after a week in Kitgum

WOW! Exhausting, exhilarating and excellent are just a few words to describe my experience with the Bregma Medical Centre staff and Yotkom staff here in Kitgum. After flying into Pader courtesy of our MAF flight, Dr Vincent's brother Leo brought us across to the Italian Aid Agency AVSI accommodation where we have been for a week.  Our cook, Margaret, has kept us nourished for the activities and visits we have made during my week here. Andrew and I have visited many places and people that Andrew have been in our prayers since 2001 when Andrew first set out with a team from Gateway Baptist.

Highlights for me have included:
* encouraging staff and gaining commitment to have a morning devotional and prayer time before 9am and seeing some real prayer warriors (esp Ann and Peter) step up to lead in the 3 days since we started last Friday.
* enjoying the professional development for 30 outstanding Bregma and Yotkom staff over 5 days
   (including a team development day last Saturday at Bomah Hotel),
*riding a motor bike out to IGF and being escorted by young American Assistant Director Trent through their vocational training areas (business, welding, construction, tailoring, carpentry, mechanical), their P1-P7 school, their Community Church, their medical facilities and seeing many of the staff including CEO Jean-Paul who was Irene's right-hand man..
* catching up with some of the sponsored children, parents and staff inc Aaya Sarafin and son Joseph sponsored by Rowena and Richard and Peter and their families.
* visiting Pastor David Livingstone, hearing of his work in Okidi and his efforts raising the profile of Northern Ugandan issues globally and then touring his radio station Peace FM
* visiting ex-nun Tedi's impressive NUCBACD School and Care Centre for Disabled children,
* visiting the site and sharing in the dreams and visions of Construction Engineer Andrew M with his Early Childhood Centre on approx a half hectare
* visiting St Joseph's Hospital and being part of Palm Sunday celebrations at St Joseph and then at IGF Community Church
* investigating and understanding the impact of Nodding Syndrome and other neurological disorders on the physical, psychosocial and financial welfare of families in isolated communities outside Kitgum (courtesy of people like medical anthropologist Karin from Holland, David Livingstone and Tedi from NUCBACD)
* visiting Andrew's residential land and Yotkom's commercial sites for the future medical centre
* spending time reviewing broken jaws, broken arms, etc with Radiogapher Bosco,
* doing hospital rounds with Dr Andrew, Clinical Officer Peter and nurses Ann and Jackie
* looking at various stages and severity of malaria parasites through a microscope with Lab Technician Godfrey
* and, of course, travelling and having a Tusker (just one!) with my great friend Andrew

Andrew stays on for another week to bring together as many of the Yotkom plans as is possible while he is here. Hopefully, with your prayers, he can recover quickly from the stomach bug that has plagued him since last night.  One thing is very clear, so much more can be achieved in a short time when you are on the ground in Kitgum as there are so many competing demands on the lives of those who live and work here - and not just with Primary Health Care. Your prayers and support are most necessary to first prioritise the Primary Health Care needs, to pray for them, to be called to action and then to ameliorate the needs. 

Monday, April 14, 2014


Kitgum Town with a population of 60,000 has no Physiotherapist.
There is a huge gap in the provision of these services to the community.
The most needy are children and adults with disabilities including Cerebral Palsy, Epilepsy, Stroke, Deafness and Visual impairment. Children with Nodding Syndrome would also benefit from these physical interventions.
Yotkom has been exploring ways that we can support current disability services here and include a component of outreach to the Nodding Syndrome communities.
We would like to seek out donor funding to support an outreach program to a village community focusing on the delivery of interventions for children with disabilities, including but not limited to Nodding Syndrome.
Today we visited a wonderful project in Kitgum town which is struggling to continue. It has been established by Teddy, a former Ugandan Nun. It is called :
Northern Ugandan Community Based Action for Children with Disabilities. (NUCBACD)

Here, children with deafness, visual impairment, Epilepsy and other Neurological disorders, attend for special schooling and supplemental nutrition. Vocational Training is also included. Children make jumpers for local schools with the assistance of a taylor. This, along with a small farm, provides some income. 

Recently, The Mater Hospital, Brisbane  was instrumental in raising funds for a Physiotherapy Building which is now complete.
But, there is no Physiotherapist.

Perhaps someone from Australia could come for a short term and help train some local volunteers in basic interventions. Then it may be possible to arrange sponsorship for one of the most gifted volunteers to undertake a 2 year course in Physio here in Uganda, bonded to return to the community.
This person could also work from Bregma Clinic part time and possibly be involved in a rural outreach, along  with our clinical officer and a counsellor , focusing on a village with high incidence of Nodding Syndrome. It may be possible to also establish a day care centre to help relieve Nodding Syndrome families in this specific village.
There are trained special needs teachers in this school who at risk of losing their jobs because of lack of donor aid. The facility has some great facilities and is so well maintained.It would be great if we can do more to help make this service sustainable and at the same time do more for outreach. Please pray about this .We are brainstorming ideas here!

This morning Andrew enjoyed going on grand rounds, seeing all the patients staying in Bregma Clinic with the Clinical Officer and Nurses. Great opportunity to do some teaching and training, seeking to improving the excellence of health delivery in this place.

In the afternoon, Neil had another 7 of the Bregma and Yotkom team members join him for a mini training seminar. They had missed the day at Boma Hotel on Saturday and appreciated catching up on all the information.


