“Life in all its fullness”
John 10:10
ANNUAL REPORT
2012 - 2013
www.kisiizihospital.org.ug
Topic
Page
Church of Uganda Kisiizi Hospital – introduction
2
Chart of overview of Kisiizi Hospital Ministries
4
Report for the Year
5
Curative Services / Statistics
13
Support Services
18
Future plans and Vision
19
Appendix 1: Board of Governors
19
COU KISIIZI HOSPITAL– Introduction:
Church of Uganda Kisiizi Hospital is a 260 Bed Private-Not-forProfit (PNFP) rural Health Care Provider situated deep in the hills
of North Kigezi in Rukungiri district, South West Uganda.
Kisiizi Hospital was founded in March 1958 by the late Dr. John
Sharp of Ruanda Mission on the site of an old flax factory. Kisiizi
is a Church of Uganda (COU) hospital and is part of the Diocese of
North Kigezi with the Bishop being the Chairman of the Board of
Governors.
From its inception the aim was for Kisiizi Hospital to be a place
of healing, in body, mind and spirit.
COU Kisiizi Hospital has never closed its doors to patients. It has
continued to expand, now offering Consultant-led services in Obstetrics and
Gynaecology, Paediatrics and Surgery and specialised care in Dental Health, Infectious Diseases& HIV,
Occupational Therapy, Ophthalmology, Orthopaedics, Physiotherapy and Psychiatry.
COU Kisiizi Hospital is a member of Uganda Protestant Medical Bureau (UPMB) network and is a licensed private
not for profit Health Care provider. We run a School of Nursing, Primary School and Hydro-electric power
company. In addition to nurse and midwifery training we train intern doctors in Obstetrics & Gynaecology,
Paediatrics and Surgery.
COU Kisiizi Hospital has a community outreach programme and has responsibility under the District Health
Officer Rukungiri for Health Centres in Rubabo health sub-district. We provide care for the most disadvantaged
and vulnerable groups including in-patient and out-patient mental health services, rehabilitation therapies for
those with short and long-term disabilities, and neonatal care for preterm babies.
World Health Organization [WHO] programmes:
COU Kisiizi Hospital is the only hospital in Uganda in the first-wave of the WHO African Partnerships for Patient
Safety [APPS] programme. Kisiizi has also been chosen in the past year, along with Mulago National Referral
Hospital, Kampala, to take part in the WHO Surgical Unit-based Safety Programme in conjunction with John
Hopkins University, USA. Furthermore, Kisiizi Hospital is one of five locations worldwide chosen by WHO as a
“learning laboratory” for implementation of patient safety principles into universal healthcare coverage
programmes. This relates to Kisiizi Hospital having one of the largest community health insurance schemes in
Uganda with the extraordinary figure of over 35,000 people registered up to 60km from the Hospital.
Motto
The motto of Kisiizi Hospital is taken from John’s Gospel 10:10 and is “Life in all its fullness”.
Vision
Our vision statement is the Summary of the Mission Statement: “Bringing holistic healthcare and life in all its
fullness to the staff, patients, clients, and visitors in the Hospital and Community”.
In addition to the Hospital and its community
Kisiizi Hospital School of Nursing:
Kisiizi Hospital Primary School:
Kisiizi Hospital Power Limited:
Kisiizi Hospital Health Insurance Scheme:
Kisiizi Hospital Child Sponsorship scheme
health work Kisiizi ministries include:
offering Nursing and Midwifery courses
offering Primary Education with a vocational element
generating and supplying electricity to the community.
helping improve access to Health Services by the community.
supporting orphans and needy children’s health & education
Together with partners in Uganda and overseas including United Kingdom, Republic of Ireland, Holland,
Australia, United States of America, we continue to improve our infrastructure and the quality of services
offered at Kisiizi Hospital. As we celebrate 55 years of services at Kisiizi, we wish to significantly increase our
health promotion activities in the hope that we can prevent some of the avoidable diseases we currently see.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
2
The Scope of the Hospital’s core purposes and activities:
We shall provide all the services appropriate to a district hospital, including
community outreach, health education and disease prevention as a not-forprofit organisation. We will provide more specialist services as resources
permit providing they do not detract from the quality of our basic services.
So far as our resources permit, we aim to provide benefits to the local
population socially and economically, as well as providing healing and spiritual
blessing.
We see undergraduate and postgraduate education and staff development as
part of our core purpose.
Our responsibilities:
Our first responsibility is to God
As a Church of Uganda Hospital, our ultimate aim will be to serve and glorify God in all that we do.
Our second responsibility will be to the community
Our care will be holistic in nature, providing for the physical, socio - economic, psychological and spiritual needs
of the people we serve.
Through health education, we will enable local communities to make healthy choices and become more
responsible for their own health.
Those who fall sick will be offered care to the highest standard at an affordable cost.
