Monthly Archives: September 2018

Specialized Surgical Interventions For Refugees

Men, women and children wait to be attended to under a tent at a health centre at the Kyangwali refugee settlement. These 54 men and women members of the host community and refugees living at the refugee settlement in Hoima District, Western Uganda.

With an estimated 1.3 million refugees seeking safety on its territory, Uganda is Africa’s largest refugee hosting country. Although refugees should have similar access to quality health care services to that of their host population, many cannot acquire them due to economic and geographical obstacles. Throughout 2017, Uganda received refugees from the Democratic Republic of Congo (DRC), Burundi and South Sudan. Women and children represent about 84% of the new arrivals.

To address this issue, Uganda country programme of Action Africa Help International (AAH-I) organized a 3-day (27th to 29th August 2018) surgical camp, which was implemented with the support of the UN Refugee Agency (UNHCR) and the Medical Training Initiative (MIT).


Patients at the surgical camp


“The initiative is an effort to bridge the gap in accessibility of specialized surgical interventions for displaced populations and the host community. We conducted an awareness campaign prior to the camp in all sectors of the settlement in order to identify sensitive cases and treat them accordingly. It is essential to bring specific health care services to vulnerable communities” says AAH Uganda Health Coordinator Wycliffe Matende. According to UNHCR, the need for curative medical care is greatest in the immediate aftermath of displacement.

There are currently 5 health centres set up across the Kyangwali settlement where refugees can access primary health care services. While basic health care needs are attended to on site, comprehensive interventions such as surgical operations are available at referral hospitals such as the Hoima Referral Hospital, situated at 85 km from the settlement.

“Despite the available medical facilities on site, the demand in health care services almost tripled with the significant influx of refugees and asylum seekers. We opened an operating theatre at the Kyangwali Health Centre on 28 March 2018 in order to better respond to the health issues and to decrease the number of referrals to the regional referral hospital. A total of 16 AAH-I and MTI personnel currently work at the theatre,” continues Wycliffe.

“We successfully carried out a total of 249 operations between March and September. 244 of the operations were performed on women, and most of the operations were caesarean sections. The establishment of the theatre was instrumental in the provision of health services to the community” says AAH Uganda Medical Officer Dr Gabriel Tubo.


Dr. Gabriel Tubo (second right) and his team performing an operation


AAH Uganda began operations in 1993, extending emergency health to over 80,000 refugees originating from South Sudan. Since then, its programmes have delivered services in 5 refugee settlements using an integrated, comprehensive community approach with the support of the local government and other development partners.


Equipping Graduates For Health Care Delivery

37 students taking Diplomas in Nursing and Midwifery graduated from the Maridi School of Nursing and Midwifery (MSNW) in Maridi County, South Sudan on 1 September 2018. The graduates (21 female and 16 male) have successfully completed the 3-year courses.

Maridi State Governor Hon. Africano Mande, alongside other State officials attended the graduation. Country Director of Action Africa Help International’s (AAH-I) South Sudan programme Stephen Lukudu and AAH-I South Sudan Board Chair Leonard Logo were also present.

“Today marks the first graduation ever commemorated at MSNW since its inception in 1992. We have stayed true to the course to ensure that we continue to support the government of South Sudan in adding the skill force in healthcare. Congratulations to all graduands on their remarkable achievement” said Stephen Lukudu. “The MSNW faculty was established to increase health human resource and therefore improve access to, use of and quality of health care services in South Sudan. I have no doubt that all graduates will fulfill this goal with dedication and professionalism”.

AAH-I South Sudan Country Director Stephen Lukudu at the event

 South Sudan has an estimated population of 12.34 million people. With 75% of its people not having access to health services, South Sudan has the world’s highest mortality rate. The country holds an under-5 mortality of 135 out of every 1000 births.

It is in this regard that AAH-I South Sudan is implementing three health projects focusing on the improvement of access and quality of health services in order to strengthen the country’s health systems. The projects pay particular attention to mothers, children and infrastructure development.

MSNW is funded by Bread for the World. To date, a total of 947 students have graduated from the school. The school’s current intake is 92 students for both Nursing and Midwifery programmes.

Midwifery granduand Deborah Nyibol expressed her heartfelt appreciation and motivation on behalf of her fellow colleagues “Maternal and infant mortality are one of the main health challenges that need to be addressed in South Sudan. We are all thankful to AAH for implementing in us the requisite skills that will enable us to combine forces in order to provide quality health care for our community”

Hon. Africano Mande extended his gratitude to AAH-I for its long service and devoted commitment to South Sudan.

