Tuesday, February 26, 2013

Medical Education in Uganda - Rebecca Cook, MD, MSc

February 7, 2013

This week we visited Bugoye which is a town nestled in the hills of Southwest Uganda. The MGH Global Primary Care Program is partnering with Mbarara University of Science and Technology and Bugoye Health Center to improve primary care in the area, particularly focusing on under five mortality. It has been a refreshing change from the dark and overcrowded wards of the regional hospital to learn about healthcare in action at a completely different level: in the community.

We have traveled with the village health teams home-to-home through some of the villages in the catchment area of the health center; learning the realities of the social determinants of health and how they are being addressed at the grassroots level. Village Health Team members are community members who are elected by their communities to be health advocates and a liaison with the health care system. They go home to home educating households on the most basic fundamentals of health; such as hygiene measures like a proper latrine, hand washing, and a drying rack for dishes.

The “tippy tap” a hands-free way to wash hands without running water

A women's group we visited in Bugoye has also received education in how to make indoor stoves out of mud that are more energy efficient and where smoke goes outside -- addressing two important aspects of health -- exposure to indoor smoke and environmental degradation through deforestation which affects rain patterns and soil erosion ultimately effecting the food supply. Interestingly, these women, of their own accord have made building the stove and other such "household improvements" a requirement for membership in the women's group – here they model ownership and support to make positive changes.

The Village Health Team at Bugoye is in the early stages of a new initiative: community case management of common childhood illnesses. A spin-off of the WHO Integrated Management of Childhood Illnesses IMCI village health workers have been trained in identification of danger signs in children, and appropriate basic management including treatment with basic antibiotics and anti-malarial and appropriate referrals. This week at a health outreach, we had the privilege of witnessing the unveiling of a drama they have written and perform in to help sensitize the community to this new initiative.

Village Health Team performing a drama to sensitize the community to new health initiatives

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