Our care will be characterized by compassion unaffected by ethnicity, socio - economic status, religious,
denominational or political affiliation or any other prejudices.
Our ultimate aim is to provide ‘life in all its fullness’ through a living relationship with the Lord Jesus Christ to
the patients/clients and the community within and around the Hospital.
Our third responsibility will be to the State
We shall be responsible and law - abiding citizens and make every effort to cooperate with National and District
medical services regarding health care delivery in our area.
Our fourth responsibility will be to our partners and donors
We will communicate effectively with all our partners and donors informing them of our progress and accounting
properly for all assistance given. In the long term, we hope to reduce the need for financial support but as we
serve an extremely poor population then for the foreseeable future we need on-going partnership. We value and
will seek to develop our clinical partnerships in Uganda and overseas.
Our fifth responsibility will be to the Board of Governors
All members of the Management and staff will work to the best of their ability and actively participate in the life
of the Hospital Community.
All members of the Management Committee will be of mature Christian commitment, well educated,
experienced and competent in their respective fields. They will be in Kisiizi most of the time and be accountable
for their respective departments to the Chairman of the Management Committee who in turn is accountable to
the Board.
The Management Committee will be responsible to the Board for financial, personnel and operational
Management and for the maintenance of Hospital premises and property.
We shall conduct all our affairs with integrity and honesty.
Our sixth responsibility is to our Staff
The Committee will ensure that all staff are rewarded with adequate accommodation, fair and adequate wages,
access to high standard primary schooling for their children, job security, clean and safe working conditions and
an organised system where suggestions and complaints are expressed and adequate feedback received.
Our seventh responsibility is to the Environment
We are committed to the environment we live in including the preservation of the waterfall, proper forest
Management and the safe disposal of waste material.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
3
“Life in all its fullness” John 10:10
Chart 1: OVERVIEW OF CHURCH OF UGANDA KISIIZI HOSPITAL MINISTRIES
K.H. CHILD SPONSORSHIP PROGRAMMES
K.H. PRIMARY SCHOOL
610 Children supported for education and health
350 Pupils
Link with Malmo Borgarskola
School, Sweden
KISIIZI
KISIIZI POWER COMPANY
300 kW Hydro-electric plant serving
the Hospital and Community
[a separate limited company]
Board
OVERSEAS SUPPORTERS
Management
Staff
Kisiizi Partners; Dorkas; Cheshire & Wirral Mental Health &
Countess of Chester NHS Trusts; University of Chester; Royal
Berkshire Hospital; Jamie’s Fund; St. Paul’s Church Dublin;
Putnoe Heights/St Mark’s Bedford; TFW Macclesfield; Church
Mission Society; Medical Missionary News; Danida; Uganda
Maternity & Newborn Hub; Peace Corps USA; University
College Dublin; Friends of Kisiizi UK ,USA, Australia
K.H. SCHOOL OF
NURSING
COMMUNITY
CHAPLAINCY
Public health
Supervision Rubabo Health subdistrict Health Centres
Outreach clinics
Mental Health clinics
Community-based Rehabilitation
for patients with disability
Hope Ministries HIV support
K. H. COMMUNITY HEALTH
INSURANCE SCHEME
Over 35,000 members in Rukungiri, Kabale,
Ntungamo and Kanungu Districts
NETWORKS
[one of the largest programmes in Uganda]
North Kigezi Diocese
Rukungiri District Health Officer
Uganda Protestant Medical Bureau
Joint Medical Stores
Inter-Religious Council of Uganda
OPD
IN-PATIENTS
Ante-natal
Medical
General
Surgical
Dental
Maternity
Diabetes
Children
Eyes
Psychiatry
Family spacing
Rehabilitation
Gynaecology
WORLD HEALTH
HIV
ORGANIZATION
Hypertension
*The Immunisation
only hospital in Uganda in
WHOHealth
first-wave
Mental
AfricanPaediatrics
Partnerships for Patient
Safety
programme
Surgery
*Surgical Unit Safety Programme
*Learning Laboratory
Around 200 Nursing and
Midwifery Students
Pupils
TRAINING
Medical Students from
Uganda and overseas
6 Interns rotating through
Obstetrics & Gynaecology,
Paediatrics and Surgery
REPORT FOR THE YEAR
see Chart 1: Overview of Church of Uganda Kisiizi Hospital Ministries
As we celebrate 55 years since the opening of Kisiizi Hospital, we thank God for His faithfulness and provision. Against all
the odds, and with the usual mixture of blessings and buffetings in the past year, Kisiizi has not only continued to provide
health services but has significantly expanded its ministries. It is now a large and complex organisation employing 350 staff
to run all the activities shown on Chart 1.
However, in spite of all the changes and growth, the core aim of Kisiizi is unaltered: that our patients, staff, community and
visitors find for themselves the “life in all its fullness” that Jesus came to bring.
