Real Medicine Foundation Healthcare Implementing Partner for UNHCR at Kiryandongo Refugee Settlement in Uganda Project Summary Project Title; Primary Health Care support to South Sudan refugees and Asylum Seekers residing in Kiryandongo Refugee Settlement Project Objectives; 1. Health status of the population improved 2. Population has optimal access to reproductive health and HIV services 3. Operations management, coordination and support strengthened and optimized Supported Health Units; 1. Panyadoli Health Center III 2. Panyadoli Hills Health Center II 3. Reception Center Clinic 4. Nyakadot Health Center II Project Overview In July 2014, RMF signed a tripartite agreement with UNHCR and the Government of Uganda to implement a health project aimed at addressing two goals of emergency operations and care and maintenance of 24,722 (20,269 new caseload and 4,453 old caseload) refugees and asylum seekers in Kiryandongo Refugee Settlement through provision of quality, accessible and sustainable health care services. However, the project has since then grown to benefit 43,615 refugees, according to the August 2015 Refugee Statistics from the Office of the Prime Minister. This signals a 43% beneficiary increase, it is also recorded that over 20,000 Uganda nationals living within the vicinity of the settlement continue to benefit from the Health Project as a result of quality health services provided. The refugee population increase has been mainly attributed to the precarious security situation in South Sudan which has resulted in a continuous inflow of refugees to Uganda. On average 100 asylum-seekers/refugees are received every day in Kiryandongo Refugee Settlement from South Sudan. The Office of the Prime Minister has indicated that Kiryandongo Refugee Settlement has not reached its maximum carrying capacity and can still accommodate more families, its
agricultural richness, easy access to the capital city Kampala and the Central Business Region in Uganda makes this Settlement very attractive for many South Sudanese Refugees that seek asylum in Uganda. It is therefore evident that basic and lifesaving services like health will continue to be overstretched by the ever increasing Refugee Populations. Health Services in Kiryandongo Refugee Settlement are delivered to the Refugees through established Health Centers namely: Panyadoli Health Centre III, Panyadoli Hills Health Centre II, Nyakadot Health Center II, and the Reception Centre Clinic, and enhanced by outreach for communities with limited access to the existing health units or located over 5 km from the health facility as per the Ministry of Health access standard. The health care services were in critical shape by the time Real Medicine Foundation signed the tripartite agreement with UNHCR and the Office of the Prime Minister, since this was the time the influx of the South Sudanese was still at the climax. Challenges were ranging from inadequate staffing, shortage of drugs, poor referral system characterized by both lack of an ambulance and the community structures, poor infrastructure, low demand for health services by the population and absence of a coherent disease surveillance strategy. Additional support from RMF assisted in addressing the highlighted gaps. Generally the health care service indicators were far below standards. Hence, along the contingent of three objectives implemented by RMF all the indicators have been improved. However, with the ever increasing population, it is evident that pressure is being exerted on the existing health services. In order to sustain results, RMF continues to conduct needs assessments to ascertain the arising needs in order to inform its planning. Project Progress Objective 1 Health status of the population improved Health workers including the clinical officers, medical doctor, laboratory technicians, nurses, midwives, data clerks, laboratory assistants, pharmacists, counselors with support staff like guards, cleaners, drivers and interpreters have been recruited to enhance access to health services. Objective 2 Access to reproductive health and HIV/AIDS services insufficient or needs constant attention Children < 5 and pregnant mothers receive regular vaccinations, routine antenatal care including foliate and iron supplementation, and preventive treatment for malaria. Objective 3 Operations management and coordination insufficient or needs constant attention Over 80% staffing norm has been met for the requirements for general project management.
School children receive regular preventive health education, deworming, and Vitamin A supplementation through school-based health program. 100% of the target population has easy access to quality curative services and treatment in three health units. All health workers have benefited from tailor made continuous medical training and support supervision programmes. Enhanced Preventive and Community Based Health Care Services with recruitment of 30 community health workers and 01 community health assistant. Disease surveillance for AFP, Measles, Hep B + E, Rabies, Viral Hemorrhagic Diseases, Neonatal Tetanus and introduced Human Papilloma Virus Vaccine (HPV) for girls 9-13 years of age to prevent against Cervical Cancer at Reception Center and all other health units. General management of health activities at Reception Center with services like ANC, OPD, vaccinations and screening for diseases of epidemic nature and developed an epidemic contingency plan; developed and regularly updated. Procurement of supplementary drugs to Panyadoli Health Center III on a quarterly basis. Communities including primary school students >12 years and teachers have benefited from HIV/AIDS awareness campaigns and HCT services. Production and distribution of IEC materials based on Ministry of Health (MOH) standards to health facilities, schools and communities. Functional maternity services in the three Health Units, Antenatal Care, Delivery Care, Post Natal Care, Family Planning, Sexually Transmitted Disease Management. Effective and timely referrals for ANC, PNC and maternity services - pregnancy mapping by Community Health Promoters, training and fuel for ambulance. Community Health Promoters, the Replica of the VHT strategy, are facilitated to carry out home visits, health talks and community referrals for mothers. Mentorships by District Health Teams (DHTs) to the midwives in especially Management of Obstructed Labor and Active Management of Labor by use of partograph, retained placenta, PPH, asphyxia and cord prolapse, prompt referral, insertion and removal of implants. Logistics and supplies for programme management have been provided and all programme mechanisms are functioning well. Being the main health implementing partner, RMF takes the lead in organizing health sector bi-weekly meetings involving all other health partners.
Project Photos Children participating during World Refugee Day 2015 at Kiryandongo Refugee Settlement
RMF Laboratory team at Panyadoli Health Center III
The Kenyan Returnees Convoy enroute to Kenya, the RMF Ambulance and Medical Team provided medical services up to Malaba Reception Center, Kenya
RMF staff at maternity wing giving antenatal care
RMF nurse in children s ward
Outreach programme, RMF immunizing children, adult HIV testing, etc in communities
Outreach programme, RMF immunizing children, adult HIV testing, etc in communities