KUMI HOSPITAL - ONGINO
“WE TREAT, GOD HEALS”
ANNUAL REPORT 2011
TABLE OF CONTENTS
TABLE OF CONTENTS
ACRONYMS AND ABBREVIATIONS
EXECUTIVE SUMMARY
GOVERANCE
ADMINISTRATION DEPARTMENT
NURSING
OPD
ANC & PHARMACY
ART CLINIC
LABORATORY
ORTHOPAEDIC
PHYSIOTHERAPY
NUTRITION UNIT
MEDICAL SOCIAL DEPARTMENT / LEPROSY CARE
FARM
FINANCIAL REPORT
HOSPITAL STATISTICS
GRAPHS
Kumi Hospital Annual Report 2011
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Acronyms and Abbreviations
ART
CBM
CP
CTEV
DTLS
EDP
FOAG
GLRA
HIV
HMC
HOD
I&D
IOL
JMS
MSD
NGO
NSSF
OPD
PAF
PAYE
PMTCT
PPP
PRS
TLMI
UPMB
VCT
VVF
Kumi Hospital Annual Report 2011
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Anti-Retrieval Therapy
Christoffel Blinden Mission
Cerebral Palsy
Congenital Talipes Equino varus
District Tuberculosis and Leprosy Supervisor
Essential Drug Programme
Farmers Overseas Action Group
German Leprosy Relief Association
Human Immune Virus
Hospital Management Committee
Heads of Department
Incision and drainage
Intra ocular lens
Joint Medical stores
Medical Social Department
Non-Government Organization
National Social Security Fund
Out Patient Department
Poverty Alleviation Fund
Pay as you earn
Prevention of Mother to child Transmission.
Post-Polio Paralysis
Preventative and Rehabilitation surgery.
The Leprosy Mission International
Uganda Protestant Medical Bureau
Voluntary counseling and testing.
Vesico Vaginal Fistula.
Page 3
EXECUTIVE SUMMARY
The year under review saw many huddles overcome and many challenges met and we thank the almighty
God for his unfailing mercy and faithfulness.
We are forever grateful to our partners who have much faith in us and have taken great courage to
continue supporting us despite our fragile situation at that time- indeed a friend in need is a friend indeed.
All appreciation goes to
 FOAG
 CBM
 Kumi Hospital Dutch foundation
 Kyoga foundation
We also thank the visiting surgeons through the Kumi Hospital Dutch foundation (Dr. Ton, Bass and
Carole), AMREF (Dr. Kirya, Wachira and Dr Davis) and Dr. Charles Viva for providing highly
specialized services that our people would have not otherwise accessed.
The year was full of new beginnings. With open minds the Board of Governors and management team
worked hard to begin the process of making a five year strategic plan. This plan will serve to help the
hospital remain focused on progress in certain key areas. The support from CBM and UPMB was of a
great help to the development of this document.
The key strategies in the next five years include;
1) KH Institutional Strengthening (Governance and Management) and motivating our human
resources to depict a well governed/managed health facility with adequate resources and quality
healthcare
2) Improved KH Clinical performance and service delivery to contribute to having a healthy
population in a healthy environment by targeting the most vulnerable, stigmatized and disabled
persons
3) KH improved relations and image within the local communities - “the community identifies with
KH as their health facility”
4) KH institutional Resource Mobilization for sustainability; and improving the hospital financial
management/ accounting/ procurement and records management systems
5) Develop new/ refurbish existing hospital infrastructure for improved quality of healthcare
6) Develop financial plan to meet the hospital medical, administrative and personnel needs
We are hopeful for a bright future in the event that these strategies are adopted over the next five years.
I therefore welcome you to look into the data, activities, achievements and challenges of the year under
review.
Dr. Ruth Obaikol
Medical Director
Kumi Hospital
Kumi Hospital Annual Report 2011
Page 4
GOVERNANCE
Members of Board of Trustees
His Grace The Archbishop of CoU
Mrs. Okiria Gladys
Canon Thomas Mugoya
Canon Pauline Magomu
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Chairman AGM
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Bishop of Bukedi Diocese : Chairman
Bishop of Mbale Diocese
Bishop of Kumi Diocese
Nominee CoU
Nominee Mbale Diocese
Nominee Bukedi Diocese
Female Representative
District Health Officer Kumi
CAO – Kumi
Medical Superintendent Ngora
Medical Superintendent: Secretary.
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Chairman
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Medical Superintendent/Secretary
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Chairman
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Secretary
:
Chairman
Members of Board of Governors
Rt. Rev. Dr. Nicodemus Okille
Rt. Rev. Patrick Gidudu
Rt. Rev. Thomas Edison Irigei
Mr. Sylivanue E. Isiagi
Mrs. Wakumire Edith
Mrs. Emoit Salome
Ms. Rose Ochom
Mr. Bataringaya Willy
Dr. Okia David
Dr. Ruth Obaikol
Members of Appointments Board
Rt. Rev. Dr. Nicodemus Okille
Personnel Officer – Kumi
Sr. Jane Edyegu (PNO) Kumi
Dr. Ruth Obaikol
Mr. Edmond Emokol
Mr. Okula Charles
Finance Committee:
Mr. Sylivanus E. Isiagi
Dr. Ruth Obaikol
Mr. Okula Charles
Mr. Etiang D.
Hospital Management
Dr. Obaikol Ruth
Mr. Okula Charles
Mr. Etiang D.
Mr. Emokol Edmond Obuku
Sr. Odikor Margaret
Ms. Isangu Rose
Kumi Hospital Annual Report 2011
Page 5
ADMINISTRATION
Many of the difficulties we experienced in the previous year followed us into the year 2011
The normal functioning at the hospital continued though with difficulty. A lot of strain was still realized
in the areas of Human Resource, Financing and Medical supplies. However, the later part of the year
showed signs of positive recovery.
Routine meetings were held during the year as follows:1. Board of Governors Meetings
2( with one board retreat)
2. Hospital Management meetings
8
3. Heads of department meetings
2
4. General Staff meetings
3
5. Interested stake holders meetings
2
Achievements
 Energy Project was launched with the arrival of the Project Manager Mr. Ouke Dijkstra with his
wife Hanneke Dijkstra as shown in picture below during the ground breaking ceremony of the
ESCo office at Kumi Hospital.