“It is in fact a God-ordained work and as long as it is run with Him in the
centre of every part, then He will continue to use it for His glory.”
Doreen Sharp
Challenges:
We were shocked by the sudden severe illness and death of Sister Gorreti, a much-loved Midwifery Tutor in our School of
Nursing. This was completely unexpected and has left a big gap as she was a key member of the staff and she is greatly
missed.
Some staff left Kisiizi, sometimes to go for better paid jobs than Kisiizi can afford. Tutor Wilber left to take up a post as
Principal Tutor in a private school of nursing. We have been able to fill vacancies for a radiographer, pharmacy technician
and dental clinical officer created by staff moving on.
Financially we continue to be pressurised as the community we serve is so poor and just do not have any spare reserves
whilst inflation continues though at lower rates than before. The Spencer Trust, a registered charity set up in the 1990’s
particularly to support the Kisiizi Hospital Primary School, has closed. We are very grateful for all the support they provided
over decades that has helped us to provide good primary education and retain staff.
Having only recently come through the Ebola scare, we faced an outbreak of Marburg viral haemorrhagic fever close to us
just south of Kabale and once again had to triage all our patients at the entrance to the hospital. Thankfully although we
had a number of possible cases, in the end all the tests proved negative. We are particularly grateful to those Staff who
volunteered to care for the suspected cases, potentially putting their own health at risk in order to serve.
We had inherited targets for our HIV programme with Inter-Religious Council of Uganda that were far too ambitious and not
practical. This has put us in a somewhat embarrassing and uncomfortable position as our performance is falling short of
these targets. They had been negotiated by our predecessors and of course we have to do our best to honour them. We are
grateful to Dr. Josephine Nantongo, Consultant Paediatrician, who is our HIV co-ordinator, and has worked very hard with
her team to put plans in place to improve the numbers of patients cared for.
Bureaucracy can also be challenging, such as the frustration of delays when trying to get tax exemption on a vehicle for our
Mental Health service or the Hospital Land Deeds finalised.
Workload can be extreme, this is particularly the case for our Maternity department and Children’s Ward. We have been
stretched to provide the service as demand is high, with more patients electing to come to Kisiizi.
Data collection has proved a challenge but after a number of training sessions with staff is now improving.
Blessings:
We are delighted to have appointed some key new colleagues including Night Atwongyeire, our physiotherapist, Victor Abaho
in our imaging department and Bowers Turyazayo as our new Finance Manager. We have also welcomed new midwifery and
nursing staff, clinical officers and interns. The national intern committee recognise the level of training we are offering and
confirmed an increase in our intern numbers from 3 to 6 – two in each specialty. We have welcomed back Dr. Robert
Mugarura from Surgical Specialist training and Miss Sandra Owembabazi from Pharmacy Technician training, and Dr. Henry
Lukabwe as a medical officer following his completion of his intern training year.
We have welcomed many visitors, both long and short term, who enrich the life of Kisiizi and hopefully go away encouraged
themselves. One special visitor was Eric Smith who had never been to Kisiizi before but had faithfully prayed for us for fifty
years!
In addition to the interactions shown in Chart 1 we have welcomed volunteers with a new link, the Uganda Maternity &
Newborn Hub. Dr. Rachel Ion, an obstetric registrar, came for six months and more recently Maryanna Ryan, an
experienced nurse with special skills in high dependency care, has joined us for a year.
We are so grateful for support from Kisiizi Partners for equipment including a number of oxygen concentrators, vacuum
delivery set etc as well as their crucial help with salary support and funding for a new Mothers’ Waiting Home plus their kind
further support to help us complete the Jubilee House project. Jamie’s Fund have raised money for a vehicle for our
mental health service which has now arrived in Kisiizi and are fundraising to help us with a new Mental Health Unit.
Dr. Angela Cooper, a recently retired Anaesthetist, joined us for six months and has subsequently provided a new
anaesthetic vapouriser, as have the Kessell family. This equipment is most welcome as the previous apparatus was very old
and becoming unreliable.
Churches in UK, Medical Missionary News and individuals in Uganda and Dublin have
supported our surgical ward renovation fund which has allowed us to refurbish about
half of the old building that was originally a flax factory. This is a real
encouragement as the new terrazzo tiled floors allow proper cleaning which should
reduce cross-infection. We hope to continue this refurbishment to the other half of
the building if funding can be found.
MINISTRIES
[see Chart 1]
[see later in the report for statistics for each area]
1]
CHAPLAINCY
Reverend Patrick Bagorogo has had two jobs as he has been acting finance manager as well as Chaplain (this has now
changed as Mr. Bowers Turyazayo has commenced as Finance Manager). He is supported by Rev. Warren Tumwiine and the
Chapel Council. The latest big event was a Thanksgiving service on 25th August as we celebrated 55 years of Kisiizi. Mrs.
