Uganda is a small, landlocked East African nation that is home to 30 million people. Their life expectancy is a mere 49 years and nearly 14 of every 100 children born do not live to see their 5th birthday. Access to basic health care is lacking - less than half the country has access to safe drinking water, half the nation's children are stunted due to long-standing malnutrition, and HIV/AIDS continues to kill over 100,000 people per year, with over 1 million people infected. The greatest cause of morbidity and mortality remains malaria, infecting 12 million Ugandans and killing 8,500 young children, immunosuppressed people and pregnant women each year.
When the first group of Hands of Help volunteers arrived in Bufuula in 2005 to rebuild the local Primary School, a hut-to-hut survey was conducted to gain a glimpse at the economic indicators of the community and to understand the main health issues that impacted their day-to-day life, and extensive meetings were held with local Village Council members. It is from this initial research that the Hands of Help Community Health Project was born.
The Community Health Project aims to educate and build capacity of Ugandans to educate them to take charge of their own health care. This is achieved through the employment of local clinical officers who then oversee the training of dozens of Community Health Workers, who are selected by their own community. These health workers are not paid a salary, but are instead rewarded under an incentive program and see their knowledge as a gift (rather than their job) which they are enthusiastic about spreading. After a five-month training program, the health workers are put in charge of educating and informing their communities in topics including malaria, HIV/AIDS, respiratory illnesses, malnutrition, family planning and water sanitation. These education sessions are complemented by access to interventions such as insecticide treated nets to combat malaria, water sanitation sachets to purify drinking water, and HIV testing with the AIDS Support Organisation. Therefore, the two arms of the CHP are education and intervention, which are coupled together to empower Ugandans to take charge of the basic health care issues in their own communities. The Community Health Project is therefore run by Ugandans and for Ugandans.
The evidence for community-based health projects in the developing world is widespread. The recent UNICEF report - "The State of the World's Children 2008' - states that:
We know that lives can be saved when children have access to community-based health services, backed by a strong referral system. The focus must be on delivering key interventions at the community level, as part of integrated efforts to support the establishment of stronger national health systems. And particular attention must be paid to the special needs of women, of mothers and of newborn children.
The CHP is consistently evaluated through baseline and follow-up surveys, and the data collected is analysed to ensure we are continually implementing a project which is appropriate for each town we work in. It is also compared with the most current literature in the field to access its efficacy. Furthermore, Hands of Help partners with local organisation's such as The International Medical Group, The AIDS Support Organisation, and The AIDS Information Centre to gain their local knowledge, create synergistic partnerships and to ensure the project is run efficiently.
Since its inception in 2006, 13 villages in the Jinja District (in the parishes of Kibibi, Buwagi, Namisi, and Nawangoma) have had the CHP implemented which has involved the training of over 150 community health workers in the five-month health education program. Over 1,000 heavily subsidised insecticide-treated mosquito nets have been distributed to thee villages, with super-targeting strategies implemented to reach pregnant women, young children and vulnerable families. In January 2008, a one month intensive program was held in Wanseko VIllage, Northern Uganda which included the distribution of 500 nets and HIV testing (alongside the re-building of Wanseko Primary School by Hands of Help volunteers). To date over 500 HIV tests have been conducted with locally-trained counsellors and HIV-positive individuals referred to The AIDS Support Organisation for follow-up.
In 2008, 5 more villages in Jinja district will select health workers to undergo training in the CHP program, which will have completed the CHP roll-out in the district so that the project will therefore be reaching 50,000 Ugandans with a grassroots health care system. Education and interventions will continue in all trained villages, expanding the distribution of mosquito nets, condoms, HIV testing and sanitation interventions (including specific sanitation competition to be trailed in the first six months of 2008)
The Lira district of Northern Uganda is home to over 700,000 people who have spent the last 20 years under a constant state of insurgency due to the activity of the Lord's Resistance Army (LRA), which saw 44% of the population living in IDP camps. Health statistics in this region are hence amongst the most deplorable in Uganda and soaring rates of HIV infection are not being addressed due to a lack of resources to do so.
Hands of Help are excited to announce their joint venture in 2008 with The International Medical Group Uganda to provide a home-based HIV program in Lira. This project will expand free HIV testing in Lira, and follow-up all HIV-positive individuals with the appropriate laboratory tests required as well as providing access to the life-saving antiretroviral medications (ARVs), which can so easily and effectively change a person's life. The ARVs will be distributed via a closely monitored home-based care program which will ensure excellent compliance and follow-up among individuals in the program. The program aims to replicate the success of the Reach Out model of community health care of HIV individuals (www.reachoutmbuya.com). The project is named 'The ALDO Project' in honour of an HIV patient who died at the clinic in Lira while Hands of Help volunteers were implementing this project in December 2007, due to a lack of access to life-saving antiretroviral medication.
The Hands of Help Community Health Project is an intensive project which requires an extensive number of hours of involvement for its implementation by volunteers in Australia. It also requires a significant amount of funds to continue to distribute heavily-subsidised insecticide treated mosquito nets, condoms, HIV testing kits, incentives to community-based health workers, and laboratory testing and antiretroviral medication as part of the 2008 HIV program to be run in Lira.
Donations to ensure the CHP can continue to be implemented in more Ugandan villages are gratefully welcomed, and Hands of Help is also seeking the sponsorship of a full-time employee to assist in the operation of this program and ensure its sustainability, as many of its currents volunteers will soon graduate to become Doctors.
Please contact any of the members of Hands of Help below for more information of donate now
Founder - Phoebe Williams
President - Sarah Lally
Vice President & CHP Manager - Joe Dusseldorp