Umeme bill of Shs. 71Million was paid with the help of the Government of Uganda and the
Kyoga Foundation of Holland.
Power was reconnected to the hospital.
Kumi Hospital Annual Report 2011
Page 6

Renovation of stone/children’s ward was accomplished as shown in picture below.


15 Salaries (including 3 arrears of 2010) were paid.
Donors continued to support the Hospitals namely
- The Dutch Foundation
- The Kyoga Dutch Fund
- FOAG
- Elspeth Robinson
- Rev. Benwell




We managed to continue funding the training of the Orthopaedic surgeon and 3 Nurses.
Our Gynaecologist Dr. Ntege completed training and resumed work.
Auditing was carried out successfully for both 20009 and 2010.
The Five year strategic plan was initiated.
Challenges
 Staff attrition continued though at a reduced rate.
 Tightening in internal controls led to abrupt departure of Accountant, Cashier and Accounts
Assistant leaving only one Senior accounts Assistant to manage the department.
 Reduced funding was received from our major donors CBM and none from TLMI creating
difficulty in management of resources.
 Salary payments were irregular and unpredictable.
 The hospital continued running without the services of a Human Resource Manager and a Farm
Manager because of failure to identify a competent farm manager and lack of resources to pay for
a human resource manager.
 Though now reduced, the hospital still has a challenge of meeting 2 Months’ Salary arrears and
backlog of NSSF and PAYE remittances.
 Staff houses are getting dilapidated and require urgent repair.
 Reduced support from Government, increased poverty levels among our Clients leading to
inability to pay hospital bills.
Kumi Hospital Annual Report 2011
Page 7
Staffing
During the year staffing levels reduced with the total staff at 170 broken down as follows: Doctors
:
06 (one at School)
 Clinical Officers
:
04
 Registered Midwife Nurse
:
10
 Enrolled Nurse
:
13
 Enrolled Midwife
:
03
 Nursing Assistants/Aids
:
23
 Laboratory staff
:
05
 Ortho. Technicians
:
06
 Orthopaedic Officer
:
01
 Physio/Social Workers
:
06
 Administrative Staff
:
08
 Support Staff
:
85
TOTAL :
170
Recommendations
 Intensify public awareness on services offered by the hospital to improve utilization.
 Continue to lobby for increase in Government support both in funding and staffing.
 Enhance collaboration with other Agencies/Organizations both internal and external.
 Continue lobbying for funds to revamp the Farm.
 Increase utilization of Farm land by tree planting.
NURSING
The department improved in the handling and management of patients and other clients. The Staff
turnover reduced due to encouragement from the Management and payment of salaries.
The department did perform to its full capacity as recent better health information and promotion
messages dissemination.
Out reaches services were regularly performed because of the assurance of the availability of PHC
funding.
Staffing
Management has done a lot in improving the staffing levels in the department. This includes:- Increase in number of Nurses and training and it continues to train and give professional
development Continuing Medical Education Workshops and Seminars for Special service
delivery points.
- The friends of Kumi, UPMB and other Partners are hereby thanked for this immense contribution
towards staff development.
Kumi Hospital Annual Report 2011
Page 8
Staffing levels
Table 1
Out
PNO
SNO (RCN)
RN/MW
RN
RMW
E/N
E.M
ECN
N/Assistants/Aids
Opth/Assistants
Vaccinators
TOTAL
-
01
01
03
08
01
08
02
16
25
03
02
70
Training
04
02
02
05
02
The Vaccinators are not nurses but Community volunteers who were working with us. They have made a
tremendous improvement to the PHC Component of the hospital work and improved more on
relationship with the village health Teams and Community.
Support supervisors/visitors to the department
The Department received a number of mentors from the Hospital, District and Ministry of Health and
other Partners who contributed towards the improvement of health Care Delivery. The department also
received a number of nursing students/Medical students from various Institutions who equally helped a
lot in its activities as they also gained experience.
Achievements
- Staff development through short courses and Workshops and others got Sponsorships for their
Children through Kumi Hospital.
- Staff motivation and a spirit of togetherness was achieved during the end of year Party.
- Team work was also achieved.
- Some Nurses were recruited to lessen work load.
Challenges
- Inadequate number of nurses in the Ward to meet the demand.
- There were some gaps in the Nursing skills and documentation of data.
OPD
The Out-Patient Department is a starting point for all Hospital departments. It is an area where patients
are received and handled according to the severity of their sickness/conditions (triage). Deciding who to
be managed as an Emergency (triage), who to be admitted to which ward and who to be managed as an
Out-Patient.
Activities
 Receiving and recording patients
 Health education
 Diagnosis, Treatment and Monitoring
 Referral to appropriate units for definitive care
Kumi Hospital Annual Report 2011
Page 9
Achievements
 Many staff attended workshops that helped in improving the way patients are handled
 Two members of staff were deployed to OPD improving the staffing and efficiency
Challenges
 There is lack of equipment for examination; Bp machines, books
 There is difficulty in transferring patients to the wards and to the sites of investigation because of
lack of a mobile wheel chair.
 Delays within the different functional units increasing waiting time
 Challenges in storage as the cupboards cannot be kept under key and lock
Recommendations
 Avail equipment and books to aid diagnosis.
 Improve on storage
 Improve on staff efficiency at OPD
ANC