Doreen Sharp, wife of the first medical superintendent Dr. John Sharp, was with us accompanied by her daughter Maggie and
son-in-law Stephen. The next Mission will take place on the weekend of 25-27th October.
There continue to be a number of fellowship groups meeting during the week as well as the usual morning prayers for staff.
A discipleship class has run since October 2011 led by Herbert Kwikiriza and is well attended. In addition, quite a few staff
and students are involved in the Langham training courses inaugurated by the late Rev. John Stott which are quite in-depth
Bible and preaching studies. The chapel choir provides musical support for services and the weekly Attendants’ fellowship is
popular. There are regular times of sharing on the wards with patients and attendants.
2]
KISIIZI HOSPITAL PRIMARY SCHOOL
Motto:
“for a better future”
We have 350 pupils enrolled under the leadership of Headmaster Spencer Tweteise. There is a mixture of day pupils and
boarders. The school has a link with Malmo Borgarskola school in Sweden and there have been bilateral visits. The results of
the most recent examinations were encouraging. The school had been established originally to help the hospital retain staff
when their children reached school age.
3]
KISIIZI HOSPITAL POWER COMPANY
After many years of valuable service, Mr. George Wadsworth handed over his role as Manager to Mr.Herbert Kwikiriza.
Charles Swainson kindly came back to Kisiizi a couple of months ago to supervise the routine maintenance changes of the
bearings of the new generator which has been in service for four years. The power to the community was off for a couple of
days during this work but the hospital ran well on the older hydroelectric generator. We really appreciate the staff of the
company and the wonderful support from Dr. Bill Cave, Paul Darrall and Charles Swainson which has given us such reliable
power and allowed the hospital to develop and provide higher levels of care. The company has continued to expand the
distribution network and the pre-payment meter system works well. There is a good level of demand as our power is
cheaper than the national grid and more reliable. We have faced challenges in the dry season when the river had reduced
flow affecting our potential to generate and we need to find ways of controlling the current levels of usage by our staff
accommodation so we can free up more power for selling to the community.
4]
KISIIZI HOSPITAL CHILD SPONSORSHIP PROGRAMMES
These are supported by Dorkas Aid International, a Dutch-based Christian charity with a regional office in Kenya; and the
Sponsor an Orphan arm of Kisiizi Partners. The programme provides support for education and health care for 610 children.
We hope to develop our support for children with special needs in future and the sponsorship programmes may help us in
this.
We are grateful to Olwyn Goulding for her help in auditing the scheme with a very useful and detailed analysis which we are
now reviewing with the Staff.
5]
KISIIZI HOSPITAL COMMUNITY HEALTH INSURANCE SCHEME
The first of its kind in Uganda, our scheme has grown over the years and now has over 35,000 people registered. The annual
premiums are between 7,000 and 12,000 Ugandan shillings [approx. £1.75 – 3.00 equivalent] and cover all emergency
treatments and quite a lot of other non-urgent care. The scheme has allowed extremely poor people to access health
services at Kisiizi that would otherwise be out of reach. It all works by spreading risk over large numbers.
There was a large deficit in the financial year to June 2012 amounting to around 80 million shillings. Happily after adjusting
the premiums and co-payment rates we have broken even for the year to June 2013. Our goal is to run the scheme at cost
without either profit or deficit and it is encouraging that we have achieved this in the current period. The scheme does not
have any external or donor support, hence World Health Organization’s interest in it as a model that may be applicable in
other parts of the world.
We need wisdom in planning the way ahead. It is likely that we could expand the numbers on the scheme further and
potentially in the longer term provide some clinical services in other centres nearer to some scheme members. The scheme
has now grown to include Ruhama and Bwambala.
The scheme originated from the community “engozi” groups that had grown up to share the cost of burials. It was a logical
step to move to health insurance. There are 173 groups in the scheme at present, up to 60km from Kisiizi. The attendance
of the group leaders at the AGM is really good with an enthusiastic spirit of working together to make it all work as they
really appreciate the scheme.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
6
Recently Kisiizi ran a Health Promotion training day for the group leaders and this went well. We will analyse how
effectively the key messages have been transmitted to the members.
We are planning to make local-language videos on key health topics to try and facilitate health promotion through the
scheme and the church networks plus schools. We have produced the first pilot and this has been tried out in our OutPatient area where people wait for clinics.
6]
KISIIZI HOSPITAL SCHOOL OF NURSING
Motto: “Compassion and Competence”
We were pleased to welcome back Sister Annet Komukama who has completed her
training as a Midwifery Tutor. Sister Leah Tumuheirwe continues to lead the team
who were shaken by the unexpected loss of Sister Goretti after a sudden severe
illness. In addition the departure of Tutor Wilber has left the staff stretched.
