What we hope to do

Butta Community Health Centre

We are raising funds to complete the building of a small community owned Health Centre next to the completed school, with treatment rooms and a number of ward-type beds. The government would staff it and provide medicines. At December 2023 the Health Centre is nearly finished, but needs some additional funds to complete.

When complete, the school could take advantage of the Health Centre to monitor their pupils' health and, of course, it would be advantageous to the wider community as they have no clinic or health centre near them at present. One group that would benefit would be women and children with the provision of accessible midwifery.

Access to healthcare in Uganda is similar to that for education, with, according to one study (Dowhaniuk2021) the percentage of Ugandans within a one-hour walking distance of the nearest health centre being 71.73%, with the biggest limitation to access being a lack of transport especially for poorer residents. This lack of care has been highlighted recently with the Covid pandemic, and other highly infectious diseases and non-communicable diseases such as cancer which require support due to their long timescales.

Outside of the new health centre

In early summer 2022 Friends Community Development Trust (Uganda) was asked by our colleagues in Uganda to if we would support their project to build a health centre in Butta. Since we are supporters of their ideas, rather than being proposers of them and research showed that a health centre was needed, we agreed to help.

Over 50% of healthcare facilities in Uganda are in or around Kampala while rural areas are poorly served. In Manafwa District there are ten local health centres for a population of 175,079, that is 17,506 people per healthcare facility. Compare that with the average number of patients each GP in the UK is responsible for which now stands at 2,248. In the Butta area between 67% and 83% of households are more than 5km from a health centre and, in a country where the rural population often have no transport apart from walking, this is an added disincentive to seeking medical help (data from the British Medical Association (BMA), Manafwa District Local Government and Uganda Bureau of Statistics, 2017).

According to UNICEF, the top three medical issues in the Manafwa area are malaria, chest infections, and intestinal worms, issues that can be treated at a local community health centre. Malaria also leads to child mortality as young children are especially susceptible to the disease and, in 2019, 67% of malaria cases in Uganda affected children younger than 5 years. Chest infections such as pneumonia affect both adults and children however, when looking at child mortality statistics, roughly 16% of child mortality in Uganda is caused by pneumonia. As the World Health Organisation (WHO) website says about childhood pneumonia, “most cases of pneumonia require oral antibiotics, which are often prescribed at a health centre”. Intestinal worms are found in many parts of Uganda and cause as high as 9% morbidity in children below five years old (African Health Sciences Journal), an outcome avoided by taking a single dose of a medication called mebendazole to kill the worms. Finally, diarrhoea causes 10% of infant deaths in Uganda and diarrhoea can be treated with an oral rehydration solution (ORS) at health centres.

inside of the new health centre

The First Lady of Uganda, the Hon Janet Museveni, in a speech recorded on the WHO website, emphasized that no woman should needlessly die in Uganda due to maternal and child birth complications and recommended all women to always deliver their children in health facilities under the supervision of skilled health workers. She also asked Ugandans for effective action and impact at village community level as that is where the bulk of maternal and neonatal deaths occur. Statistics from UNICEF, WHO and the UK's Office for National Statistics show that the maternal mortality ratio in Uganda is 343 deaths per 100,000 while in the UK it is 8.79 per 100,000; the under-five mortality rate in Uganda is 42.1 deaths per 1,000 live births while in the UK it is 4.06 per 1,000 live births. Other postnatal and childhood health statistics for Uganda are also poor compared with world statistics. All this is evidence to us that a healthcare facility is badly needed.

The health centre that our colleagues propose to build with Friends Community Development Trust (Uganda) financial support will adhere to Janet Museveni's hopes for local health care and will emphasize Quaker support for services supporting the whole community regardless of gender, ethnicity or religion. The building we are raising funds for will contain a lab to test bloods, room for 8 beds and a small consulting room for a doctor. We have confirmation that the government of Uganda will provide trained medical personnel for the Health Centre once it's built. The health centre will be modest by European standards but a quantum leap for the Butta community.

Our colleagues in Uganda are aware of the need to provide good financial control on projects and so all materials required are bought in small quantities, delivered to the site where they are needed and used immediately. Local skills and trades are also sought. The bricks that are needed in the building work are made by young people in the village who are trained in the method and techniques required. The raw materials for the bricks are dug from local land hired for this purpose and the bricks are fired using timber from local trees. This raises environmental issues and so special attention is paid to minimise the impact on the local environment. The hole left by the digging of the earth for the bricks is filled with manure and green plant waste such as banana leaves to create, over time, a rich soil. For every tree cut down to fire the bricks ten new ones are planted, all local species.