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






Health education talks to all the clients every morning
Pre test counseling and post test counseling for all pregnant women
HIV testing
History taking and examination
Providing mothers with ITN
Provision of drugs for PMTCT
Identification of complication of pregnancy and referring mothers appropriately
Attending to mothers post natally
Preparing patients and providing family planning
Achievements
 There is an improvement in male involvement from 20% to 90 %
 Provision of ITN has reduced the prevalence of malaria in women
 Provision of ART services in the ANC has provided for an opportunity for holistic care for HIV
patients hence instilling confidence in the health service
Challenges
 Occasional Stock out of test kits
Recommendations
 There is need to develop a means of sustaining test kits.
PHARMACY
Activities
 Organizing the department
 Placing orders early enough to prevent stock outs
 To scrutinize the prescriptions in order to prevent stock outs
 Dispensing in well labeled envelopes
 Control drug flow right to the actual consumer who is the patients
 Prevent irrational drug use
 Prevent drug theft
Kumi Hospital Annual Report 2011
Page 10
Achievements
 There has been improvement of rational drug prescription
 Issue forms were designed and in use to monitor drug flow
 Envelopes for dispensing were designed and now in use
 The drug store was arranged and all the leakages were sealed
Challenges
 Adhering to pharmacy policy remains a challenge to many staff especially the procedures of
ordering drugs
 A few new leakages are starting to show with need of re sealing the roof
 The student bills are not met this need to be clarified
 There is delay in other OPD procedures making patients exit late.
Recommendations
 Discharge forms should be filled before the billing is finalized
 The leakages should be sealed
 The dispensing with envelopes should be sustained as it is presentable.
ART CLINIC
Activities
 HIV counseling and testing
 Comprehensive palliative care services +
 Provision of anti- retroviral service
 HIV AIDS prevention
Achievements
 More clients were tested compared to the previous year
 Availability of ARVs for eligible clients
 Improved and prolonged life of People living with HIV AIDS
 Easier follow-up of clients due to availability of motor-cycles.
 Assistance to the poorest of the poor in management of OIs and the transport facilitation.
Challenges
 High expectation by clients
 Inability to fully investigate patients because they cannot pay.
 Occasional stock outs of test kits and septrine
 Lack of nutritional support for clients especially children
ART Clinic Output
Activity
No Counseled & Tested
No +ve
Enrolled for HIV/AIDS Care
On ART (ARVs)
TB/HIV
TB/HCT
HBC/Home Visiting
CD4 Count
PCR/DNA
Kumi Hospital Annual Report 2011
2009
2010
4766
302
295
142
42
61
177
824
166
2011
6051
241
287
197
49
128
177
1109
180
2895
128
196
106
35
77
134
633
145
Page 11
ITNs-IRCU
PACE
12
0
388
0
228
406
LABORATORY
Activities
Clinical laboratory helping with diagnosis has six sections:
 Hematology
 Blood transfusion
 Parasitology
 Microbiology/ virology
 Clinical chemistry
 Serology
Specimens for histology are sent to Mulago National Referral Hospital.
Other specimens as for CD4 P.S.A. etc. are still on referral.
Laboratory Statistics for the year 2011 in comparison to 2010
Section
Haematology
2010
2011
HB Est
ESR Est
CBC Total
Differential
Film Comment
Sickling Test
Total
504
Bleeding & Clotting Time Est: 16
9811
2809
3810
3810
3810
+ve
162
2010
Blood
Transfusion
Parasitology
Grouped Total :
Transfusion:
Children
Male Adults
Female Adults
B/S – mps
Microfiliria
Trypanosomes
Stool Microscopy
Modified ZN-stain
Concentration
Method
Kumi Hospital Annual Report 2011
Total
19710
16
19710
873
12
443
4846
2844
2610
97
137
+ve
9412
00
00
58
00
21
5663
626
597
597
597
Total
+ve
137
03
Bleeding & Clotting
time Est:12
2011
2050
1050
605
156
289
Total
+ve
12916 4998
23
00
12916
00
1334
27
16
00
349
06
Page 12
Celebral spinal
fluid (CSF)
Clinical chemistry
Serology
Virology
Total Abnormal
112
08
Total: 4956
Protein: 639
Sugar: 1
Deposit: 388
Total: 2455
Protein: -1335
Sugar: -04
Deposit: 750
Total
Abnormal
1778
34
398
+ve: 34
258
63
Total
+ve
337
48
2350
787
132
08
Total Abnormal
2003
154
402
+ve: 36
19
09
Total +ve
355
36
2650
802
121
04
Urinalysis
Blood Sugar
(RBS)
HCG (Preg. Test)
LFTS/RFTS
Sputum: ZN-stain
Bacteriology
Total Abnormal
106
06
Skin scrape (F1)
Skin smear (Lep)
(BI & MI)
H.V.S. Swabs
(Gram stain)
Wound Swabs
(G/Stain)
Culture/Sensitivity
RPR/VDRL
HEP.B
WIDAL TEST
Brucella B.A.T
Rhematoid Factor
HIV TEST
PCR/DNA
CD4 Samples
Referred
Kumi Hospital Annual Report 2011
14
14
26
26
123
63
19
17
04
1796
397
4180
287
49
4180
162
04
13
25
120
10
1
209
12
00
00
00
1011
20
515
22
2078
483
898
111
48
02
8822
370
108
03
771 Male: 294
Female: 477
Page 13
ORTHOPEDIC WORK SHOP
Activities
 Fabrication and fitting of Orthopedics appliances
 Repair of Hospital equipment.
Achievements
 Department received a new Orthopedics Technologist
Challenges
 Need for one carpenter to meet rising demands for Crutches and C.P. Chairs.
Output of Orthopedic Work shop
Section
Foot wear
Appliances
 Open Sandals