Hospital staff have supported their colleagues in the School of Nursing teaching
clinical topics.
We have around 200 students in the school studying nursing or midwifery. Our
goal is to have an integrated approach rather than a separation of the school and
the hospital and this will require Tutors and, particularly, Clinical Instructors, to
spend more time on the wards and in clinics.
The old and the new – buildings at the School of Nursing showing the modern
practical clinical classroom block.
We plan in November to undertake a strategic review of the School of Nursing
supported by colleagues from the University of Chester.
[See the Kisiizi
Hospital School of Nursing annual statistical report for more information]
7]
TRAINING
The following have completed their training and are now back working in Kisiizi:
Doreen Twakire
Registered midwife
Owembabazi Sandra
Pharmacy Technician
Sr. Annet Komukama
Nurse/Midwifery Tutor
Akankwasa Justine
Chartered Accountant
We will continue to build up the current systems of audit and continual professional development at both departmental and
hospital wide levels. We are introducing formal appraisals and mentoring arrangements.
We currently have 5 Medical Officers, 6 intern training posts and 4 Clinical Officers. We have a range of specialist clinical
officers in anaesthesia, dentistry, orthopaedics etc.
We also train medical students from Mbarara, Kampala and overseas when they come on attachments here.
We continue to invest in training of Staff in midwifery, nursing, tutor training etc both by sponsoring staff for specific
courses and through partnership links with training on-the-job here in Kisiizi, for example in radiology and obstetrics. Some
have been sponsored for short visits to the UK, for example in Anaesthesia, Radiology and Ultrasonography, visiting our link
hospitals in Chester and Reading. We appreciate Bursaries from the Ministry of Health and Kanungu districts that help to
sponsor some students in our School of Nursing.
External courses
Name
Dr. Robert Mugarura
Mucunguzi Emmanuel
Mr. Ahmlet Turyahikayo
Course
Masters in Surgery
Nurse Tutor
Diploma in Laboratory Studies
Duration
3 years
3 years
2 years
End date
September 2013
August 2014
June 2015
Kisiizi Hospital School of Nursing
Name
Muhwezi Levi
Sam Byaruhanga
Agnes Katwesigye
Alice Nakanwagi
Joan Aharizira
Jadress Asimwe
Plaxeda Nagawa
8]
Registered
Registered
Registered
Registered
Registered
Registered
Registered
Course
Nurse
Nurse
Nurse
Nurse
Nurse
Nurse
Nurse
18
18
18
18
18
18
18
Duration
months
months
months
months
months
months
months
November
November
November
November
November
November
November
End date
2013
2013
2013
2013
2013
2013
2013
COMMUNITY PROGRAMMES
a)
Supervision of Health Centres:
We have delegated responsibility for the health centres in Rubabo Health SubDistrict. We liaise with the District Health Officer in Rukungiri. Dr. Onesmus Ahabwe, one of our medical officers,
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
7
is the lead for this work. He will also be working one day a week for the North Kigezi Diocese clinic in Rukungiri and
will have a supervisory role for the diocesan health centres so this should all join up well.
b)
Primary Health Care outreach clinics: We continue to provide five general outreach clinics a month with antenatal, child welfare and immunisation, and basic medical care plus health promotion.
c)
Mental Health Clinics: We run two clinics a month in the community and these are heavily over-subscribed with
over a hundred patients turning up. The new mental health vehicle should facilitate these outreach trips. We need
to increase our staffing levels but as the service runs at a loss with the hospital subsidising the care of these very
needy patients, it is not so easy to find resource for more salaries. There are active and very positive patient
groups.
d)
Community Based Rehabilitation: Our CBR worker is Hannington, from our Rehabilitation Unit team. He visits
community groups on his motorcycle. The main emphasis is providing therapy in groups for children and adults with
disability. The physio teams from Dublin have provided valuable support.
e)
Hope Ministries: This is the entry point for all HIV/AIDS Care and support activities.Key to the services rendered
are spiritual and psychosocial counselling and practical support. They do home visits to support families as well as
the patients and are involved in health promotion to try to minimise the spread of HIV. Dr.Josephine Nantongo coordinates the HIV service here. Option B+ has been introduced.
9]
OUT-PATIENT SERVICES
We continue to provide a wide range of out-patient clinics. We now allocate at least one Medical Officer to the clinic daily
which has improved the quality of care, and we have been able to allocate a Paediatric intern to see children in clinic most
of the time. The HIV clinic is now running every weekday due to demand.
We have analysed the problems of flow of patients through the department and plan to streamline this with a one-way
system and a fairer queuing arrangement to ensure patients are seen in the correct order unless their clinical condition
warrants urgent attention. We have allocated a separate area for children to wait.
We have piloted a health education Rukiga video made in Kisiizi and plan to develop this resource.
We have installed a further oxygen concentrator to deal with emergencies.
