HEALTH CENTERS IN KASESE DISTRICT GET WASH KITS

Promoting sanitation and hygiene in the 89 health facilities of Kasese district:

Published by; Geoffrey B. WASH Program officer KALI. 

  District Medical officer of Kasese and Sub county  leaders after meeting with minister of Defence Dr. C.Kiyonga on issues of Sanitation & Nutritional improvement in kasese district at Bwera Trs College.

 KALI in partnership with Kasese district local government with funding from CDC Atlanta through UVRI has been implementing a two month project on promoting Sanitation and hygiene at health facilities in Kasese district. This involved supporting the health facilities by installing hand washing and drinking water stations, training health workers in general sanitation and hygiene, and motivating health workers to use the water stations as platforms to teach their patients about the importance of water treatment, hygiene, and sanitation. These interventions also included; engaging with Health Unit Management Committees to assure a self-sustaining program.

The health facilities have acted as demonstration for good San&Hygiene to the community members who come for treatment. It is believed that after practicing hand washing and taking clean water at the health facility, community members will continue practicing the same in their homes.

The project aimed at creating demand for water treatment and hygiene and increasing access to hand washing and drinking water facilities as well as engagement with the Health Unit Management Committee (HUMC), sub county and district leadership

Hospitals, HC IV, HC.III and HC II in Kasese well given due attention during this project.

Activities Conducted:

1.      Conducted meetings with health workers at health unit level

2.      Conducted meetings with sub county leaders on their roles and purpose of the project

3.      Conducted meeting with District leaders on the distribution plan,

 Notes/Findings:

        I.            It was found out that most health units do not have access to water and those which had lacked constant supply at their facilities and this was affecting sanitation and hygiene at large.

      II.            It was found out that out of the 32 units visited; only Kasanga PHC had functional hand washing facility near latrine with soap fully an utilized.

    III.            Most of the units Visited had hand washing facilities only in the medical rooms but not near latrine.

    IV.            Some of the health units Visited had latrines not meeting sanitation conditions. Some of them had open defecation on and around their latrines.

      V.           

    VI.            It was also found out that water treatment was also not given attention at health unit level. Workers agreed that they thought tap water is always treated at the source, therefore safe.

  VII.            All sub county leaders appreciated the project innovation of improving sanitation at health unit level. Sub county chiefs and LC.iii C/persons pledged for total support at the time of implementation.

1.      Conducted leaders meeting with LC III C/persons of Bukonzo west constituency,DHO’s team, LC.V District CDO, Medical officers from; Hospitals of; Kilembe, Bwera,Kagando including Kasanga HSD,Rwensande HSD,Hima Cement H/C IV.

This meeting was on request of the minister to help mobilize the district stakeholders on sanitation and hygiene promotion as well as come up with action issues especially for those sub counties/households without latrines. The meeting was build on the background ensuring health centers work as centers of excellence in sanitation and hygiene which would roll down to communities through of eradicating cholera and typhoid.

           

 Result on training/meeting:

The sub county leaders who attended the meeting have affirmatively started monitoring Sanitation in their sub counties and arresting those without. New latrines have been built in Bwera and Nyakiyumbu Sub counties.

  

2.      Project launch with the MP Bukonzo West and Minister of defence Dr.C.Kiyonga with the entire public at Mpondwe Primary school. This launch aimed at mobilizing the entire Bukonzo west and the entire district of Kasese. It was attended by district leaders, Bukonzo west constituency leaders, VHTs and the community of Mpondwe Lhubiriha T/C.

3.      Distribution of the hand washing, Drinking containers and aqua safe.

4.      Training of Health workers on Hand washing, water treatment and the approaches to CLTS. This was facilitated by the District Health Inspector and Health Educator Kasese.

The training of Health workers:

1.        

 
Training health workers on water treatment.

Opening Remarks with a pre-test managed by Facilitators

2.       Presentation from DHI on the different types of water treatment, safe water chain and the effects of Cholera and typhoid to the communities.

