Below is a summary of what was seen and discussed by the team during the last very fruitful trip to Gulu in August.

Mama and Baby Packs
It was agreed some items would not be included in the packs but given direct to the clinic so the split is now:

Give to mothers:
Hand towel
Small soap
Sanitary towels (pack of 10)
Knitted baby top and hat
Baby vest
Baby blanket

Give to the clinic:
Razors (allow one per birth + a few spare)
Roll of black plastic sheet (currently allow one metre per birth)
Tea and sugar
Gloves (allow one pair per birth + spare)

Currently we are giving a pack of 10 razors to each mother but only one is required for the birth so
we can reduce costs if we give the packs to the clinic and they only use the razors as and when

We were including one pair of gloves in each pack but they were getting dirty so it was decided to
just supply the clinic with boxes of gloves.

Leonard said some mothers walk great distances to the clinic and may not have eaten, consequently they require an energy boost to help them give birth. A mug of sweet tea will help.
This was added to the ‘pack’ during the visit and we bought the clinic a kettle.
Leonard said one meter of black plastic should be increased as this is not enough. He said he cuts the roll of plastic into one metre lengths before giving the plastic to the clinic. The mothers take the cleaned plastic away with them to use for other things. Leonard noted that some months the clinic runs out of baby packs so we agreed to increase the supply from 30 to 35 per month starting from this month. He also noted that the government has added a third health worker to the clinic to help with the increasing demand – which has increased from around ten births per month  before the trial started.

Michelle said the trial has been going for nine months; a three month initial set-up / learning period and then six months at thirty packs per month.

Leonard pays for an additional seat on the bus for the pack items as they were arriving damaged or dirty when they were transported on the roof.

Leonard said he is currently waiting for instructions to start follow-up interviews with the mothers.

The Ugandan Catholic / Anglican (not sure which) church has contacted Michelle and is interested in introducing the packs in their eight clinics.

25:35 Feeding Project
The hospital is still employing two full time cooks and whilst they turn up to work each day, there is no food for them to cook! According to Harriett (our cook), the longest period this has continued is two years.

Having now seen where Harriett works and what she has to work with, it was not possible for Harriett to provide non-bottled water so we bought Harriett the equipment she needs so that
water could be provided from now on.

The water supply was off for several days and can be off for a week or more. We found water for Harriett and bought her two Jerry cans to add to the two she was borrowing – but we probably should buy more. Roger found water for Harriett and filled the four containers but this would not be sufficient to last one week.

Included in the items we bought are beakers for the patients to drink water out of. One cup probably does not meet a patient’s daily fluid intake needs so we need to devise a way for Harriett to provide more water (or ask Harriett to come up with a solution).

Some patients we met had already been in hospital for three months. If we are feeding patients for this length of time we need to be sure we are providing a well balanced diet. (The meals Paul witnessed where heavily weighted in favour of carbohydrates – are we sure we are providing enough fruit and vegetables?)

Sulai does not have much contact with Harriett. The doctors and nurses make Harriett aware of which patients need feeding. Harriett’s estimate is that there are usually around twenty to twenty
five patients that need feeding each day.

Harriett does a great job and is respected by the hospital staff and patients alike. She is passionate about her work and does it diligently.

Patient Interviews
Patient 1: Peter was injured in a motorcycle accident whilst at work. His colleagues took him to the hospital but he was working far away from home so he has no relatives to cook and care for
him. He loves Harriett’s food “I’d give it a big tick… its super!”.

Patient 2: Robert Olweny had been in hospital for three months when we met him. For the first month he had an attendant but his attendant had to return to work after one month so Robert
would have gone without food had it not been for Harriett, he said “Harriett has come to my rescue.”

Patient 3: We met a father in hospital with his three children. One of his children had been admitted but he had brought all three as his wife had died and there was no one to care for them back home whilst he cared for his son in hospital. Dr Kibwota G Adoka, who is treating the boy, said: it is a joint effort – food and medicine working together helps patients recover more quickly as the food helps to stabilise patients. He said many patients come from far away so they do not have an attendant to feed and care for them. NRO bridges the gap.
Mosquito Screens

Due to the lack of a reliable in-country champion, the funds expended to date, the progress made and the possibility of the wards being demolished, it was agreed that NRO would not fund this project any further for the time being. Funds would be directed to the projects that are currently working well and require ongoing funding to continue. For reference, the status of the project was as follows:

Surgical ward:
Male side – 0 / 21 fitted
Female side – 11 / 24 fitted
Medical ward:
Male side – 11 / 24 fitted + most beds have nets
Female side – 10 / 18 fitted + 6 nets
Infectious ward – 3 / 3 fitted + 0 nets
Small room – 0 / 1 fitted + 0 nets
Nurse’s room – 0 / 1 fitted + 0 nets
None of the main wards actually have screens on all windows.