We are unhappy with the very low numbers seen in our Family Planning services and plan to increase these significantly.
We plan to move our Mental Health clinic up to the general out-patient block in a designated room once the electricians who
currently occupy the room have moved to their new workshop area.
10]
a)
b)
IN-PATIENT SERVICES
Medical & Isolation Wards: Our Medical Officers have been supervising the care of general medical cases in adults
as we do not have a specialist. However, we were delighted to welcome Dr. Sam Hardman for six months with her
husband Dr. Simon who worked in Paediatrics. In addition, we had a valuable visit from Dr. Dwight McLeod,
Consultant Physician who came for 3 weeks with his wife Sandy who is a Health Visitor. We are delighted to report
that they have offered to come and work voluntarily with us for at least 6 months from September 2014. We have
just welcomed another volunteer couple, Drs Paul and Bryony Bambrough, working with us for 5 months, who have
experience in general adult medicine and paediatrics.
Surgery Wards:
Having opened our new Operating Theatre suite, provided with support from St. Paul’s church in
Dublin, we have now been working on renovation of the old flax factory building which houses the surgery ward.
With support from Putnoe Heights and St Mark’s Churches in Bedford, plus some individuals in Dublin and Uganda,
we have refurbished the first half of the building with a new ceiling, plastering of the walls and a completely new
floor. This involved removal of the old very poor floor and installing concrete foundations and then terrazzo tiling.
The result is that we can now clean the floor properly allowing infection control. We are now seeking funds for the
remainder of the building.
This is timely as we have welcomed our second Consultant Surgeon, Dr Robert Mugarura after his training. This will
mean we can have a specialist surgeon on site almost the whole time and should increase our capacity.
This also fits in very well with Kisiizi being asked by WHO to participate in the new Surgical Unit based Safety
Programme. Dr. Gabriel Okumu, our lead Consultant Surgeon, attended a planning meeting for the programme in
Geneva. He was one of only five African Surgeons present so it is recognition of the level of work we do. He has
just returned from a further trip to Harare and the programme will commence in the next couple of months. We
hope it will facilitate us being able to introduce microbiology culture and sensitivity testing.
Our colleagues in Royal Berkshire Hospital have continued to provide regular Consultant visits for Urology and have
trained Dr. Gabriel in this specialty. He will be spending a clinical attachment with them in Reading in October. He
is also going to learn more upper and lower GI endoscopy in Reading and in Chester and then expand this service in
Kisiizi.
Safe anaesthesia is, of course, an essential pre-requisite for good surgical care. We are grateful for two Consultant
Anaesthetists who have provided valuable support and training, initially Dr. Neil Fergusson from Chester for a
couple of weeks and then Dr. Angela Cooper, a CMS Volunteer, for six months. She is now helping us with some new
and overdue equipment. Our senior anaesthetic clinical officer, Gershom Kabagambe, has been to Chester for an
attachment. Dr. Mark Fisher from New Zealand is here for a couple of months supporting the department.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
8
c)
Mental Health Unit:
The Mental Health Services has
continued to develop. Kisiizi is the only non-government hospital
in the country offering dedicated in-patient mental health
services. The department is run by Sr. Nancy Mwebesa, Psychiatric
Clinical Officer supported by two Registered Psychiatry Nurses. We
are sponsoring the training of a second Psychiatric Clinical Officer.
Outreach mobile clinics every fortnight are overwhelmed by
demand with over a hundred patients turning up at times. The
team continue to provide a vital service supported by invaluable
visits from colleagues in the Cheshire and Wirral NHS Mental Health
Trust including Dr. Maureen Wilkinson, Consultant Psychiatrist. We
are aiming in the next 2 years to construct a purpose-built new
Mental Health Unit on a new site to replace the current Ahumuza
ward which is in poor condition and will itself be then demolished to make way for new ward facilities linked to the
new operating theatres. Jamie’s Fund, a new UK registered charity, launched on 28th September to help support
Kisiizi mental health programmes. Plans for the new Mental Health unit are being finalised, and Jamie’s Fund have
started fundraising having already raised the cost of the mental health vehicle.
d)
Maternity Ward: The workload has been high as some other hospitals have not functioned so well. This has meant
we have had over-crowding making it very hard to nurse patients and to avoid cross-infection. We are grateful to
Kisiizi Partners for providing funds to allow us to put up a Mothers’ Waiting Home to take the low-risk mothers who
are simply waiting on-site so that when they go into labour there is no delay in being cared for. The foundations
have been started and we hope this facility will significantly reduce the pressure on the main ward.
We also appreciate the input of Dr. Helen Allott and teams from Reading plus the volunteers on the Maternity and
Newborn hub link in helping train staff in emergency procedures in obstetrics and reviewing our clinical protocols.