The South Sudan country programme is the largest of AAH-I’s six country programmes implementing projects in basic services (health, education, water, sanitation and health), food and income security and humanitarian relief and recovery.

Improving Health Care Services With Sustainable Energy

Nearly 60 % of refrigerators used in health clinics in Africa have unreliable electricity, compromising the safe storage of vaccines and medicines. Half of them are destroyed due to lack of refrigeration.

These are the findings of an Atlas released by the United Nations Environment Programme (UNEP) in 2017.

“The lack of access to continuous electricity is frequent in this area of South Sudan impacts on health care services delivery. Many health facilities are forced to rely on diesel generators in order to obtain a few hours of daily power. Electricity shortages make it very difficult for referral health facilities like ours to attend to patients and handle delicate medical cases that may require surgical intervention” says Jackline Oyella, a nurse at the Ibba Primary Health Care Centre (PHCC) in Ibba County. Ibba PHCC is managed by the South Sudan programme of Action Africa Help International (AAH-I).

Due to inadequate access to primary and curative health services, South Sudan has one of the highest maternal and infant mortality rates in the world. In addition, over 30% of the country’s population does not have access to safe water supplies. Thus, one third of children under 5 suffer from diarrhea in South Sudan.

It is in this regard that the AAH-I has installed photovoltaic equipment for solar panels and water harvesting tanks in 25 health facilities in South Sudan’s central and western Equatoria regions. One of the facilities that benefitted from the installation include the Maridi State Hospital and the Ibba PHCC among others.

Solar panels and water harvesting tank installed at Ibba PHCC

“The electricity and water challenges we faced had a negative impact on our ability to attend to patients and the quality of our services. All our facility’s units are now functional and efficient. Our patient attendance capacity has significantly improved,” says Ibba PHCC Manager Alex Marona. “Thanks to the solar panels, we can uphold World Health Organization health standards through improving and sustaining our vaccine cold chain management. We are able to maintain vaccines quality even when transport them outside the facility for immunization campaigns.”

Alex articulating the benefits of the facility’s new source of electricity

A total of 8 water harvesting tanks were installed in order to address water scarcity, facilitate water collection and sustain basic sanitation and hygiene practices.

Although the project was implemented in 2015 with funding from Bread for the World, the benefits continue to be experienced by the communities we serve. This initiative was under AAH-I South Sudan’s regional primary health care project which aims to improve use, access and quality of health care services.


26 letters of the alphabet changing the course for women in Narok

Imagine not being able to read text messages on your mobile phone. Your children come home from school and at the end of the day you cannot supervise or correct their homework, or read their progress reports at the end of the term.

Yet this is the reality for a majority of women in some rural areas in Kenya. While efforts are being made globally to reduce literacy rates, data from the United Nations Educational, Scientific and Cultural Organization (UNESCO) indicates that at least 750 million youth and adults still cannot read and write, the majority of these being women in sub Saharan Africa. The low socio-economic status of women in the Maasai community in Kenya puts them in the vulnerable group of the population that is likely to have low literacy skills. This excludes them from fully participating in their families and communities.

By the age of 28, a majority of young people already have their professional goals well planned. Most have already completed their high school education. An even gradually growing number are way into their university education by the age of 28.

But this has not been the case for 28-year-old Nariku Kuyo from the Maasai community. Nariku first walked into a school classroom in 2017. Nariku, a mother of two, is the third wife in a polygamous marriage. “I was a housewife and solely depended on my husband to provide for me and my two children. But this was not practical because my husband also has to provide for my co-wives and their children. I asked my husband if could begin a business so that I could contribute to the family income. It took some time but he eventually gave me his blessing. He sold one sheep and gave me the capital to begin my business.”


AAH Kenya adult literacyNariku Kuyo at her stall on market day at Naikarra centre in Narok County


This is how Nariku’s journey to economic empowerment began. She and 337 other women in Narok West sub-County who graduated from an adult learners’ class run by Action Africa Help International (AAH-I) on 6 September 2018. These women embody this year’s theme ‘Literacy and Skills Development’ of the UN World Literacy Day marked globally every 8 September. These women successfully completed a 6-month training on numeracy and literacy skills for social and economic empowerment.

