Bringing Hope & Health to Masooli, Uganda
Karen Damon-Callahan and Nancy Crouch
Jolly Lux introduced just Nancy Crouch, as at first Karen Damon-Callahan had trouble logging on and was delayed. The topic of their presentation is the medical clinic they helped establish in Masooli, Uganda. Nancy reported that in 2005 she and her husband traveled to Masooli, Uganda to see the health situation of the people first hand. The people there were suffering with Malaria and other preventable diseases. On their return to the US, they reported their observations to their church, which fully supported an effort to build a health clinic in Masooli. The now well established clinic currently has a staff of eleven, including a doctor and several nurses, and have done a great deal to treat Malaria and AIDS among the populace. The Ugandan government has been supportive and they treat 6000 people annually. The clinic needs a facility expansion for added childbirth related services, and they are seeking funds to do so. They deliver 20 children yearly now, but they could help a lot more people if they had more space and more equipment.
Despite having received needed health care at the clinic, people must subsequently return to their villages, which generally do not have running water. This is a serious hazard for waterborne disease transmission, due to the unsanitary water sources, such as a nearby river, they are forced to use. We hope to eventually provide them with a well or other system ensuring safe water. Jolly has taught the clinic leaders how to use local people as community workers in the clinic and in performing its operations. This is also important to help the local people develop faith and confidence in the clinic itself, and the community workers they employ.
After just a few minutes, Karen Damon-Callahan successfully joined the video conference, and shared a slide presentation about Masooli Uganda, and the clinic they established there.
Karen is a former accountant, nurse and director of global health at Connecticut Children's Medical Center. That is where she got her start in global health work, first in Cameroon while still a student, and later in Uganda. The Ugandan clinic is called the Faith Mulira clinic, named after a local woman who escaped the Amin regime and returned later to assist the people. The clinic is designated as a Level 3 center, providing 20 -30 deliveries yearly, well care and family planning. The clinic includes exam rooms, an obstetrical area, a pharmacy and a laboratory.
The first important emphasis of today's presentation is the clinic's work to assure access to clean water for the populace. WHO has declared access to clean water a human right.
Fecal contamination of water is the primary issue, as the use of the river as a latrine upstream, leads to disease in those accessing drinking and cooking water downstream. Diarrheal diseases caused by such organisms as Giardia lamblia or intestinalis, Entamoeba histolytica and Cryptosporidium lead to much morbidity and mortality, particularly among children and the elderly.
Clean water access methods include harvesting rainwater, digging wells or by water treatment methods including solar, chlorine tablets and flocculents, which sediment contaminants. Filtration by slow sand filtration is another method that Karen is very experienced with and hopes to implement in Masooli.
The clinic itself uses a rainwater catchment system. Most homes catch rainwater in buckets, but without any filtration.
The sand filtration system was the subject of Karen's master's thesis. It's effective because it can be built with locally available resources. Sand and gravel for concrete and copper tubing are required and locally available. The top layer is the "bio-layer" which catches the eggs of waterborne parasites, and then the water filters downward where it becomes continuously purified.
The second important aspect of emphasis in today's presentation is the establishment of a community health initiative in Masooli, in which caregivers travel to those with chronic conditions who are unable to travel.
The overall health system in Uganda is structured under the National Ministry of Health. Village Health Teams, the active arm of the community health initiative, are considered "Level 1" and are closest to local people within their communities.
Village Health Team members go out into their community to identify those in need.
Pneumonia is just one of several serious health risks for young children in Uganda. Dental care is also a pressing need.
The third important aspect of emphasis in today's presentation is a desired expansion of the existing clinic's infrastructure. They have the land, but not the funds, to make the necessary expansion and improvements.
The existing space is too small and inadequately equipped for the need. They seek funding to expand their infrastructure.
The desired improvements will assist in preventing many postpartum and neonatal deaths.
Q: Larry Sullivan asked how long the sand filtration systems last before needing replacement or rebuilding. A: Karen reported they can last 30 years if properly maintained by stirring the biolayer regularly. They do not have these sand filters in Masooli yet, but they have been successful in Bawa, Cameroon, where Karen worked previously. They cost approximately $200 each to build and Masooli needs about 200 of them to serve everyone individually, but in the beginning they could make a good start with just 10, providing one within each compound.