We are looking forward to welcome Geraldine Godwin and Mandy Borton, two midwives on the hub link joining us in
November.
e)
Special Care Baby Unit:
This unit is supervised by Sister Ann Moore and can be extremely busy. There is
very little neonatal care offered in our area and so we sometimes receive very small babies from some distance.
The babies are generally either pre-term or, sadly, asphyxiated babies whose mothers may have come in to Kisiizi
with obstructed labour in the community. We have had some very good outcomes with neonatal surgery too.
Although we do not have basics such as blood gas analysis and certainly nothing like surfactant, we can give oxygen
and continuous positive airways pressure, intra-venous glucose, blood and antibiotics, phototherapy and we can
keep babies warm which allows us to help a good number.
f)
Children’s Ward: This is a very busy unit with large numbers of admissions,
especially under 5 years of age. The commonest problems are pneumonia,
malaria, gastro-enteritis but also we sadly see a number of cases of
malnutrition. We also receive some children damaged by traditional healers
who will cut incisions in the skin of the chest and back in children with
breathing difficulty and will dig in the gums of those with gastro-enteritis.
These interventions may lead to sepsis or haemorrhage and, in one child, a
punctured lung presumably due to the child struggling whilst being cut. We
hope to include explanations about the risks of these procedures in our Health
promotion videos. We see some extremes of pathology, for example a 7 year
old with a massive collection of fluid in the pericardium, the sac around the
heart, which had been present for about 3 years.
g)
Rehabilitation: Mr.Aloysius Batarigaya,
an Occupational Therapist, heads the department supported by Mr. Ntumwa
Bedard, Orthopaedic Officer, and Mrs. Night Atwongyeire, our
Physiotherapist. There are 2 rehabilitation assistants, 1 community based
rehab worker, 1 carpenter and a porter. Around 38 patients a month receive
physiotherapy, 43 occupational therapy, 45 orthopaedics, and there are
regular sessions for psychiatry in-patients.
Children from the malnutrition unit are seen in Rehabilitation for sessions to help
stimulate their development and play, and to train the parents in how to continue this
at home.
The unit was busy recently following a paediatric orthopaedic camp where around 30 children underwent corrective surgery
for a variety of problems. Initially they were cared for on the Children’s ward and then moved up to Rehabilitation
dormitories where some stayed for weeks as they recovered and mobilised. University Collge Dublin send teams of
physiotherapists annually to support the work and we are most grateful to Liz Hardinge, a senior very-experienced
Physiotherapist for coming on a consultancy visit. The recent Dublin team helped us to install a new playground for the
children and this has given the department a real facelift.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
9
11]
NETWORKS
We work in partnership with our local District Government officials. The Medical Superintendent had the honour of being
asked to represent the Employers of the District at the Labour Day celebrations in Rukungiri. We continue to network as
members of the Uganda Protestant Medical Bureau (UPMB). Partnerships are core to our ability to provide the level of
services we now run, and we are very grateful to support from Inter-religious Council of Uganda (IRCU) and the Ministry of
Health as well as overseas friends including Friends of Kisiizi in UK, Ireland and USA, Kisiizi Partners, Royal Berkshire
Hospital, Countess of Chester Hospital, University of Chester, Cheshire & Wirral NHS Mental Health Trust; Dorkas Child
Sponsorship programme, Uganda Maternal & Newborn Hub; Peace Corps USA, Medical Missionary News, Church Mission
Society; Tropical Health & Education Trust (THET) and a range of churches and individuals in Uganda and overseas.
We are deepening our relationships with the Diocese, hoping to engage more with parishes in the future to mobilise health
promotion, family planning etc. as well as sharing the Gospel. We greatly value the visits of individuals and church groups to
encourage us spiritually as well as medically.
The formal link established between COU Kisiizi Hospital and the Countess of Chester Hospital / University of Chester in
England with the main Objective of Improving the Quality of Care offered to patients at Kisiizi Hospital completed the 3 year
programme. It made a real impact in the areas of the School of Nursing, Radiology /Imaging, Pharmacy and Medicines
Management and other areas such as supporting our Anaesthetic Clinical Officers with bilateral visits. Both parties are keen
to continue the partnership, as are colleagues at Royal Berkshire Hospital.
We work closely with Joint Medical Stores in Kampala who are the main providers of our medicines and equipment. InterReligious Council of Uganda, supported by USAID, sponsor and support our HIV programme.
We enjoy an annual visit from a group of teenagers and teachers from St. Andrew’s school in Dublin who stay in Kisiizi as
part of their time in Uganda and interact with Rubiriizi Secondary School, about a mile from us.
We have appreciated visits from colleagues at Church of Uganda Kagando Hospital, PAG Health Unit in Lira and Bwindi
Community Hospital and hope to set up more opportunities for interaction and mutual support.
