Case Study

Uganda: rebuilding a community hospital for Comic Relief (UK)

"The local community has adopted the facility as their own and spends a lot of time maintaining and improving the hospital. Patient numbers increased by 500% following the opening of this much-needed facility." Ged Healy, Director of Special Projects, Iqarus.

Background

The village of Lyolwa, in one of the most remote areas of South East Uganda, contained the principal healthcare facility for 20,000 people living in remote village communities in and around the district. The clinic served 1,450 patients a month through a small outpatient department and maternity unit. Patients typically presented with TB, HIV and malaria, and the clinic was also responsible for treating trauma injuries. It was in an extremely bad state of disrepair with fears that vermin infestations would cause infectious diseases. Comic Relief, a major UK donor funding organisation, announced its intention to deliver a brand new, life-changing project on a scale never contemplated before by the organisation.

They proposed to completely redesign, rebuild and equip the dilapidated level 3 hospital clinic in Lyolwa in just five weeks. In October 2014, Iqarus was brought into the project by Comic Relief, to provide strategic advice, medical equipment, medical consultancy, training support and a complete rebuild of a level 3 medical clinic in Uganda.

Challenges

The existing hospital was below a functioning, clinical standard. The maternity unit was found in an incredibly poor state, and the clinicians were still expected to deal with routine, non-surgical deliveries, as well as running a limited post- natal service. The clinic had no running or clean water, no sterilisation equipment and no electrical power.

Water damaged ceilings were close to collapse, allowing the infestation of bats, presenting a risk of infectious diseases through the bat guano.

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The medical equipment was outdated with many critical items damaged or broken. Pregnant patients were forced to give birth under torchlight from the delivery nurses’ mobile phones. Patient numbers had declined over the preceding months as a result of the poor reputation of the facility; the community took much longer journeys to other hospitals in the region, or remained at home and received no treatment, rather than risk infection from a visit to the centre.

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Solutions

Iqarus took the two existing separate block buildings and converted them into a single pitched roof facility, greatly expanding the available floor space. The project aimed to provide the site with clean, running water, roof-mounted solar power and clinical waste removal.

While work was underway, Iqarus built and staffed a temporary clinic using prefabricated units and sent a number of professional medical trainers from the UK to train the clinical team on the new equipment and on advanced medical techniques in pre-hospital care. While addressing manpower and medical training, Iqarus offered technical solutions for water, power, sewage/waste, roofing, and equipment steriliseration. Iqarus engaged local workforces and regional supplies to support the project.

Outcome

The Iqarus team overcame the natural challenges of the project to deliver on time and under budget.

The result was the delivery of a healthcare solution, meeting international standards, in a remote part of East Africa. Since the hospital’s opening in March 2015, patient numbers have increased by 500%.

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The local community has adopted the clinic as their own and spends a lot of time maintaining and improving the site at their own expense. It has been deemed a success by all stakeholders and, particularly, the local community.

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