3.       Presentation on Sanitation related disease & how they can be prevented with emphasis on hand washing at critical times

4.       Practical Illustration of water purification using Pure.

5.       Closure remarks by District Health Inspector-Kasese

The meeting started with introductions and participants expectation of the meeting as well as pre-test which was a good start. Participants were the district health officials including, health workers from Health Centers II, III, IV and Hospitals from Bukonzo East, Busongora North and South then Kasese Municipality.  Results obtained were as follows;

S/no	Range	No. of participants
1	100	2
2	90-99	04
3	80-90	24
4	70-80	27
5	60-70	10
6	50-60	4

The table above shows that none of the 71 participants was below 50%.

 The above results shows a picture of an average understanding of sanitation and hygiene issues by majority of the health workers, “ safe water chain and hand washing practices

However, the results indicated that there was still more needed to learn on water treatment methodologies and public sanitation & Hygiene facility management.

ATTENDANCE;

Practical Illustration on water treatment.

 

He talked about community led total sanitation, CLTS which involves all stakeholders to be conscious and take action on WASH.

An experiment of water purification was done which triggered their minds and emphasis on promoting WASH at their health centers which was evidenced by their confessions

ACHIEVEMENTS OF THE TRAINING

·         The health workers were able to understand much more the concept of WASH and use of Hand washing and safe drinking water chain

·         The training triggered participants on taking immediate action, sensitisation on treating drinking water to make it safe and adoption of hand washing as evidenced in their expressions and confessions during the water purification illustrations.

·         Willingness of Health workers to go sensitize and adapt to the best practice of hand washing and drinking water treatment at their health Facilities.

·         The participants promised to share the information received, conduct sensitization sessions at their health units as well as passing the information to the VHTs for more health talks to the patients.

·         All participants agreed to be champions of water treatment at their health facilities.

The distributions Made

 

