from All Africa
The Monitor (Kampala)
By Eva Mashoo
Sarah did not have what to eat or a job but her health condition was disturbing. She was suffering from tuberculosis (TB) and malaria yet she didn't have a coin to pay her overwhelming medical bills.
One day a friend took her to Hope Clinic and she testifies how the clinic restored her hope.
Before, she used to get medication at Mulago Hospital where often she stood in a snake-like queue that didn't favour her failing health.
Everyone, especially the poor, hope for free medical services in government hospitals. However, this is no longer possible since the collapse of the cost sharing scheme which allowed for citizens to receive free consultation but paid for the medicine.
Seated outside Hope Clinic, Sarah wore a smiling face as she narrated her experience. And she was not alone in pouring her gratefulness to Hope Clinic for being there for her and ensuring her health was in safe hands.
A single parent of two daughters and a son explained how all her relatives refused to offer her financial support leaving her to die.
"Relatives asked me to deal with my problematic disease. But my small-shop business had made a nose dive," she recalled.
"Here medicine is free for people like me. For those who have better income, they get them at an affordable price,"Sarah chipped in.
She said that the government should work-out some programmes for the HIV positive people such that they can be able to earn a living, look after their children and get something to eat since the medication requires one to have a balanced meal.
The government's failure to provide medical services especially for the poor deemed it necessary for the formation of clinics like Hope.
Located 5km south of Kampala in Lukuli Parish, Makindye division, Hope Clinic serves Lukuli, Nsambya, Kansanga, Kizungu, Konge, Bunga, Ggaba and surrounding parishes.
In the 2003 count, Makindye division registered a population of 299,000, including 50,000 within 2km of the clinic (12,000 within Lukuli parish). This community is hit by poverty, low literacy level of 20 percent against a national average of 54 percent and the population has increased by about 50 percent since the last census.
The majority of its patients are small scale farmers, sole traders and families that come to Kampala for employment, even fishermen and fisherwomen from neighbouring islands.
"The clinic targets the lower income households in the community and based on our patient records, 60 percent of our clients are female and 40 percent are children under 5 years," said Philip Mitchell, a co-founder of Hope Clinic, Lukuli.
He added, "We particularly cater for women in their own right as mothers and caretakers of children and are independent of any organisation which could limit our access to the community and yet coordinate our work with the Joint Clinical Research Institute (JCRC) to treat mosquito nets, Kampala City Council (KCC) for child immunisation vaccines and the Ministry of Health for voluntary counselling and testing (VCT)."
Since its initiation in 2000, the clinic has recorded 33 percent increase of patient inflow, which necessitated the staff increase up to 22 that includes counsellors and paramedics. Today, it attends to 50 antenatal cases, 15-20 babies and tests over 100 people for HIV.
"We are now attending to over 600 patients through our out-patient department. Last year, that number stood at 450. This increase reflects the trust that the community has in us and the quality services offered," said Mitchell.
In March 2006, it became the first quasi-governmental source of anti retro viral drugs (ARVs) after accreditation by the Ministry of Health. Late that year, it began a fortnightly clinic for people living with HIV/Aids in cooperation with the Joint Clinical Research Centre (JCRC).
Dr Timothy Musila, from the Kampala City Council health department said Hope Clinic operates as an NGO whose aim is mainly a philanthropic cause. It provides community health services to several groups of people as well as individuals. The clinic has worked closely with KCC and is involved in a number of co-coordination services and programmes with the government.
However, the biggest obstacle they are facing is the huge demand for services with inadequate supplies. Dr Musila said that the government is trying to increase support through the primary healthcare subsidy.
It is also growing greatly due to coordination and partnership with agencies like Global fund, PEPFAR, and Usaid. They hope they are given more assistance such that the low income earners can be able to access medication.
Hope Clinic which is equated to Health Centre III grade by Ugandan standards was started by Mitchell, his wife and six Ugandan friends living in Lukuli who wanted to bring their non-medical skills together to assist a dedicated midwife who worked with minimal drugs and equipment to treat childhood illnesses, especially fevers and dehydration.
Mitchell said that the clinic has grown from a small entity to a big one.
"We have 300 square metres structure which translates to three wards, a lab and four consultation rooms," Mitchell added. "We spent $30,000, all from savings from one of the founders, grants and donations, and discounts from Ugandan companies as well international organisations."
"We are a financially self-sustaining health unit. The out-patients department and maternity services provide revenue which is entirely used to pay the salaries of the medical and support staff. None goes to the founders/ owners/ directors."
Hope Clinic only charges Shs1,000 for consultations, most lab tests cost under Shs5,000 and admissions are Shs2,000. The clinic also offers medical services at a reasonable cost, but is free to those who cannot afford it.
The clinic is supported through organisations which operate in the area, notable among them being Aggreko Plc. and the government of Uganda, that provides malarial and anti retroviral drugs.
As Hope Clinic serves the community, Mitchell calls for continued partnerships and coordination with government and donors to enable the management meet the growing demand for the services.
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