Outreach

KAMUDA

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 October 2008 was a very exciting month for TSMP’s staff. After much preparation, we began mobile outreach clinics in an area called Kamuda. Kamuda is a sub-county that includes 50 villages. The village closest to Soroti is only nine kilometers from town, but it is less developed than the IDP camps. A finger of huge Lake Kyoga reaches into Kamuda, and the people subsistence farm around the lake. As the pressure is turned up on IDPs to leave Soroti, many of them are relocating in nearby Kamuda. Adequate drinking water is a problem because there are insufficient bore holes. Some people drink out of the lake, so there is plenty of water-borne illness. The local leaders are working to organize the people to dig new pit latrines, as there is also no sewage system. Electricity is something that is only dreamt of.
Registered Comprehensive Nurse Ebunyu Emma checking a boy's ear for signs of infection.
Going barefoot in and around the lake exposes the folks to a disease called bilharzia (its more proper name is schistosomiasis). There are only two health centres for the 50 villages, and the Ministry of Health finds them impossible to staff. So every Thursday, the majority of our clinic staff packs up and rides out to Kamuda. Kamuda is divided into four parishes, so the mobile clinic is in each parish at least one Thursday a month. Thursday is avery slow day in Soroti because it’s the market day. Only a couple of the maternity staff stay behind in case a mother comes in to give birth. Everyone else works the mobile clinic, so all services are offered: prenatal care, general medicine, vaccinations, family planning and laboratory. The need in Kamuda is enormous. Some Thursdays many more people show up for the clinic than can be seen in a day.

Medical triage is conducted to make certain the very sick are seen first, and then the team manages to treat an awfully lot of people in one day. The first Thursday in October 2008, they saw 105 people. By the fifth Thursday in October, they were able to provide care to 225 people. In total, nearly 2,000 people were seen in 2008, and nearly 2,000 people were seen in the first quarter of 2009 (January through March).These big numbers are possible in part because of the excellent on-going relationship between the clinic ad ministration and the community leaders. The community provides vital support to our staff. So far, the outreach has been a big success. A large number of needy people are getting help — people who otherwise have little or no access to medical care. As more and more former IDPs leave the Soroti area, TSMP will be considering mobile outreach to more areas.
Sr. Akello Petua Echodu and U.S. Midwife and IMA Program Director Jennifer Braun at outreach antenatal clinic. Clinic Pastor and Driver Ochen Richard assists U.S. Nurse Midwife Angie Fujioka with a baby.
outreach
Patients waiting to register at outreach. Finance Officer Oteger Martin helps Enrolled Comprehensive Nurse Apio Judith at dispensary.
   

ACOWA

Acowa

Since beginning mobile outreach clinics in Kamuda in October 2008, the TSMP staff has learned a great deal about conducting mobile clinics. At the same time, many patients have received care. The staff felt that after nine months of outreaches in Kamuda, they were ready to try to serve another venue. Two of the four venues in Kamuda had been working very well. Two others were selected to be phased out: one wasn’t working, the other is close enough to the clinic for the people to come to the Soroti clinic now. At the same time, a terrible famine has been developing in Teso, with Amuria being one of the hardest hit districts. Many of the Soroti IDPs had been from Amuria, so that felt like a good fit for outreach. Where there is famine, there is disease. Since July 2009, TSMP has been lending a hand at the Acowa Health Centre Level III. We offer many services the centre does not and carry many medicines the centre never has.
The first two outreaches in July were attended by 184 people on the first day and 214 the second day. We have seen that the need in Amuria is great, and the people have responded very positively to the availability of our services. As in Kamuda, so many people show up for help, TSMP staff must conduct medical triage to ensure the people who are in greatest need see medical personnel.
Acowa Acowa
Patients waiting to be seen at outreach The need for health services in Acowa is great. There are just too many people for the small health clinic to support without TSMP's help.
Acowa Acowa
Nursing Assistant Aseno Esther talks to patients while they wait to be seen. The patients enter Acowa Health Centre Level III where TSMP staff wait to help them.