Supporting health centre in remote mountainous region
We were in such trouble here.
Rainwater tank now fixed and another one added. Staff say water shortage is now history! They can even let local villagers have some.
Rutaka Health Centre is situated high up in mountains, over an hour’s drive from the nearest town or hospital. It functions like a cottage hospital, with three small in-patient wards as well as clinics and a maternity unit. But it was severely under-resourced. There was no running water inside the clinic building, just one outside tap which only gave water for 2 hours a day at most. There was a solar panel which was not efficient, so that if a woman was giving birth in the night, the midwife had to have her mobile phone charged up from a nearby village and had to be ready to use that for light! This was the situation when we first saw Rutaka Health Centre in 2017.
We have realised just how isolated and at risk we are!
Electric lighting and fridges – the first things
By 2018, HealthTree Uganda had raised funds to get started. The local leaders asked if we could pay to get the health centre onto the National Grid, which had been working its way up into the mountains. This we did, then two fridges were carried up the mountain road and put in for storage of medicines and vaccines. A few months later a small team went out from UK to help expand the electrics throughout the main building and into the staff accommodation too. Each room ended up with a light, and most had sockets too. Some examination rooms were given bright LED lights, such as the delivery room.
Water
There was an old rain-water harvesting tank near the back of the building, but the roof and guttering to the tank were broken. These were spotted and fixed during the team visit, and the inside of the tank was scrubbed clean. Within weeks, that water tank was filling with rainwater, so the staff had access to more clean water. However, the bathing facilities for both staff and maternity patients remained very minimal.
Water shortage is now history!
Bathrooms and toilets
At the very back of the building was some rusty corrugated iron tied into a circle with cord. This was described as the “women’s bathroom”, but there was no evidence of any water available there.
Good hygiene is essential for mums after giving birth. Infections in new mums and babies, especially in the developing world, can be fatal, so improved measures would be potentially life-saving.
A plan was conceived with a local builder to put flushing toilets and bathrooms in the main building, and possibly even water-heaters for warm showers. Some generous donations came in, enabling a second big rain-water tank to be installed, and local builders started digging into the hard volcanic rock to put in drains. Gradually, with the right builders, the right tools and the right funding, the infrastructure came together.
Rutaka Health Centre now has flushing toilets for male & female patients, and showers. There is a staff shower, and right next to the delivery room in the maternity unit is a lovely new bathroom with a warm shower, which everyone is very proud of. The midwife told us that this is making a huge difference to hygiene standards and prevention of infection in the maternity unit. She said “If a woman in labour arrives straight from the fields, I can help them have a shower before they give birth, as well as afterwards.” This will certainly improve the health of women and infants.
Many thanks
Lack of water was a constant problem at Rutaka, but the lives of staff and patients have changed considerably since 2017 when we first visited. They now have so much water that on a recent visit to Rutaka we discovered that they invite local villagers to help themselves to water if needed.
One member of staff told us “Water shortage is now history!” The clinical officer at Rutaka says “We are so grateful. Long live HealthTree Uganda!”
Ongoing project
This is an ongoing project, as the villages served by Rutaka Health Centre are so remote that it takes over an hour by road to reach the nearest hospital in an emergency. In the rainy season it takes much longer as the roads are flooded. Therefore, we are planning to get increased medical equipment into the health centre to cope with emergencies and a wider number of illnesses. The local diocese have included Rutaka Health Centre in their 5-year development plan, and we are partnering with them in this where we can.
It was the first time any Westerner had visited Rutaka since before the Covid-19 pandemic. In fact Jon and Chris Foster, the secretary and director of HealthTree Uganda, were apparently the first Europeans to arrive in the area since restrictions had been lifted. In August 2022, Jon and Chris went to visit Rutaka Health Centre to look at the development there. The progress was tremendous and everyone was delighted.
Rutaka Health Centre, in south-west Uganda, is high up in the mountains close to the border with DR Congo. The health centre serves 16 villages and approximately 6,000 people, but to reach the town and the nearest hospital, which is 20 miles away there is an unmade road with hairpin bends and steep edges. Especially in the rainy season it can be a treacherous journey.
So upon their arrival at Rutaka several community leaders came to talk to Jon and Chris. They said “We have realised just how isolated and at risk we are!” They said that this was highlighted during the pandemic, as no traffic was allowed on the road for long periods and they were completely cut off from the outside world.
There are no ambulances in the area, and the staff said that in usual times if a woman gets into difficulties while in labour, and it is decided that she needs a Caesarean section, the midwife will flag down a vehicle going along the road, or ring up a contact, asking them to drive the patient down off the mountain to the nearest hospital. But during lockdown, this just wasn’t possible. It was scary and potentially life-threatening for mother and baby, and very worrying for the extended family.
We discovered that as a result the local community had clubbed together to buy some land adjoining the health centre, so that in due course they can extend the building or build a house for a doctor. The local diocese had agreed to put them into their 5-year development plan.
But the first things they were hoping for were some items of medical equipment that they could use in those times of emergency, when they might not be able to get a patient to hospital.
These were an oxygen-concentrator for giving oxygen especially to mums and babies; an electric steriliser for sterilising equipment; a centrifuge; a microscope; and a baby-warmer.
We realised that the poor road will be an ongoing problem for the health centre and the community, so funds have now gone out for these items. We’ll let you know when they arrive!