 Plastazote
 Orthopedic Boots
 Shoe repairs
 Shoe raise
 Hospital
equipment repairs
2010
S/TOTAL
Orthotics





















AF0 Splints
KAFOS Splints
A.K Calipers
Knee Caps
T. Straps
Arch Supports
S.FABS
Lumber Corsets
Wooden Crutches
Wooden cane
Cervical collars
Hand Splints
C.P. Chairs
Head support
Corner seat
Wooden walker
Standing Frame
Splints Repairs
S.FABS Repair
Caliper Repair
Wheel Chair
repairs
75 Pairs
18 Pairs
14 Pairs
252Pairs
21 Pairs
2011
84 Pairs
03 Pairs
19 Pairs
268 Pairs
34
71
66
451
334
55
13
14
05
08
102
11
35 Pairs
04
19
13
37
11
09
37
12
126
17
19
474
283
41
12
28
04
27
119
22
59
30
20
27
19
19
06
11
12
31
26
12
130
135
S/TOTAL
988
1009
Prosthetics
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

Symes
Transtibial
Knee
Disarticulation
Kumi Hospital Annual Report 2011
11
55
06
29
28
20
Page 14


83
40
217
1677
Transfemoral
Prostheses repair
S/TOTAL
Grand Total
14
35
104
1566
PHYSIOTHERAPHY
Activities
 Outreach clinics
 Managing surgical camps
 Performing physiotherapy for patients
 Offering social support for patients with disability
Challenges
 lack of adequate funding reduced the bulk of the much needed help
 staffing was low
Recommendations
 There is need to re-establish support for the disadvantaged disabled children
 As the new orthopedic surgeon comes the next year it is advisable to recruit a physiotherapist and
an occupational therapist.
Summary of Patients seen in the Disability Outreach Clinic from January to December 2011
Adults
Male
Hearing Impaired
Cerebral Palsy
Epilepsy
No. of individuals
screened
No. of individuals
screened entering
CBR services
No. of individuals
screened referred
to other services
Leprosy
Children
Female
10
61
144
116
Total
11
53
185
Boys
21
114
329
142
258
Girls
Total
Grand
Total
45
166
200
1040
47
120
224
1067
92
286
424
2107
92
307
538
2436
1040
107
2107
2107
105
128
233
491
3
3
5974
Summary of Patients seen in the Rehabilitation department from January – December 2011
Adults
Male
Children
Female
Kumi Hospital Annual Report 2011
Total
Boys
Girls
Total
Grand
Total
Page 15
Physiotherapy
Club foot
manipulation
P.I.P & Gluteal
fibrosis
Epilepsy
Fractures
Others
Cerebral Palsy
Cleft Lip and
Palates
V.V.F
TOTAL
8
3
11
114
160
104
70
218
230
229
230
10
30
40
327
328
655
695
106
89
195
26
33
59
382
42
25
22
14
346
32
20
27
12
728
74
45
49
26
923
74
104
49
26
63
45
108
108
2438
Nutrition Unit
This has been a most challenging year for the department but nevertheless, with the little/limited
resources realized the department was able to provide initial feeds to malnourished children/patients.
The department was rim by one staff (Social worker).
Activities
- Feeding
- Daily weighing (growth monitoring)
- Health and Nutritional education/counseling
- Playing therapy
Recommendation
- There is a need to extend nutritional education and counseling to the community for early
diagnosis and referral of malnourished children to reduce on the complication of malnutrition.
Output of the Nutrition Unit
Type of PEM
STATUS AT DISCHARGE
Improved
Died
Escaped
Kwashiorkor
Marasmus
Marasmus
Kwashiorkor
Total number of
Patients
Transferred
Total Number
18
53
33
3
1
4
1
-
21
34
38
94
8
1
-
93
Medical Social Department:
Persons challenged by Leprosy
1. At the beginning of the year
2. Total Counseled with Social problems
3. Run away
4. Discharges
Kumi Hospital Annual Report 2011
M
14
77
F
13
71
2
46
0
44
TOTAL
27
148
2
90
Page 16
5.
6.
7.
8.
Referrals to other facilities
Soaking of ulcer/ dry skin daily
Pending for resettlement
Those who died
HIV/Other Clients
1. PHA with Social Economic problems
2. Health Education talks
3. Teaching sessions
0
3
4
2
4
3
1
21
4. Meetings with Patients/attendants
3
29
8
5
22 (with 50 orphans)
Daily on microphone
Once weekly to ART Clients
31 (978 people attended)
NON MEDICAL/SUPPORT SERVICE DEPARTMENTS
Building and
maintenance
Activities
 Water
distribution and
maintenance.
 Electrical
Maintenance
 Building
maintenance
 Compound
Maintenance

