Malaria Education and Prevention Program
Soft Power Health’s first program, the Malaria Education and Prevention Program, started in 2004. Malaria is the leading cause of death in Uganda. A tropical, equatorial country with rainfall throughout much of the year, malaria here is a
year-round rather than seasonal illness.
When Jessie Stone first arrived in Kyabirwa she found that people had no understanding of the root cause of malaria. This led her to develop the educational program still used by SPH today that teaches important facts about malaria through pictorial diagrams which explain:
- How malaria is transmitted.
- Signs and symptoms to look out for.
- Treatment options and the how-to’s to avoid developing drug resistance.
- Malaria prevention through use of long lasting insecticide-treated mosquito nets (LLINs) recommended by the World Health Organization.
Each education program also includes a question and answer session, after which LLINs are sold to community members at subsidized cost making them affordable to all. We record each purchaser’s name and home village in order to perform follow-up home visits within six months time of purchase. This allows us to evaluate proper use of the net, history of malaria infection since purchasing the net, and knowledge retention.
In addition, we train other local NGOs and organizations in our Malaria Education and Outreach Program model. To date we’ve sold over 55,000 mosquito nets and this number is continually growing; as each net serves an average of 3 people, a total of more than 150,000 Ugandans have benefited from the malaria program.
Allan Stone Community Health Clinic
In 2004 when SPH’s Malaria Program was first beginning, the program received an enormously positive response from the local community and Jessie received numerous requests for her to stay and open a clinic. She embarked on fundraising and construction phases and upon its completion in 2006, the Allan Stone Community Health Clinic (ASCHC), named in memory of Jessie’s deceased father, finally opened its doors. Today the clinic, part of SPH, offers primary and preventative health care services, dentistry, and the Field Patient Program to any and all who come in need of its care.
ASCHC is an outpatient facility that emphasizes prevention and education alongside medical treatment. An office visit costs a flat, all-inclusive subsidized fee of 5,000 Ugandan shillings, approximately $2.30 USD at the 2012 exchange rate. SPH employs an entirely Ugandan staff which currently includes 1 medical doctor, 2 clinical officers (each of whom have three years of medical training), 6 nurses, 1 nurse’s assistant, 2 laboratory technicians, 1 dentist, a receptionist, a cook,
and a handyman.
The facility holds two consultation and two treatment rooms, a laboratory, and a pharmacy. The lab has capabilities to perform comprehensive microscopic testing and rapid diagnostic tests for malaria, diarrheic conditions, diabetes, UTI’s, filarial (parasitic worm) infections, and beyond. In addition, while few clinics in Uganda have pharmacies attached, the pharmacy here is fully stocked and supplies the best quality pharmaceutical treatment for
Solar power and water collection allow the clinic to operate independently of local power supply, which can be sporadic at best, and bio-digester toilets have been installed that convert waste into by-products usable as additional fuel. A recently acquired solar powered refrigerator has ample storage space for all vaccines and medicines requiring refrigeration.
Dr. Paul, our dentist, began working with SPH in 2009. He sees patients at the clinic two days a week, and spends an additional two days per week doing community outreach to make the clinic’s dental services known to other areas in the region.
Field Patient Program
The ASCH Clinic offers important medical referral and financial assistance to patients whose health conditions require them to seek outside treatment available only at specialized health care facilities or hospital settings - surgeries, chemotherapy and radiological exams are some examples.
Currently in Uganda, in theory, a state system exists offering health-related financial assistance to everyone, but in practice generally only those with the means to pay their expenses actually can access care. Furthermore, drug offerings at these facilities often are very limited or unavailable.
Therefore our Field Patient Program provides crucial aid to its patients; they pay for 50% of their bills, while the clinic covers the other half of all charges incurred – this includes referral assistance, all outside medical bills and long-term follow-up exams provided by the clinic that are not currently available anywhere else. It also includes transport to and from the referral facility, which is often quite far from the
The Field Patient Program also monitors the CD4 T-cell count of a number of HIV positive patients in the hope that by catching worsening illness in its early stages, drug regimen can be started to ensure the best long-term prognosis.
Family Planning Education and Outreach Program
The Family Planning Education and Outreach Program began in 2007 and has proven to be as popular as the Malaria Outreach Program. It is based on the structure of our malaria program, i.e. teaching through pictorial diagrams, followed by Q & A sessions and distribution of condoms and/or other birth control types with long-term follow up.
Three teams of nurse-educators return to 39 outlying villages within Jinja District (our home region) on an ongoing quarterly basis. Both men and women are encouraged to attend, and do so. The program offers information about:
- Conception and various forms of contraception.
- Family planning including benefits of child spacing.
- STD’s including HIV.
- Condom use as a means of protection and birth control.
The nutrition discussion emphasizes the importance of breastfeeding, vitamin supplements, and gives a breakdown of the food pyramid.
The nurses give detailed information about a variety of short, medium, long-term and permanent contraceptive methods available including condoms, tubal ligations, vasectomies, birth control pills, three-month protective injections, birth control implants, and IUD’s. All questions and concerns about side effects of these various birth control methods are addressed in depth. Nurses also make known that at the Mother and Child Wellness Center (see below), patients can obtain the same forms of contraception made available to them during outreach program visitations, as well as certain long-term forms of contraception which require a clinical setting
In addition, the family planning teams offer safe, biannual de-worming pills to children 2 years and older. Worms in children have been linked to impaired cognitive development, while studies done in Uganda have shown de-worming negates this problem.