S/n	Name of Health Unit served	Sub county	Grade
1	Kasanga PHC	MLTC	IV
2	Kamasasa	Karambi	II
3	Karambi H/C	Karambi	III
4	Kisolholho	Karambi	II
5	Bikunya	Karambi	II
6	Mushenene	Nyakiyumbu	III
7	Ihandiro	Ihandiro	III
8	Bubotyo	Ihandiro	II
9	Kikyo	Ihandiro	II
10	Buhunga Muyagha	Ihandiro	II
11	Kitholhu	Kitholhu	III
12	Kanyatsi	Kitholhu	II
13	Kiraro	Kitholhu	II
14	Kyampara	Isango	II
15	Kamukumbi	Isango	II
16	Katholhu	Nyakiyumbu	II
17	Kayanzi	Nyakiyumbu	II
18	Kinyamaseke	Munkunyu	III
19	Buhaghura	Rukoki	II
20	Kiburara	Kisinga	II
21	Nyabirongo	Kisinga	III
22	Kabirizi Upper	Kyarumba	II
23	Kyarumba	Kyarumba	III
24	Kyarumba PHC	Kyarumbu	III
25	Kabirizi Lower	L.Katwe	II
26	Kahokya	L.Katwe	II
27	Kitabu ST. Francis Martinet	Kyarumbu	III
28	Hamukunku	L.Katwe	II
29	Katwe	Katwe Kabatooro T/C	III
30	Mweya	L.Katwe	II
31	Katunguru	L.Katwe	II
32	Kasenyi	L.Katwe	II
33	Kasese Municipal	Nyamwamba Div.	III
34	Rukoki	Nyamwamba Div.	III
35	Bughalitsa	Rukoki	II
36	Kilembe Mines Hospital	Bulembya Div.	Hosp.
37	Kilembe H/C	Bulembya Div.	II
38	Kirembe	Central Div.	II
39	Nyakabingo	Rukoki	II
40	Mubuki Irrigation	Rukoki	II
41	Katooke	Bughoye	II
42	Nyangorongo	Bughoye	II
43	Bughoye	Bughoye	II
44	Maghoma	Bughoye	II
45	Maliba H/C	Maliba	III
46	Isule H/C	Maliba	III
47	Mukathi	Maliba	III
48	Muhokya	Muhokya	III
49	Kahendero H/C	Muhokya	II
50	Kasese Police station	Central Div	II
51	Katadoba UMSC  H/C	Central Div	III
52	Railway H/C	Central Div.	II
53	Bishop Masereka H/C	Central	III
54	St.Paul	Central	IV
55	Saruti H/C	Nyamwamba Div.	II
56	Kisamba H/C	Bughoye	II
57	RMS H/C	Bughoye	III
58	Ibanda H/C	Bughoye	II
59	Bikone	Maliba	II
60	Kyanya SDA	Maliba	III
61	Mubuku Prison	Maliba	II
62	Muhindi H/C	Nyakiyumbu	II
63	Nyabugando H/C	Mpondwe L T/C	III
64	Kihyo H/C	Maliba	II
65	Mubuku Kisojo	Maliba	II
66	Ibuga Prison	Kitswamba	II
67	Buhuhira	Kyabarungira	II
68	Bwesumbu	Kyabarungira	II
69	Kasangali	Kyabarungira	II
70	Nkoko	Kitswamba	II
71	Ibuga Refugees	Kitswamba	II
72	Kabiri	Muhokya	II
73	Butale	Mahango	II
74	Mbunga	Kilembe	II
75	Kyondo	Kyondo	III
76	Hima dispensary	Kitswamba T/C	III
77	Kavera army barracks	Hima T/C	III
78	Kabatunda	Kyabarungira	III
79	Kitswamba	Kitswamba	III
80	Nyamirami	Muhokya	III
81	Kalibo	Kilembe	III
82	Karusandara	Karusandara	III
83	Mahango	Mahango	III
84	Kanamba	Karusandara	III
85	Kinyabwamba	Kitswamba	III
86	Rwesande	Kyabarungira	IV
87	Kilembe Mines Hospital	Bulembya Div.	Hospital
88	Kagando	Kisinga	Hospital
89	Bwera Hospital	Mpondwe L T/C	Hospital
OTHER HEALTH UNITS GIVEN
90	Railway	Kasese Municipality	II
91	Kahendero	Muhokya	II
92	Kasungu	Bwera	II
93	Nyakimasa	Bwera	II
94	Bukangara H/C	Nyakiyumbu	II
95	Bwito	Kyondo	II
96	Nyakatonzi	Nyakatonzi	II

KEY PROJECT ACHIEVEMENTS.

·         This project has increased joint efforts in fighting sanitation and Hygiene diseases in the district. This was through engaging district leader both political and technical including Sub County and all HUMC in Kasese.

·         Patients, care takers and health workers from 96 health units are accessing hand washing facilities aqua safe water treatment tablets in Kasese district.

·          Patients, care takers and health workers accessing safe and clean water for drinking in the 96 health units of Kasese district.

·         Health workers of 96 health Centers wash their hands and instruments before and after patient contact

·         Health workers and VHTS from 96 health units report that they teach hand washing and water treatment to their patients before daily business at health centers.

·          At least a number  of patients and care takers practice hand washing with soap at critical times and observe safe water chain in their homes.

HOW SHS. 268 WAS SPENT ON TWO MATERNITY WARDS IN KAMWENGE DISTRICT

The communities in Kamwenge district questioned how the Shs. 268Million was spent on just two maternity wards that could even cost less in the public eye. The RDC of Kamwenge district took interest in the community concerns by joining RWECO, KALI and the community monitors in monitoring the projects in Kiyagara HCII, Kahungye Sub county, and Kanara HCII, Kanara Sub county,

Findings

The monitoring team sharing notes

The Kiyagara HCII Maternity ward that will cost shs. 192Million

Key findings at Kiyagara HCII, Kahungye Sub county:

•Contractor: YANKA Enterprises limited

•Work started  on 22/03/2013

•Main building  at shs.192,185,200

•Placenta PIT   shs.2,000,000

•Medical Pit  shs.2,000,000

•3 stance latrine shs.9,000,000

•Total cost  is shs.201,185,200

Kiyagara receives 600,410  per quarter  servicing 1000 patients from 7 Parishes per month

 Unfinished works at Kiyagara HCII

•Grinding the flour

•Painting

•Internal door  shatters

•Electrical  Installations for solar and Hydro

•Plumbing and Drainage

•Medical waste pit

Kanara HCII

Kanara HCII, that will cost the tax payer shs. 203 million

 

•Contractor: Block Technical services

•Work started on 22/03/2013

•Preliminaries  at shs.27,500,000/=

•Maternity Ward shs. 203,020,200/=

•3 stance latrine shs. 17,618,330/=

•Medical Waste and Placenta Pit  2 x  7,000,000= Shs. 14,000,000/

Total shs.262,138,330Actual in the Agreement is shs. 263,138, 530/=

Is   there value for money  by spending shs.201,185,200 on Kiyagara and shs.263,138, 530/= on Kanara for the  same work?

Did the service user  follow the ministry of health specification on maternity ward construction?

Will the maternity ward serve high population

What is the implication of paying  a  3 stance latrine  at shs. 9,000,000/= in Kiyagara  and shs.17,618,330/= at Kanara?

A pit latrine that will cost the tax payer shs. 14M

 What about  Placenta PIT   2,000,000 in Kiyagara and 7,000,000 at Kanara? 

Getting instant feedback from the community during the joint monitoring exercise at Kiyagara HCII, Kahungye S/C,

Compiled by
Geofrey Bwambale and Angella Biira
KALI Staff

 

Kasese expectant women brave the national park to deliver in hospitals

Patients take shelter under trees during the health workers’ strike over unpaid salary arrears in Kasese District last year. Health centres at landing sites in the district lack essential services. Photo by Misairi Thembo Kahungu 

 

By  Misairi Thembo Kahungu

Posted  Friday, August 22  2014 at  01:00

 The picture that landing sites in Uganda creates in the mind of citizens is not a rosy one.

The landing sites in Kasese District are no exception. Six in number, Hamukungu, Kasenyi, Kahendero, Katunguru, Katwe and Kayanzi landing sites are lagging behind in service delivery. All the six are spread across Lakes George, Edward and Kazinga Channel.

Aside from other infrastructure, health service delivery at these sites is in a poor state compared to what the communities on the mainland receive.

Currently, it is only Katwe Landing Site (doubling as Katwe-Kabatoro Town Council) and Kasenyi Landing Site that have health centre IIIs where the communities can access maternity and Antiretroviral Therapy (ART) services.

Such remains a dream for Kayanzi, Kahendero, Katunguru and Hamukungu landing sites. Most of the big health cases in these landing sites are taken to Bwera, Kagando and Kilembe hospitals, which are between 40 and 50kms away.

In addition to the long distances, people have to brave the risks that come with moving through Queen Elizabeth National Park.

According to Mr Peter Kakule, the chairperson of the Beach Management Unit at Kayanzi Landing Site on Lake Edward, expectant mothers are rushed through the national park to Bwera Hospital when in labour.

Danger of elephants
They sometimes face obstacles along the way such as herds of elephants since the motorcycle is the main means of transport. However, the health centre II is rendering other services well.

“In Kayanzi, the health centre nowadays has staff and the drugs are delivered on time, but the biggest challenge is still lack of maternity facilities. The same challenge is faced by our people with HIV/Aids,” Mr Kakule said.

At Hamukungu Health Centre II in Lake Katwe Sub-county, Ms Nyesi Biira, a midwife, seems to be redundant. She is like a servant sent to the garden without a hoe to dig.

She says the health centre does not have maternity facilities where women can deliver from.

Her work is only limited to antenatal care to expectant women after which she refers them to a hospital for delivery. In most cases, they do not heed and opt for the Traditional Birth Attendants arguing that the hospitals are far away, she says.