Security


Catering
section
Main Store



Garage


Guarding the
hospital premises
and property
Solving disputes
Cooking
Achievements
Completion of the
renovation of stone
ward
Theft is reduced
Bakery is in use
Receiving
Verifying and
distributing
stock.
Carrying out
external stock
count with stock
taking Committee
Proving transport
Maintenance of
the Air strip
using the Mower
Tractor





Kumi Hospital Annual Report 2011
Transport
Officer
Water in the
Garage.
Putting right
our vehicles.
Our old tractor
working
Trailer working
Challenges
 Maintenance of
the water system
as moving islands
keep blocking the
inlet to the pump
in the rainy
season
 The staff houses
remain
dilapidated in
need of
renovation
 Law staffing
 Lack of cooperation with
the Police
 Not all staff get
refreshments at
work
(a) Weighing scale
needs
rectification
(b) Leaking roof of
the stores
(c) Lack of
protective gears
for the staff
 Not having
enough working
tools
 Need to put the
Compressor, tyre
aligning Machine
right
 Fitting light in
the depart is
Remarks
Need to develop a
maintenance -plan


This year
has been
better than
2009 and
2010
We are
going to use
all old metal
works for
Page 17



Pastoral
Ministry





Devotions
Church services
Administering
sacraments
Ministering to the
sick
Home visits



Enough staff
Welding Solar
stands for the
Hospital
Covering up
transport part
without many
break downs
Received
donation from
Rev. John
Barnwell of
100 Plastic
Chairs
Mother of Mr.
Ouke gave 20
Come &
Worship Books
and 20 UYP
Books
Mission Team
came to
evangelize
within the
Hospital