In 2008, SPH partnered with DIG (Development in Gardening) who helped us establish an organically grown, wide variety, sustainable garden (i.e. one that’s environmentally friendly and low-maintenance but produces high quality, maximum yield plants) in front of the health clinic. Patrick Kayima was DIG trained and is the amazingly gifted head gardener and instructor to the local community. He works with small groups at a time, showing them how to set up their own gardens so that they have enough food to feed themselves and to become financially self-sufficient through selling off the surplus. This financial benefit is of particular importance to certain groups such as single women who may otherwise lack the ability to
Mother and Child Wellness Center
The center opened its doors on February 23, 2011 in response to community need for a center offering comprehensive family planning services, treatment of malnutrition, and vaccinations. Forms of contraception available at the Mother and Child Wellness Center include those offered through our Family Planning Education and Outreach Program, plus additional methods such as IUDs and long term implants which require a clinical setting for implementation.
Marie Stopes is a partner organization dedicated to providing under-served populations with reproductive health care. They began working with us in 2010, making one-day visits to the center on a quarterly basis, at which time they offer permanent contraceptive surgical procedures to men and women.
Since many children and adults suffer from malnutrition and protein deficiency in particular, we provide patients with specially formulated high-energy milk for home use, and monitor signs of health improvement on an ongoing basis. De-worming pills are another important part of treating malnutrition.
Vaccinations of many types are offered to infants and adults. These include tetanus, polio, BCG against tuberculosis, MMR against measles/mumps/rubella, and DPT against diphtheria/pertussis/tetanus. And with our newly acquired solar refrigerator vaccines can now be safely stored without worrying about
Malnutrition continues to be a serious and underappreciated health problem for much of the developing world. In Uganda, children, immune-compromised individuals, and disabled individuals are the most affected by malnutrition and account for all the cases of malnutrition treated at the Mukagwa Twekembe Allan Stone Community Health Clinic. More than half the cases are severe malnutrition, meaning that the treatment interventions are life saving for these people. The other cases of malnutrition seen at the clinic would progress to severe malnutrition if untreated.
In 2013 with the help of the Deerfield Foundation, we started a very effective and popular educational outreach to provide the communities where the majority of our malnourished patients were coming from with education about nutrition and malnutrition. Part of the educational outreach includes showing people exactly what local common foods should be included in creating nutritionally balanced meals. Although this may sound like information everyone has, it is clear from our experience that the vast majority of people in the communities we serve cannot tell you what comprises a nutritionally balanced meal and why.
Other important information related to combating malnutrition that people need to know is:
- How to prepare clean water for use in cooking and drinking.
- The importance of immunizing and deworming children against common and preventable diseases.
- Hygienic cooking techniques such as washing hands with soap and water before cooking and after using the bathroom.
Prior to every nutrition/malnutrition outreach, a pre-education survey is administered to assess all participants’ baseline knowledge. The second part of the educational assessment comes several months after the nutrition/malnutrition outreach. The team returns to the same villages to administer the follow up survey to see if people’s baseline level of knowledge about nutrition and malnutrition has changed. So far we have educated over 400 people, and are in the process of following up to measure the actual impact.
One of the things we have discovered during this first year of the outreach, apart from the fact that there is a much greater need for—and interest in—this kind of intervention than initially anticipated, is that people often make some rather extraordinary decisions about how best to use the resources available to them. For example, if a woman has a cow, she may prefer to sell all the milk from the cow and not keep any aside for her children and family to have.
Since the implementation of the outreach, we have also begun treating more people at the clinic for malnutrition than we had previously. This is due mainly to the outreach staff referring people with malnourished children to the clinic for treatment. Frequently (in approximately 80% of the cases) when children are brought into the clinic for malnutrition treatment, they are also suffering from other medical problems, such as malaria.
In light of the need for and usefulness of this outreach, we plan to continue it and expand into additional communities. This year we hope to add a complementary piece to the project. Our clinic DIG organic garden has been extremely successful, and our head gardener, Patrick, has been instrumental in instructing and assisting community members in starting their own gardens. This has led to better health and increased financial self-sufficiency for those people and their families. Therefore, we plan to pilot a small DIG garden start - up program for some of our especially needy community patients.
The idea would be to have Patrick assist these patients to implement their own sustainable, organic, high-yield family gardens. In combination with the educational outreach for nutrition/malnutrition and the treatment of malnutrition offered at the clinic, the establishment of their own family gardens would be an important step for our neediest community patients, and would, we anticipate, lead to increased health and self-sufficiency for those individuals. This is completely in line with our mission to provide low-cost, high impact solutions, and to assist people to take control of their own health and that of their families.
Inner City Kids Kayak Camp
The Inner City Kids Kayaking Camp was started in 2002 to teach Inner City youth from New York City to whitewater kayak. With the help of a number of dedicated instructors over 200 kids have learned to paddle and been able to explore a whole new world both in and around the urban jungle.
The camp currently works closely with the Graham Windham School in Westchester County, New York teaching kids from 13 – 18 years old how to paddle. For more information about the camps, please contact Jessie Stone at Jessie@softpowerhealth.org.
Links to learn more
Connecticut Outdoor Guide: Inner City Kids Kayak Camp
Jackson Kayak: Jessie Stone's NYC Kids Camp
Also read Jessie's article about her 10th year of teaching the camp here