Long queues
“I am not busy like I was in Kasangali health centre in Bwesumbu Sub-county where pregnant women for delivery overwhelmed me. Here, there is no maternity ward. I only sit and wait for Thursday when a handful of women come for antenatal care moreover without their husbands,” Ms Nyesi says.

According to Mr Yusuf Mawazo, the national programmes coordinator for Uganda Fish and Fisheries Conservation Association, much as the landing sites in all parts of the country are a little bit similar in nature, those is Kasese District are lagging behind on all government services because they are hard-to-reach.
Mr Mawazo said in addition to having bad roads, some of the landing sites have no clean water, poor sanitation projects and lack of access to modern public latrines.

He cites an example of Kayanzi Landing Site where the only public latrine constructed by the local government was abandoned due to shoddy work about four years ago.

“All landing sites in Uganda look more less the same in nature, save for those in Entebbe, Kampala and Jinja that are close to administration centres.

They receive good services compared to those in Kasese,” said Mr Mawazo, whose organisation has been working on landing sites for five years.

State of structures
At Hamukungu health centre II, it is by the grace of God that the main block that includes a treatment room, the office of the in charge and the drugs store has not collapsed because it is dilapidated. On arrival, one is welcomed by the bats that have also littered the would be main hall with their waste.

The in-charge was not on duty when we visited the health centre. The nurses available open the centre and wait at their residences for any call for help. The wild pigs make use of the compound as a playing field.

The chairperson management committee, Mr Abdul Karim, says the health centre with a committed staff of five people, currently needs new structures to cater for a maternity ward to reduce on the risks of women delivering in the middle of Queen Elizabeth National Park on their way to hospitals.

He said in 2012, a woman delivered twins just about 4 kms inside the national park as she was being rushed to Kilembe hospital 45 kms away. She has since relocated to Kainja landing site in Kamwenge District.

What has been done?
However, the Kasese District local government is doing its best to balance the health services on landing sites with the mainland, as is revealed by the secretary for social services, Mr John Businge.

According Mr Businge, aside from posting more staff and intensifying the supervision of drugs, health centers in Kayanzi, Kasenyi, Katunguru and Hamukungu have received some fairly good buildings.

Some work needs to be done at Hamukungu Health centre II and Katwe health center III to have the maternity wards fully operational.

“With little budgetary allocations to the health sector, we have tried to construct houses at health centres in Kayanzi, Katunguru, Kahendero and Kasenyi in the last three years.

At Kasenyi we got support of the development partners who have helped upgrade the centre to the level of three. We are planning to renovate the maternity ward in Katwe and also build one at Hamukungu,” Mr Businge said.

Mr Businge revealed that Shs20 million was spent on the construction of a solar powered gravity flow scheme that supplies Hamukungu landing site with water.

What is needed?
Mr Yusuf Mawazo, who has experience in working with fishing communities in Uganda, calls for a bottom up planning.

He said the Kasese District local government should carry out a special needs assessment at the landing sites so that the people are able to point out what they want to be done for them.

WAY OF LIFE AT THE LANDING SITE

The way of life at the landing sites in Kasese is not different from what other landing sites in the country are experiencing.

The men concentrate on fishing as the women remain at home doing domestic work. The flourishing businesses do not exclude bars and lodges which has to a large extent contributed to the exploding spread of HIV.

According to HIV/Aids activist attached to the national council of women living with HIV/Aids, Ms Rehema Aryema, who has been traversing the landing sites sensitising the masses about the prevention of the scourge, the people care less about protected sex.

“The men at the landing sites only enjoy booze and sex. This increases the spread of HIV as women and youth are also not spared in their way of life. It is not easy to control this at the landing sites as the mindset of the people about positive living remains highly negative,” Ms Aryema said.

Releasing the report on status of HIV/Aids early this year, the Kasese District HIV/Aids focal person, Mr John Thawite, pointed out the landing sites are among the scourge’s major hotspots.
Quoting the 2012 national Aids indicator survey, he rated the prevalence rate of Kasese District at about 11per cent which is higher than the national rate of 7.3 per cent.

