Uganda > Activities by Sectors
The Need for Health Services
Health care programme
Health care within Pader District is still poor due to major district health staff shortages and lack of infrastructure. In some areas, only 30 percent of vacancies for health centre staff have been filled. Ongoing support for the Ministry of Health is vital; without it, community access to health care would be impossible. Medair currently supports existing health staff through training, drug management, vaccination days, secondment of nurses to health centres, and the selection and training of Village Health Teams.
Man-made and climatic shocks plague the Karamoja region and adversely affect food security, livelihoods, and the asset bases of inhabitants. In 2009, a majority of the Karamojong people were “food insecure” and relied on external food distribution for their daily survival.
In northern Uganda, incidence of stunting due to chronic malnutrition remains higher than the national average. Outbreaks of common diseases are frequent, and use of mosquito nets is only at 14 percent, which makes malaria a major health hazard (with prevalence up to 48 percent.) Diarrhoea is the third highest cause of morbidity, and cholera is endemic..
In Uganda, Medair’ health services activities are funded by Swiss Solidarity, The European Commission, UNICEF, USAID, and private donors.
Medair's Health Service Activities
Emergency Relief
In Kaabong District, Medair established a rapid water and sanitation emergency response capacity for disease outbreaks which was handed over to the local authorities in September 2009. We hope that the district will now be able to provide a timely and effective response to disease outbreaks.
In 2009, Medair started a programme to increase the food security of the Karamojong, and to mitigate the effects of potential droughts in the future. This programme includes cash-for-work projects and the distribution of seeds and tools to farmers’ groups.
In Pader, our health teams act as a focal point for four sub-counties on disease outbreaks and containment plans. Disease responses have included cholera, meningitis, Hepatitis E, and dysentery.
Rehabilitation
Medair is improving access to basic curative and preventative health care in Pader District. Medair works alongside health staff within the health facilities, and provides training to ensure a minimum level of satisfactory service. This type of capacity building involves training local health staff on topics such diagnosis and treatment of the main diseases, referrals and general health, nutrition, and hygiene.
Medair, with funding from UNICEF and private donors, supports newly implemented child protection structure and the roll-out of child protection committees (CPCs) in five sub-counties of Agago County and in two sub-counties in Abim District, including training on UNICEF protection modules, monitoring, management of complex cases, and support of referral pathways.
In the last quarter of 2009, Medair started a project aimed at increasing capacity and awareness of good health and nutrition practices. It consists mainly in undertaking baseline surveys, developing behavior change communication material on mother-and- child health and on nutrition, and on tailored training of health facility staff, village health teams, and lead mothers in Karenga and Kapedo sub-counties.
The Need for Water & Sanitation (WatSan)
Distribution of water
In settlement sites and villages of origin in Pader District, there is poor access to safe water and sanitation. In Karamoja, water-and-sanitation-related diseases are common. Latrine coverage in the region remains very low with an estimate of only 12 percent coverage. Many boreholes are not functioning properly, in poor technical condition, and/or have poor sanitary conditions around the hand-pump. This problem is connected to the fact that there is no system in place for the community to pay for spare parts. This is also linked to the absence of a well-trained, motivated, effective Water User Committee (WUC) for each borehole.
Medair's WatSan Activities
Emergency Relief
Medair maintained a capacity to respond to emergencies affecting water supply in both Pader and Karamoja. In 2008-2009, Medair responded to a Hepatitis E outbreak in Pader District with a distribution of jerry cans, soap, and chlorine tablets—serving almost 20,000 households. Other emergency relief activities include testing and chlorination of boreholes, latrine construction, and sensitisation on key hygiene messages. At the end of 2009, all emergency stocks were handed over to Kaabong and Pader District.
Rehabilitation
Until March 2009, Medair continued constructing new water points in underserved areas of the Pader District, and in new camps as they developed. In the last phase of operation, Medair’s water supply project focused on transferring capacity to the community for the operation and maintenance of all existing systems developed over the previous five years. To enable communities to manage their own sanitation, slab makers were trained to construct latrines within villages. Parish Development Committees were revitalised and encouraged to develop community action plans to identify and tackle their own hygiene/environmental issues.
In Karamoja, Medair focused until the end of 2009 on increasing the capacity of the population to maintain a safe and sustained water supply for both human consumption and for production (cattle)—using a community-based approach to rehabilitate existing hand-pumps. This included setting up a supply of spare parts, training pump mechanics, and establishing a contribution system for future repairs.
In Karamoja and in Pader, capacity for school latrines is woeful—which is a protection issue for children in schools and a health hazard. Medair came alongside the schools and constructed latrines in three districts to counter these issues. Medair also constructed household latrines and promoted good hygiene practices.
To ensure sustainability, Medair supported, trained, and monitored water user committees who help to keep boreholes functioning and in a hygienic state. Medair also constructed cattle troughs at waterpoints, and constructed sub-surface dams to increase the water-holding capacity of seasonal rivers.
The Need for Shelter & Infrastructure
Access is a key issue for settlement sites deep in the bush in Pader District. Without decent road access, people cannot get to market, health centres or schools. Security is also at risk. Medair’s spot road repairs have ensured that communities are kept connected to main trading centres.
Medair's Shelter & Infrastructure Activities
Rehabilitation
Medair constructed and rehabilitated roads in Kaabong, Abim, and Kotido district in 2009, with funding from USAID. These projects were done through a cash-for-work approach which provided immediate cash to the most vulnerable individuals in the communities to mitigate the impact of food shortages and allow them to purchase goods.
In turn, the rehabilitation of infrastructure permitted better access to remote communities, markets, and health centres—which were previously inaccessible to NGOs and other service providers.