needed
Boots and
Uniforms are
needed
income
generation
Office for the
Chaplain
Transport
Expectations of
Clients during
Home visits
THE FARM
Resources:
Ongino Farm is yet a small diary business project with a vision to operate for self sustainance and to raise
supplement for Kumi Hospital support; both of which are not successful yet.
1. LAND RESOURCE: 1061 HA = 7 miles perimeter
2. STAFF: by December 2011 the Farm employed seven (7) staff on contract. Because of the
financial problems the other four workers were retired off by October 2011. The post of Farm
Manager has not yet been recruited.
3. CATTLE RECORD 31/12/11:
Mature cows:
20 Hc
Breeding bulls: 02 Hc
Heifers:
01 Hc
Steers:
Weaners:
11 Hc
Jouner calves:
Kenyan cows:
Calves born in:
23 Hc
03 Hc
05 Hc
Total:
65 Hc
4. CATTLE HEALTH:
Diseases experienced were:
Kumi Hospital Annual Report 2011
Page 18
i)
ii)
iii)
iv)
v)
Foot and Mouth Disease (FMD) June-July 2011
Cantagious Bovin Pleuro Phneumonia (CBPP): September-October 2011
Ctall Sickness: mainly September-October 2011
Anaplasmosis: experienced all the year through, but mostly when the Dip was under
repair.
East Coast Fever (ECF): experienced all the year through, but mostly when the Dip was
under repair.
5. BIRTHS: 25 calves were born in the year out of which 7 males and 18 females.
6. DEATHS: 32 deaths were realized.
Herd
Category of
cattle
Original + herds Calves
-
Weaners
Kenyans herd
Cows
Cows
TOTAL
No. Of
Causes of death
deaths
11 1 kicked by another cow
1 Persistent Respiratory Problem
3 Foot and Mouth Disease (FMD)
4 East Coast Fever (ECF)
2 Diarrhea
6 Tick Bone Diseases
(Gall Sickness + ECF)
2 Tick Bone Diseases (Gall Sickness)
13 1 cow: drowned in water trough
4 cows: Foreign Bodies/ plastic bags/
cloth pieces
3 cows: Contagious Bovine Pleura
Pneumonia (CBPP)
4 cows: Tick Bone Diseases (Gall
Sickness + ECF)
1 cow: Liver Problem (long suffered
since arrival
32 Hc
7. FREE OFFERS: 2 Heifers were given as free offers.
Date
27.01.11
Category of cattle
Weaner Heifer No. 108
14.11.11
Weaner Heifer
Client
To the son of BP. Ilukor for
marriage
Pledge to the wedding of
nurse Eunice Odeke
8. END OF YEAR PARTY 2011: one cow (no. 46) was slaughtered (sorted out from original herd)
9. SALES: The Hospital Management authorized the sale of five (5) cows of poor breed to raise
money for Dip repair and payment of accumulated Farm staff salaries, unpaid by then.
Kumi Hospital Annual Report 2011
Page 19
10. ARTIFICIAL INSEMINATION: This was carried out on the 16.02.11 on eight (8) Kenyan
Heifers with hope to boost the milk production; but unfortunately all these cows died.
11. TICK CONTROL: The full plunge Dip which was charged on the 15.03.11, with SYPERTIX
Acaricude, developed failure by midyear after noted cracks. Attempts to repair was hindered and
delayed when torrents of Oozing water rushed in and filled the Dip tank form underground. Tick
control in the El Nino rains was done merely by spraying using foot pump, which was not
effective. This resulted in high mortality rate for the year 2011. After eruption of Tick Bone
Diseases and other complications especially in the Kenyan herd (Ayrshire Breed), very susceptive
to Tick Bone Diseases.
12. VACCINES ACQUIRED: only two (2) categories of vaccines were received for the year 2011.
Date
20.01.11
Vaccine
FMD
No. Of livestock
80 Hc
12.10.11
CBPP
90 Hc
Remarks
Later realized to be dead vaccine hence
eruption of the epidemic June-July
2011
Successfully offered
13. MILK PRODUCTION: average 1360 liters per month
Month 2011
January
February
March
April
May
June
July
August
September
October
November
December
TOTAL
Milk in liters
Cows milked
1437.5
1685
1674.5
2316
2133
1405.5
910.5
1166.5
881
667.5
937.5
1104.5
16319
20
25
26
26
27
27
21
21
19
16
17
13
14. SOME OF THE PROBLEMS AND CHALLENGES EXPERIENCED:
i)
ii)
iii)
iv)
Foreign cattle encroachers within the Farm pasture hence increasing Tick multiplication and
chances of Tick Bone Diseases.
Irregular, unreliable sources and or none obtained cattle vaccines like FMD, CBPP (received),
LSD, Brucellosis and ANTHRAX (non-received) gives chances to eruption of cattle
epidemics within Farm stock. We need to observe routine mass vaccinations.
Absence of supplementary feeding – cattle stimulated to pick foreign bodies.
Paddocking (erection of fences) and maintenance not yet possible.
Kumi Hospital Annual Report 2011
Page 20
v)
vi)
vii)
Sometimes Farm suffers accumulated unpaid salary debts; and demoralized staff. Also the
apparent salary scale is quite low.
Lack of skilled labour. Training opportunities lacking but necessary for developing the Farm.
Lack of enough financial support.
FINANCIAL REPORT 1ST JANUARY TO 31ST DECEMBER 2011
Brief highlights:
In 2011 the accounts department carried out its activities well, despite reduced financing and reduced
number of staff in the department.
Financing of many hospital activities was a challenge with exception of programs funded by designated
funds. We are grateful to our partners for supporting these programs. Fruitful discussions were held with
CBM on the possibility of getting more finance support from the regional office.
During the year the department saw the departure of 2 staff resigning their appointments with the
Hospital for better alternatives. This left the department with thin staff of 3 members: 2 senior officers
and 1 volunteer.
Computerized accounting did not take off as expected. The sage accounting package installed in 2010
could not be up graded to accommodate 2011 programs (data), consequently the department continued
preparing its financial statements manually.
Source of income:
During the year 2011 the major sources of funds included: CBMI (Christoffel Blind Mission
International), PEPFAR (IRCU), Dutch Foundation, Kyoga Project, GLRA, Presidents’ office, FOAG,
TDT, UPMB, user fees, own activities and other general donations.
The total income realized in 2011amended UGX 2,106,758,215/= with grants/ donor support accounting
for 71% (UGX 1,503,759,804/=) of the total revenue. Locally generated income realized
UGX 602,998,411/= (29%).
Kumi Hospital Annual Report 2011
Page 21
This shows that during the period financing of the activities heavily relied on donor & grants support.
Thank you for the response of our partners to our plight for support to finance salary arrears 2010.
Expenditure:
The major expenditure arrears in 2011 involved: salaries & wages, procurement of medical drugs and
supplies, investment, fuel & oils and maintenance costs.
The expenditure for the year is summarized as follows:
Details:
(i)
(ii)
(iii)
(iv)
(v)
(vi)