Majority of the cases are recorded in communities along the lake shores.

However, in some areas where persons living with HIV have disclosed and accepted positive living, the government has not yet extended the services to them fully despite some efforts by nongovernmental organisations.

Mr John Bosco Onyango a resident of Katunguru landing site says that much as the health center II in the area has been given ART services, the staff are not yet committed to the patients and usually absent themselves from duty.

He says on some days patients have turned back without a service due to cases of absenteeism.

editorial@ug.nationmedia.com

Accessed on Friday 22/08/2014 from:http://www.monitor.co.ug/SpecialReports/Kasese-expectant-women-brave-the-national-park-t/-/688342/2426700/-/item/0/-/10wmm23/-/index.html 

DEFENCE MINISTER TIPS KASESE ON HYEGIENE PRACTICES

PICTORIAL KARAMBI ACTION FOR IMPROVEMENT LAUNCHES SANITATION AND HYGIENE CAMPAIGN IN KASESE DISTRICT, SATURDAY 16TH AUG, 2014

Accessed from the New Vision, Tuesday, August, 2014. Page 9.

Mr. Mkamba Augustine, Chairperson KALI handover sanitation kits to Hon. Dr. Crispus Kiyonga during the launch on Sat 16th, August, 2014 at Mpondwe Primary School

KALI Members and staff jubilating at the handover of the sanitation and hygiene kits to hon. Dr. Kiyonga ( with mic)

LCs giving their report after an inspection of Mpondwe Primary School, latrines during the launch of the sanitation kits on Sat, 16th Aug, 2014 by Hon. Dr. Kiyonga, MP and Minister of Defence

Participants at the launch of the Sanitation and Hygiene Campaign in Kasese district

By KALI Staff

Kasese to flood for 2 years - experts

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Part of the damage caused by the River Nyamwamba burst and subsequent floods in Kasese last week. PHOTO BY THEMBO KAHUNGU 

By FELIX BASIIME & THEMBO KAHUNGU MISAIRI

Posted  Tuesday, May 13  2014 at  01:00

 

KASESE- Government is asking for Shs30 billion to de-silt river Nyamwamba to stop the bursting of its banks, which has resulted in floods that have claimed lives and property.

However, experts say this move, may not comprehensively deal with the problem since there are several other rivers emanating from the Rwenzori mountain ranges that also burst the banks not to mention other environmental factors in the region causing floods.

Kasese District has been hit by floods every year for the last 5 years leading to loss of lives and property but the magnitude of the damage caused by the large volumes of water has increased since May 2013.

Environmental and hydrological experts say that the floods may be experienced for the next two years or so, a situation that has been created by climate change. The western region focal person and public awareness officer for Nema, Mr Jeconious Musingwiire has warned that the challenges of floods should be expected a little longer.

“The challenges are trans-boundary as some come from Democratic Republic of Congo as the Rwenzori ranges spread far from the Uganda border”

Mr Musingwiire lists tree planting, restoration of degraded sections of bare grounds and critical river line wetlands, and promotion of soil and water conservation structures in the agricultural fields as the quickest solution to the dilemma.

He also advises the environmental laws which regulate an area of 30 metres around the river banks be observed to allow the stabilisation of the banks.

“To achieve this, we need to bring all stakeholders on board and allow participatory planning and implementation especially in the enforcement of laws” observed Musingwiire.

The Kasese district environment officer, Mr Augustine Koli said by the time of the new floods, the district was waiting for the Office of the Prime Minister to fulfill a $10,000 (Shs25 m) pledge to take on disaster risk reduction programmes that include the river training.

editorial@ug.nationmedia.com

accessed on Tuesday 13th May, 2014  from:http://www.monitor.co.ug/News/National/Kasese-to-flood-for-2-years---experts/-/688334/2312512/-/e66vsbz/-/index.html