All the 337 women aged between 15 and 69 years went into a classroom for the first time in their lives in 2017. “This was a dream I held dearly. I can now hold a pencil and write some letters of the alphabet and some numbers. I have waited all my life for this,” says 69-year-old Naatana Karbolo. The basic, adult and continuing education classes are facilitated by AAH-I using the REFLECT methodology. REFLECT is a training technique that provides a space for a group of people to meet and discuss issues relevant to them. Participants choose the topics themselves, according to their own priorities and are supported by a facilitator. The technique uses a range of participatory methods. There are 20 REFLECT Circles in Narok West sub County.

62-year-old Noorkishili Ene Nchoe (centre) on her graduation on 6 September 2018. With AAH-I’s Training Officer Stephen Outa (L) and Community Mobilizer Amos Matirong (R)


The impact that literacy and numeracy skills is having on their lives and in the community is appreciated when you visit the Friday market day at Naikarra Centre. Most of the women from the REFLECT Circles have businesses at this market.

Watching Nariku selling her cereal stock on market day it is heartwarming. “I tried to do small businesses but it was difficult as I could not tell what was coming in and what was going out. I would have goods sent to me from Narok town to Olderkesi, but I was unable to identify my merchandise because I could not read my name,” she says. Her classmate, 45-year-old Nolari Ng’otiek, says she has now learnt marketing skills, including how to display her stock at the market and how to negotiate for better prices from suppliers.

For 26-year-old Noonkokwa Enole Karia, the classes have enabled her to better understand the grades and class positions that her four children have attained in school. “I am hoping that in future, I will be able to comfortably help my children do their homework,” says Noonkokwa.

“AAH-I is one of the organizations supporting the Narok County Government in championing the actualization of the Incheon Declaration and Framework for Action for the implementation of Sustainable Development Goal 4”, says AAH-I’s Executive Director Dr Caroline Kisia. AAH-I supports a commitment to ensure that all youth and adults, especially girls and women, achieve relevant and recognized functional literacy and numeracy proficiency levels and acquire life skills, and that they are provided with adult learning, education and training opportunities.

It is amazing just how the alphabet is changing the lives of these women.

MSNW receives medical book donation from BMA

The Maridi School of Nursing and Midwifery (MSNW) has received a donation of 90 medical books from the British Medical Association (BMA). The donation was received in July 2018.

The School is managed by the South Sudan country programme of Action Africa Help International, with funding support from Bread for the World. MSNW is part of the country programme’s health projects, designed to increase human resource in the health profession in South Sudan, in order to improve access and quality of health care services.

According to the World Health Organization (WHO), South Sudan has the world’s highest maternal mortality rate at over 2054 out of every 100 000 births. This is due to poor access to primary and curative health services, and to low demand for and awareness of preventive services.

The lack of access to basic health care services could be linked to an insufficient ratio of health practitioners to patients. Indeed, WHO statistics show that over 44% of WHO Member States do not meet the recommended 1:1000 (1 physician per 1000 population) ratio, with the African region having access to only 3% of global health workers. One of the targets of Sustainable Development Goal (SDG) 3 is to increase the recruitment, development, training and retention of the health workforce in developing countries.

It is in this regard that AAH South Sudan is training skilled nurses and midwives in order to improve the quality, access and delivery of basic health care services to the community. This complements Sustainable Development Goal (SDG) 4 of quality education and SDG3 of good health.

In 2017, 40 students were admitted at the School bringing to 120 the total student population. Maridi Hospital, managed by AAH-I, carried out 359 major and 725 minor successful operations in 2017, with the support of professionals currently enrolled or graduated from the School.

“Our trainees are overjoyed. Of course, it goes without saying that the faculty is also very pleased. The books will enable us to accomplish our ultimate goal – to support our learners in their development as qualified health professionals, ready for the job market.” says academic instructor, Asfaw Mekonen.

Nariek Chan, Midwifery student (Left) and Asfaw Mekonen (Right)

Many students embrace the value of reading but the expenses of purchasing reading materials is a significant hurdle. The donations will give learners access to a wider range of quality reading resources.

From left to right: Samuel Kwaji, Yeka Philip, Ciara Monika, Loice Kiden, Magi Josephine

MSNW will continue to collaborate with its partners in order to acquire supplementary equipment and library resources to provide its learners with the capacities required to become proficient health professionals.