Salaries & wages
Investment
Maintenance
Medical drugs & supplies
Transport (fuel & oils)
Administration
UGX
907,107,723
232,587,752
292,015,478
226,322,660
171,283,954
234,437,691
2,063,755,258
%
44
11
14
11
8
12
100
Salaries & wages accounted for 44 percent of the expenditure during the period
Investment accounted for 11 percent of the expenditure
- ESCo office was constructed
- Stone Ward renovation done
The electricity line within the Hospital duly maintained and construction of new powerhouse
Settlement of electricity bill and maintenance of water pumps
Procurement of drugs and supplies
INCOME AND EXPENDITURE STATEMENT
Note: This financial statement is not an audited report for financial year 2011 but a fair representation of
the Hospital transactions throughout 2011.
A
INCOME
UGX
DONATIONS/ GRANTS
Christoffel Blind Mission(CBM)
PAF
PEPFAR (IRCU)
Dutch Foundation
Kyoga Project
Presidents’ office
FOAG
Global fund
Teso Development Trust(TDT)
General donations
UPMB
Lilian Fund
JOCS
GLRA
157,379,612
313,176,358
180,718,000
181,893,000
472,150,150
50,000,000
45,640,326
27,481,584
6,868,251
36,135,023
6,000,000
11,500,000
4,584,000
8,591,000
Kumi Hospital Annual Report 2011
Page 22
Nutrition Unit
Sub Total
B
1
2
3
4
5
6
7
8
LOCAL SOURCES
User fees
568,366511
Orthopaedic sales
9,336,400
Bicycle park
1,008,700
Hire of vehicles
6,528,300
Patients bills recovery
1,138,000
Disposal of old assets
1,117,000
Rent
13,337,500
Training Hall Hire
2,166,000
Sub Total
1,642,500
1,503,759,804
602,998,411
GRAND TOTAL (A+B)
2,106,758,215
EXPENDITURE DETAILS
1 Salaries & Wages
2 Retirement benefits
3 Drugs & medical supplies
4 Fuel & oils
5 Operation & Travel expanses
6 Telephone, fax & email
7 Publicity
8 Audit fees
9 Ledger fees
10 BOG and other meetings
UGX
647,651,407
8,132,800
197,864,920
78,731,700
68,729,000
3,908,200
3,220,000
22,318,600
4,206,823
21,034,050
11 Cleaning mat.
12 Staff uniform (medical & non medical)
13 Theatre supplies
14 Laboratory material
15 Patients welfare
16 Leprosy patients food
17 Nutrition Unit food
18 Orthopaedic materials
19 PHC support supervision
20 Theatre meals
21 Lilian fees
22 Renovation of Stone Ward/ Bathrooms
23 Construction of ESCo
24 Forestry
25 Staff training
14,460,496
2,381,000
2,513,000
14,836,500
2,653,100
26,580,200
2,356,150
11,108,240
3,380,000
9,879,000
34,077,500
119,569,600
109,900,152
3,118,000
15,730,500
Kumi Hospital Annual Report 2011
Page 23
26 Building repairs
27 Piped water system
28 House rent
29 Electricity
30 Electricity-maintenance line
31 Entertainment
32 Sports & Games
33 Salary Arrears - 2010
34 Staff party
35 Staff medication
36 Burial assistance
37 NSSF Arrears - 2009
38 Consultancy-Strategic Plan
39 NSSF Penalty
40 Stationary, postage & office
41 Plumbing materials
42 Insurance
43 Repairs vehicles
44 NSSF - 10% contribution
PEPFAR
45 NSSF- 0% General Hospital
20,001,400
19,365,550
900,000
87,296,278
163,952,250
13,519,972
1,544,500
166,131,771
4,822,500
12,802,000
2,531,000
15,255,241
7,717,500
2,613,740
40,145,100
1,400,000
257,000
23,566,254
TOTAL
2,063,755,258
12,083,000
39,509,264
The summary of Income and Expenditure for the year ended 31st December 2011 is as follows:
A
INCOME:
CBM
PAF (Uganda Government)
PEPFAR (IRCU)
Dutch Foundation
Kyoga Project
President’s Office
FOAG
Global fund
Teso Development Trust TDT)
General donations
UPMB
Lilian Fund
JOCS
GLRA
Nutrition Unit
User fees
Own sources - others
Kumi Hospital Annual Report 2011
UGX
157,379,612
313,176,358
180,718,000
181,893,000
472,150,150
50,000,000
45,640,326
27,481,584
6,868,251
36,135,023
6,000,000
11,500,000
4,584,000
8,591,000
1,642,500
569,504,511
33,493,900
Page 24
TOTAL
B EXPENDITURE
1 Salaries & Wages/ Training (Personnel costs)
Drugs & other medical
2 supplies
3 Administration costs
4 Capital/ Investment
5 Maintenance costs
6 Transport/ Travel costs
TOTAL
BALANCE C/F (Surplus)
2,106,758,215
UGX
907,107,723
226,322,660
234,437,691
232,587,752
292,015,478
171,283,954
2,063,755,258
43,002,957
Achievements
In 2011 the department recorded the following achievements:
-
-
Fully settled the outstanding electricity bill of
UGX 71, 272, 678/=.
Audit fees of UGX 22,318,600/= outstanding was fully settled.
Sky Pharmacy - medical drugs supplier was cleared the outstanding amount
of UGX 8,956,250/=.
Significant reduction of salary arrears for 2010 from 257,940,957/= to UGX 91,809,186/=.
Regular procurement of drugs, stationary, food staff and cleaning materials was
adequately facilitated.
Successfully carried out Audit exercise for 2009 and 2010.
Challenges
Financing for Orthopaedic activities remained a challenge as funds had not yet been
approved by CBM.
Salary arrears for August - October 2010 and December 2011 could not be covered.
Computerized accounting package had not yet been installed for quick, timely and accurate
processing of financial statements.
Departure of 2 senior accounts staff at the end of 2011 left the department with a small
number of staff to cover the activities.
Settlement of the outstanding obligations UGX 483,831,875/= of the Hospital
as on 31/12/2011 as below:
Name
JMS
Abacus Pharmacy - Mbale
Kumi Hospital Annual Report 2011
UGX
17,175,337
19,531,900
Page 25
NSSF Arrears 2009 & 2010
PAYE
JEFKKE Cleaners
M/s Aromait& Sons
Staff SACCO
Retirement benefits
Salary arrears (December 2011 inclusive)
Cyber webs
TOTAL
145,477,040
115,009,363
18,379,600
450,000
8,789,000
21,538,780
136,183,855
1,297,000
483,831,875
Appendix
Kumi Hospital Statistics
Table 2: In-Patient Admissions and Deaths
WARD
YEARS
STONE (Paediatric)
OJIKAN (Surgical)
LAING (Female)
BUSIMO (Male)
PRIVATE (Ndahura)
NUTRITION
MATERNITY
EYE
REHABILITATION
Total
2009
2010
2011
Admissions Death Admissions Death
Admissions
Deaths
4313
69
5667
60
4088
46
1983
34
5667
28
227
01
990
47
1717
17
792
14
614
55
985
52
744
55
473
08
875
05
320
04
185
16
542
06
154
11
1839
06
185
11
1091
06
823
00
1723
00
447
00
532
00
879
00
1091
00
11,652
235
13026
179
8073
137
Kumi Hospital Annual Report 2011
Page 26
Table 3:
Maternity
Year
Admissions
Referrals: In
Out
2009
Deliveries
Normal Live Births
Caesarian section
Neonatal Deaths
Maternal Deaths
Lower Birth Weights
Table 4:
2011
1839
441
02
1723
141
04
1380
346
04
942
892
216
02
06
N/A
775
750
309
03
11
N/A
561
503
216
18
06
96
ANC
Activity
New Attendance
4th Attendance
IPT 2
PMTCT
+ve Mothers
Table 5:
Method
Oral
In Plant
Injectable
BT Ligation
IUD
Vasectomy
Condoms
Table 6:
2010
2009
2010
703
96
783
477
N/A
2011
668
110
452
288
788
568
101
00
00
484
Family Planning
2009
2010
2011
03
00
02
00
00
22
42
01
00
87
03
00
68
00
01
Immunization
Antigen
BCG
DPT-HepB+Hib3
Polio 3
Measles
2009
2010
1130
523
523
515
Table 7:
Immunization Pregnant Women
Tetanus Toxoid
2009
TTI
N/A
TT2
N/A
Kumi Hospital Annual Report 2011
2011
480
560
560
400
2010
663
456
513
462
2011
N/A
N/A
340
93
Page 27
Kumi Hospital ANC attendance 2008 - 2011
900
771
800
703
668
700
568
600
500
400
300
200
100
0
2008
2010
2009
2011
years
ANC
Kumi Hospital Annual Report 2011
Page 28
Kumi Hospital in-patient Admission 2009 - 2011
14,000
13,026
11,652
12,000
10,000
No. of Pts
8,073
8,000
In-patients
6,000
4,000
2,000
0
2009
2010
2011
YEARS
KUMI HOSPITAL OPD ATTENDANCE 2007 -2011
60000
50000
40000
30000
YEAR
NO. OF PTS.
20000
10000
0
YEAR
NO. OF PTS.
1
2
3
4
5
2007
2008
2009
2010
2011
28,063
29,580
57,535
39,795
28,086
Kumi Hospital Annual Report 2011
Page 29
KUMI HOSPITAL MATERNITY DELIVERIES 2006 - 2011
1200
1,117
1000
952
978
942
912
775
800
600
DELIVERIES
400
200
0
2006
2007
2008
2009
2010
2011
HCT services kumi Hospital
9,000
8,000
7,000
6,000
5,000
2010
2011
4,000
3,000
2,000
1,000
0
Clients counseled
Tested clients
HIV + clients
Confirmed with TB
Started on CTX
2010
4,933
4,933
196
47
161
2011
7,802
7,824
247
19
206
Kumi Hospital Annual Report 2011
Page 30
Kumi Hospital Bed Occupancy 2008 - 2011
80%
76%
75%
70%
60%
50%
45%
44%
40%
Bed Occupancy
30%
20%
10%
0%
2008
2009
2010
2011
In-Patient death registered from year 2007 - 2011
350
299
300
No. of Death
250
235
200
183
I/P deaths
138
150
124
100
50
0
2007
2008
2009
2010
2011
Year
Kumi Hospital Annual Report 2011
Page 31