About NUV-HOP
The first edition of NUV-HOP (Northern Uganda Village Health Outreach Project) took place in the summer of 2013. The project started as a collaboration between Belgian and Ugandan medical students. In 2016 a British team of students (Manchester) joined the project, but this collaboration has come to an end because of Covid. NUV-HOP was founded as a project that mainly focusses on ‘outreaches’. These are mobile medical clinics that reinforce the health centres for one day. Over the years we’ve been trying to focus more on preventive instead of curative care, although the latter is very prominent in the outreaches. In 2015, ‘health talks’ were introduced in the villages around the health centre of Awoo to meet this preventive aim.
The biggest challenge for NUV-HOP is to develop an initiative that is sustainable, but that also fulfills the needs of the local communities. That is why we consult locally as much as possible and a research project is started in collaboration with the International Centre for Reproductive Health (ICRH), located in Gent. Apart from the disclosed project activities, the Belgian students get the chance to do an internship in the local hospital. Moreover, it is a very interesting learning environment for all the students concerned, both from Belgium as from Uganda. There is a constructive cooperation with colleague-students with a different background. The medical students from Belgium, Great Britain and Uganda are represented by different associations (Organisation for Development And Health, Global Health Society & Gulu Medical Students’ Association).
Aim
Northern Uganda is one of the poorest regions in one of the poorest countries of Africa. The population lacks food and safe water, a solid infrastructure and adequate access to health and education. The countryside is affected even worse, especially in terms of inadequate hygiene and sanitation.
Studies have shown that 70% of the disease burden in Uganda is caused by a lack of personal and domestic hygiene and thus can be prevented through adequate prevention. This vicious circle has a negative impact on a big part of the Ugandan population. It can be broken by a coordinated and integrated use of the available resources.
The Ugandan ministry of health has formulated aims concerning the reduction of mother and infant mortality, malnutrition, the disease burden of HIV/AIDS, tuberculosis, malaria and the inequality in access to health. These efforts don’t reach the poorest of the society, the ones who need it the most: the local population of the little villages in the rural areas of Uganda. These individuals don’t get medical care or supervision, they suffer from transmitted diseases such as tuberculosis and they have a lack of vaccinations and health education about hygiene and family planning. The reconstruction of Northern Uganda is a slow and laborious process.
The general aim of the project is to provide sustainable and payable health care for the poor population of Northern Uganda who have been severely affected by conflicts in the past.
Specific aims of the project are:
- To improve the general state of health in the remote villages in Northern Uganda.
- To prevent transmitted diseases.
- To establish free medical camps in selected communities with a high need for health care in Northern Uganda.
- To start a system of health education based on outreaches that focusses on issues of hygiene, reproductive health, malnutrition, malaria, sexually transmitted diseases, HIV/AIDS and family planning.
- To encourage volunteer work by active outreaches and media attention in the area.
- To provide an international internship for medical students in the GRRH.
Preparation
This phase takes place before the Belgian students leave for Uganda and consists of a training-weekend for the Belgian medical students to teach them knowledge and skills that are needed to reach local communities. The weekend will be filled with different workshops, presentations and discussions. These are meant to hand the students basic clinical and presentation skills, as well as enough background information concerning the situation in Uganda, ethical responsibility and competence. This will allow the students to execute the project well prepared and as a team, rather than as a group of individuals.
Upon arrival in Gulu, the students will take part in a workshop, together with the Ugandan students. This will teach them open cultural norms and aboriginal customs. Moreover the skills, acquired during the training-weekend, will be repeated and sharpened. This should allow the students to interact more easily with the local inhabitants. Furthermore they will be given resources to facilitate their task during medical outreaches.
Next the students will be monitored and supervised continuously by the project-doctors, Gulu University and the management of the National Medical Students’ Association, which will provide ongoing training following the workshop.
Outreaches
During the stay in Uganda free medical camps will be organised in small villages at the countryside of the districts Gulu, Amuru and Nwoya. The timespan of an outreach is limited to one day, during which 300 to 600 patients will be reached. The students work actively under the supervision of recognized Ugandan doctors. On one hand, curative care will be provided by means of consultations and medication. On the other hand, screening and preventive care take an important role. Even though preventive care does not sound spectacular, it is probably the most effective weapon against communicable diseases in Northern-Uganda. Research has shown that 70% of disease burden in Uganda can be prevented by applying simple hygiene measures and vaccination. This is the reason why prevention is the first aim of our interventions.
During outreaches screening is conducted for frequently existing illness in the region. Due to this screening process epidemiologic research concerning the health problems of our target group can be conducted. This enables us to make better plans for the future and to identify regions where much improvement is needed.
Preventive medicine includes health-promotion in schools and outreach-communities, vaccination and patient-education. The health-education will concern common health problems such as malaria prevention and control, HIV/AIDS, sexually transmitted diseases, hygiene and teenage pregnancy. Simultaneously family planning takes an important part of the education. Due to decreasing child mortality, families grow in number while the carrying capacity therefore lacks.
Health talks
Medical students, together with translators, will give health education to local communities. These health talks will be organized in collaboration with the local health centers. They are centered on preventive care and will focus on advise concerning lifestyle measures that stimulate health and wellbeing, prevention of common diseases (malaria, diarrhea, airway infections), strategies for safe sex, reproductive health education and small changes in hygiene with a big impact on health. In collaboration with the health centers, efforts will be made concerning impact evaluation and succession of these interventions. Meanwhile public health measures are being conducted.
Students and school going children are an important target group. They are reached by health education at local schools. This takes place during the outreaches by some of the students. Except in Awoo where a separate day is provided during which the students will educate both schools in the region through a previously elaborated program.
GRRH Internship
The medical students have internships at the Gulu Referal Regional Hospital at different departments. The operation theatre and the delivery room are off limits as the students lack the experience and preparation for these contexts. The selected departments are departments where the students will be able to help without taking part in invasive medical practices. This way they get the chance to develop basic medical skills and clinical reasoning in a setting, which does not provide any technical support. These internships are very useful for the students as it will help them to understand the situation in Uganda and the health care system better. Selected departments are antenatal care, family planning, immunisation, physiotherapy, ophthalmology, ear-nose-troath, psychiatry and the HIV-clinic.
When & Where
The project takes place once a year in July. During this month the project will take place as described above. As an example, we present you the rough schedule of 2023: departure on the 2nd of July, arrival in Kampala on the 3rd, bus to Gulu on the 4th with the start of the project on the 6th. The project ended on the 31th, after which all students were free to fly back to Belgium whenever they wanted.
The project takes place in three districts of Northern-Uganda: Gulu, Amuru and Nwoya. In every district, three provinces will be selected and in every province the villages with the biggest need for healthcare will be selected for the NUV-HOP project. This need will be evaluated before through disease burden.
Future
It is very important that we remain critical about our own activities and look for the most achievable methods with maximal impact. NUV-HOP is a project that is continuously adjusted as necessary. As already said, we try to invest more in preventive care and public health. We are thinking about providing mosquito nets, but all options and possibilities will be discussed with the different partners. Final decisions will be based on data obtained from the health centres and of course in consultation with local partners.
There will be more focus on collaboration with local partners. We will look further for other organisations who want to support us or who we can support ourselves. This way we can put up actions that are complementary to each other and promote the sustainability, instead of isolated actions. There are different NGO’s in Northern Uganda. It would be a waste to ignore these chances for cooperation.
NUV-HOP 