Saturday, April 12, 2014

Full day Team Building Seminar went beyond our expectations

We had an amazing day together as a team of combined Yotkom and Bregma Clinic health workers. Neil Shuker led us through some very worthwhile sessions where we discovered more about our personalities and strengths and gained more understanding of each other. There was a lot of sharing by all the participants and a genuine spirit of hunger for personal growth and an improved work environment where the values of compassion, honesty, respect and excellence in service would define us.
There were 20 participants which was a significant turnout given it was a Saturday and some of the Bregma nursing and medical staff had to remain in  the clinic seeing patients.
Our new Chaplain, Walter spent the whole day with us and shared some inspirational words which really complemented the theme running through Neil's presentations. It has been very encouraging!
Neil shares about values and shapes
Andrew Kilama and Vincent participate in session

Pastor Walter shares some inspirational words
We shared  a great Acholi smorgasbord lunch


Friday, April 11, 2014

Pastoral Care and Chaplaincy on the agenda again

Today we have been able to have a meeting with Walter and he has made a renewed commitment to start work half time with the Yotkom and Bregma medical teams. It had been planned for him to start work in January this year,  however, his previous full time work as a counsellor with Food for the Hungry was  extended for an extra  three months . His position there will end this month.
This means he will be able to commence with YOTKOM  at the beginning of May and will come to the clinic three mornings a week . Walter will also be participating in our team building day tomorrow (Saturday ) and this will be a great opportunity for him to build relationships with our team. We believe the position of pastor/chaplain/counsellor  is a vital one  .

Neil is busy preparing material tonight for our seminar tomorrow. He is finding the old style paper, tape and pencil  rather time consuming ways of preparing a presentation !  (no IT facilities at the hotel unfortunately )
We are sure that many issues will be raised tomorrow and that the process will be very worthwhile in strengthening the project.

Thursday, April 10, 2014

Medical Team Building in KItgum

Here in KITGUM, Neil has been busy preparing for a one day team building workshop  for Yotkom and the Bregma Clinic . This will be held all day this Saturday at one of the local hotel venues. We expect about 20 people to attend and we are trusting it will be a very valuable time of sharing, hearing feedback and building strong work relationships. We will be sharing together our vision and values and reinforcing the faith basis and motivation of our medical work.
In the last couple of days, Neil has been spending individual time with some key leaders in the Yotkom project. It has been really helpful for people here  to be able to share and Neil has some great insights into ways that we can make improvements. Some of our Ugandan team have also  had some great ideas. Today, it was suggested that meeting for prayer at the clinic in the waiting room every morning would be worthwhile. We will be starting this practice tomorrow at 0830.
Andrew has been able to meet some key people involved in reaching out to the Nodding Syndrome patients. Most interestingly, an Anthropologist who has been doing a doctorate on the subject is living in a house directly across from us and we have met up on the day we arrived . Also, one of the Government officials involved in community outreach has spent some time with us and Mike, a counsellor who works with Lois Ford amongst Nodding Syndrome families came to the Bregma clinic today for discussions. This is all very helpful as we work out ways Yotkom can assist with providing care to Nodding Syndrome patients and their families.  Dr Vincent will also be attending an important meeting in Kampala on Monday (an 8 hour bus journey there and back ). This has been arranged by Dr Bob Colebunders and will be attended by Health Department, WHO and CDC officials.
One of the main goals for our time here is to finalise the employment of a Pastoral Care/ Chaplain within our team. We discussed this today and have some ideas to implement.
This afternoon, Andrew sat down with Yotkom leaders and set out some targets together for what we would like to achieve over the next 2 weeks. We have a lot to do but we  are praying it will be  a productive time together.

Neil and I are very grateful for a house which has been available for us to rent in a compound here. We have a special visitor, Margaret who is cooking our meals!

More news will follow.

Wednesday, April 2, 2014

World Health Organisation Meetings on Nodding Syndrome

During the last week , Andrew has  attended three days of meetings at the World Health Organisation in Geneva.
He was invited to meet with a number of Doctors and researchers within the organisation who have expressed concern about Nodding Syndrome and the effects this disease is having amongst children in our Kitgum district of Northern Uganda as well as Southern Sudan and other potential areas of Sub Saharan Africa which are affected.
One of the other people attending was Professor Bob Colebunders from the Tropical Disease Institute in Antwerp, Belgium. He is planning to undertake some extensive research into the condition and has a theory about the cause he wants to investigate.
Our Yotkom project is hoping to  increase our capacity to deliver better health services to the communities affected by Nodding Syndrome in our area of influence. We will also be aiming to collaborate with the World Health Organisation and researchers like Dr Bob Colebunders to gather more information and data on Nodding Syndrome in the district of Kitgum , Uganda.
We have established some very helpful networks and relationships within the WHO and they have encouraged us to continue in our work and are keen to  maintain  co-operation with us into the future.
This is a wonderful opportunity.
In the next two weeks, Andrew will be in Uganda sharing the information from the meetings with our medical team and also meeting with other agencies and individuals seeking to provide care. We will visit some of the affected villages.
We hope to put together a recommended package of health care and services and seek out specific donors who have a heart to meet this need.  I believe we have a great core team of health workers and strong foundations in place on the ground , giving us  the capacity to grow and do more as we gain the necessary resources.

One of the major steps forward which has already been achieved from our meeting  is the addition of Nodding Syndrome to the World Health Organisation web site , in the Neglected Tropical Disease section.
The NTD department will host this site and encourage the development of this  as a repository of information , a  data base of researchers and a source of  guidelines on best management.
Yotkom may have some input into the content of this web site in coming months.
If you would like to see this go to this site :

World Health Organisation : Nodding Syndrome

Next steps: Andrew will be meeting Neil Shuker in Dubai tomorrow and then travelling together to Uganda.
More news will be coming  from Africa !