Watch the full video here - https://www.youtube.com/watch?v=SXO0uqFzSoE

I had the huge privilege of working as a medical doctor in Kiwoko Hospital, Uganda, in 2020/1. Kiwoko is a private, not-for-profit hospital which provides accessible, affordable, curative, and preventative healthcare for holistic healing of members of both the local community and the wider region.

I spent most of my time working in the children's ward, seeing new admissions, doing the daily ward round, and some out-of-hours work. It was a very steep learning curve, as I learnt how to manage unfamiliar  conditions like severe malaria, severe acute malnutrition, and complications of HIV. It was also very rewarding work – children can arrive extremely unwell, but often get better after the basics are done well.

The Kiwoko staff achieve incredible clinical outcomes with very little resource compared to what we're used to in the UK, but they don’t have some important investigations like blood cultures, basic CT scans, and they don’t have a high-dependency or intensive care unit.

For many of the local families, taking a child to Kampala for higher-level treatment is simply unaffordable. Parents have to find money for the transport down, including an ambulance if necessary, as well as accommodation and food whilst there, and very often unforeseen additional medical costs, despite the fact that, in theory, the national referral centre is a public hospital. It’s often a choice between pursuing best medical care for that child, and being able to feed the other children and pay their school fees. 

At the end of my time in Kiwoko, we decided to set up the Jairus Referrals Fund to provide financial support for children needing specific investigations and interventions not available locally. After I audited our admissions data, we've decided to focus on 3 key areas:

1) Blood Cultures - to enable identification of specific organisms that are making a feverish child unwell, and tailored, specific antibiotic therapy to target those organisms. Not only could this be life-saving for the child, but will also dampen the growing threat of anti-microbial resistance that's a consequence of widespread use of broad-spectrum, non-specific antibiotics. Initially, we have arranged a service with a lab near Kampala, who will run our cultures. Long-term, we would like to purchase our own blood culture machine for use on-site, which would greatly improve the management of infectious diseases at Kiwoko.

2) CT Head - to facilitate urgent diagnosis of life-threatening diseases in the brain, including cerebral abscesses, HIV/TB-related infections, traumatic bleeds, and cancer. Once the diagnosis is made, there are often opportunities for the child to be linked with neurosurgical charities in Kampala or Mbale to get life-saving surgery, free of cost. A critical barrier is getting the diagnosis in the first place, since the cost of transport to the scan in Kampala, and the scan itself, is unaffordable for most parents. 

3) Time-critical ambulance transfer. Sometimes, a child will have needs that very clearly cannot be met by our facilities, and requires urgent treatment by a specialist service in Kampala - either emergency specialist surgery, or treatment on the high-dependency or intensive care units there. This can be a difficult call, since a large proportion of the patients at Kiwoko would be sent straight to a higher-level/critical care setting were they to attend a UK hospital, but these resources are just not available in most of the country. Sometimes, the therapy possibilities on the ward are exhausted, and it becomes clear that the child will only survive if they are taken by ambulance to Kampala and managed in a higher-level setting there. 

From the data we have, the average monthly cost of these measures would be roughly £400/month - which would cover 2 blood cultures, 4 CT Head scans, and 5 ambulance transfers - although we anticipate that the use of blood cultures will rise as they become more available, and we would also like to put some of this money towards a blood culture machine.

As you can see, what feels like not much to us can go a very long way in this setting, and just a small regular monthly donation could facilitate life-saving emergency treatment of some of the children who come to Kiwoko for help.

Watch the full video here with Dr Eric and myself https://www.youtube.com/watch?v=SXO0uqFzSoE  and don't hesitate to reach out to me if you have any questions!

We believe that all of the children Kiwoko serves are beautiful, unique individuals, made in the image of God – but many of whom unfortunately endure immense physical suffering as a consequence of systemic inequality and socioeconomic poverty. I hope you’ll consider partnering with us to empower local families and enable their children to access life-saving healthcare in Central Uganda. Thanks so much for reading + considering giving!