A week ago IDI sent me to rural Western Uganda to provide support and supervision for monitoring and evaluation (M&E) and data officers. We visited four hospitals which were receiving HIV funding from USAID and the Inter-religious Council of Uganda (IRCU). Each of these facilities had sent several staff to IDI for Data and M&E training in July, so our goal was to assess if the staff were putting into effect their newly learned analytical, logical, and organizational skills.
Our first stop was an Kisiizi Anglican Hospital deep in the hills of the southwestern region of Uganda. We traveled almost 2 hours off the paved road through breathtaking sharp green hills/small mountains past barefoot women digging in small farm plots and men making bricks from the red clay. We finally arrived at Kisiizi Hospital – an amazing huge complex bustling with almost 300 staff and countless patients lining up for HIV testing, pharmaceuticals, baby check-ups, and other care. This is where I met Kevin, the Kisiizi M&E Officer. He was sitting in the very small cramped Kisiizi records room which had papers (medical records) stacked from the floor to the ceiling along each wall and one very dusty desktop. Despite the appalling records management system, Kevin had some good computer and Excel skills, and had created some innovative spreadsheets to track patients. After our supervision session, Kevin took us behind the hospital to see the Kisiizi waterfall and then the hospital’s hydropower plant which takes some water from the top of the waterfall to power the entire hospital. Incredible. While all of us in modern Kampala lose power almost every other night, this isolated place never loses power.
From there we visited Ishaka 7th Day Adventist Hopsital – which was started by, and still directed by, missionary doctors from the Philippines. After our training, this hospital staff had done some problem analysis and realized that despite the hospital’s best efforts, some women were not being tested for HIV before it was too late, and the hospital staff was unable to stop mother-to-child transmission at delivery. So the staff decided to allocate HIV testing slots for pregnant mothers each day, and to reduce the amount of time pregnant women had to wait before their HIV testing. This streamlined process meant that fewer rural pregnant women were leaving the hospital untested. Once again, so much ingenuity with so few resources.
Our last two hospitals were a disorganized Muslim facility in Lyantonde and a very well-run Catholic HIV clinic back in Kampala, photos below. Overall the trip was eye-opening and taught me a lot about the lack of resources facing the clinicians that I teach at IDI. Not to mention the 17 bed bug bites I got all over my back and legs, and the cow intestines I had to eat for breakfast one morning. On the other hand, I was greatly encouraged by the good work I saw being done by very dedicated people, usually earning around $30 – $80 U.S. dollars per month for their tireless efforts.