Copyright Malaria Consortium
Comic Relief's Operation Health project, the focus of this year's Red Nose Day campaign, will completely renovate a dilapidated health centre in Iyolwa, Uganda. Operation Health is at the centre of a fundraising drive to improve healthcare across Africa by showing how money well spent can be used to improve health systems.
Whilst malaria is one of the leading causes of mortality and morbidity in Uganda, Tororo is especially hard hit by the disease, with residents being exposed to an average of 1.5 infectious mosquito bites every night. Malaria accounts for more than 40 percent of outpatient attendance at health facilities, with HIV and maternal health also posing significant burdens. Iyolwa Health Centre III serves as a crucial point of contact for the local community as well as a number of surrounding villages.
Before arriving I had seen photographs of cracked walls, dark and empty rooms, and a collapsing ceiling. Not to mention the stories of the hornet and bat infestation that never gave patients a moment's peace. So, as a representative of Malaria Consortium - one of the partners involved in the project - I was eager to get to Iyolwa to see the progress so far.
By the time I got there, the place already looked vastly different. Dozens of local builders scurried to and fro, making preparations for the upcoming construction (or destruction). All of the old equipment I had seen in the photographs had been taken outside, and work on the septic tank and water systems was well underway. Whilst the main buildings had been put out of use to enable renovation to take place, a bustling temporary health centre with upgraded facilities had been set up off-site to provide much-needed services. Some of the visitors and patients to the temporary clinic looked in on the state of the construction while they waited.
There seemed to be a genuine excitement in the air. "Now we will have a new building and new equipment. People are now admiring because the old place was worse, with droppings from bats all over the place. It was not conducive [to a health centre] at all," said Owere Cosmas, a local facilitator responsible for connecting the community to the health centres. "But now this new clinic is going to serve and help a lot of people. There will be more rooms and more privacy."
Owere Cosmas is a local facilitator responsible for connecting the community to the health centres. Copyright Malaria Consortium
One thing that struck me was the degree of community involvement in the project. The majority of the builders had been found locally, from Iyolwa or the surrounding villages. The more I talked to them, the more I realised that many had grown up or studied together in school. "It's an intimate community, so they tend to know each other," said Gonza Kagwa, the project architect. "All in all, it's a really fun group of people, really cheery and so hard working. It's amazing actually, their work ethic - the way they keep going and going."
Many of the builders working on site had studied or were teaching at Iyolwa Technical School just down the road. I spoke to 26-year-old Akello Florence - commonly called 'engineer Florence' - who was teaching at the school. "Some teachers [from the technical school] are here, and are working as builders. And I know some of the other workers study in the training centre as well." She told me that she was waiting for the basic infrastructure of the new building to be in place before she could get to work on installing power for the buildings.
The renovation of the health centre seemed to be having other, unexpected knock-on effects for the community as well. Okware Lawrence, site manager, told me how the project benefited the local economy. "On Saturday, we had a market just adjacent to this health centre. I was impressed when I saw most of my workers here. They had books, they were buying pencils, and they were buying school uniforms. The business community has also benefited a lot because materials like cement, we get from them."
The renovation also coincides with the beginning of the school term. Enrolment fees can sometimes mean that students postpone their studies until they can afford them. "Sometimes you'll find kids sitting out and waiting for a month or two, and by the time they get in, it's really a crash course," Gonza told me. "We've got students [working] here who go to technical college, who go to the local high school. And in a week, they're able to raise the money for their school fees."
Katand John works as a builder on site. Copyright Malaria Consortium
The enthusiasm for the project helps explain the rapid transformation I saw over the week I was there. The builders worked from dusk to dawn to ensure that everything was on schedule, with impressive results. They are heavily invested in seeing the project succeed.
Malaria Consortium is also committed to the success of the project. We want to make sure that the gains made so far in the renovation are sustainable in the long-term. That means working with communities, staff, and health authorities to guarantee quality services are provided far into the future. "Building a health facility and equipping it is not an end in itself," said Godfrey Magumba, Malaria Consortium Uganda Country Director. "We need to be looking at support activities that will make this health facility functional. It will be very important to continue to train the health workers, to supervise and support them. We also need to engage the community to support the health facility, to protect the equipment and the structures."
For now, it seems that the renovation is generating excitement and encouraging people to seek care at the improved facilities provided by even just the temporary health centre. That's already a promising start. Abbo Anastasia, an enrolled midwife at the health centre, told me that since the start of the renovation, there has been a big increase in deliveries at the temporary health centre. "Most of [the mothers] could not even come here and deliver because of the condition of the health centre, but right now they have interest." She told me that 32 babies had been delivered in that month. "They see now that in the new ward, they will be in a safe place to deliver."
Learn more about how Malaria Consortium is supporting the Operation Health project here