12]
CLINICAL SUPPORT SERVICES
a)
b)
c)
d)
e)
f)
g)
13]
a)
Medical Equipment maintenance: We are setting up a new Biomedical Engineering and Electricians’ workshop area
in an old operating theatre. This will provide improved facilities and also free up a room in out-patients needed for
mental health clinics. It should also allow equipment currently stored in one of the new theatres being sorted
properly. We are thankful for Robert and Roger, engineers who have visited Kisiizi and worked with Herbert and his
team on equipment maintenance as part of the THET sponsored programme.
Medical Data: This has been a problem area but the appointment of an assistant Information Officer has improved
the situation. There has been a lot of training input.
Pharmacy: Mr. Samson Olema, a Senior Pharmacy Technician, left the department and his role has been taken over
by Ms. Sandra Owembabazi, whom Kisiizi had sponsored for training. We wish to upgrade the IT system in use and
the system for ordering medicines which has sometimes been ineffective with some medicines running out and
others expiring, both of which are unacceptable.
With the support from WHO African Partnerships for Patient Safety, we now produce Alcohol Based hand Rubs
(ABHRs) on site used by Clinicians to disinfect their hands between patients. This is, of course, a key part of
infection control.
Laboratory: We introduced CD4 counts to facilitate our monitoring of HIV patients. However, generally we still
have only basic facilities. Our goal is to move towards culture and sensitivity testing in microbiology to allow us to
guage the current prevalence of micro-organisms and the antibiotic sensitivity patterns.
Imaging: The input from Chester has greatly enhanced the department. Unfortunately Brenda has left but we have
appointed Victor to the team. We hope longer term to try and access an image intensifier to support surgery
especially orthopaedics. We would like to develop an Echocardiogram service to help provide prompt and accurate
diagnosis of congenital and acquired heart problems but do not currently have the trained staff to do this.
Infection Control: We have had a very high focus on infection control as part of our involvement in APPS [see WHO
section]. Dr. Gabriel Okumu is Infection Control Lead. Sister Moreen Ahimbisibwe has been our Infection Control
Sister but has recently moved to Kampala. We are reviewing the role as it will be broadened as we introduce the
new Surgical Unit-based Safety Programme with WHO. We also greatly value the support provided by Ms. Alia Fry, a
volunteer with Peace Corps USA who has worked very hard in infection control, patient safety and health insurance.
Administration: Various committees offer support to clinical governance. Dr. Francis Banya is Clinical Governance
Lead and chairs the CG committee. There are also Drugs & Therapeutics and Infection Control meetings. Weekly
audits are held with all relevant clinical staff and students to look at each of the main departments in turn.
Mortality is reviewed and interesting cases discussed.
NON-CLINICAL SUPPORT SERVICES
Internet: We are very grateful to Dr. David Hibbard and his team in USA for their help in sponsoring our internet
provision. We have had rather erratic service due to an unreliable internet-service provider and we are hoping to
change to a new company this month. We have updated our website and can edit it in Kisiizi.
b) Guesthouse.
The Guest House and Round Houses remain very popular with Ugandan and overseas visitors. We have now opened
up extra rooms at one end of a large staff house as a Guest House annexe for overflow when demand is high and this
is proving valuable.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
10
c)
d)
e)
f)
g)
h)
i)
Laundry: The provision of an industrial washing machine by friends in Chester has made
a big difference to the challenging job of cleaning linen for theatre and the wards.
Vehicle workshop: The roads remain rough and demanding and we had problems with
one of our relatively new vehicles which cost us a lot of money and may have been
related to poor workmanship by one of our mechanics in the past. However, the
alternative of getting all services done at a Toyota dealer in Kampala is very expensive
too. We have not had any problems with fuel supplies. We have just received the
Mental Health vehicle and would like to be able to acquire a bus for the School of Nursing
as they have to take numbers of students out for field work.
Estates: This department is responsible for maintenance of buildings, water supply and
plumbing, sanitation etc. Unfortunately the maintenance side of things has not
functioned as well as we wish and plans are in place to improve the situation. We are
preparing to fell sections of our eucalyptus forest which are ready for harvesting. The
woodwork shop employs 6 staff that makes household items such as beds, chairs and
tables together with items for the Hospital.
Goat Project & Farm: The 5 cows of the farm graze the riverside meadow and their milk is used on Children’s ward
and for staff. The goats are given to needy families to help them be self-sufficient.
Stores: These are in need of an overhaul. We need a proper inventory system and stock control and clear lines of
accountability for both medical and non-medical supplies. To this end we are establishing an inventory database.
We sadly had to dismiss one of our storekeepers for serious issues.
Administration / Finance: The appointment of a new finance manager is
important. In addition, Justine Tushemereirwe has successfully achieved
her Chartered Accountant qualification. We plan to re-organise the
department and create more of a bank style environment for security.
Buildings: We are delighted to have just opened the Jubilee House, our
Staff accommodation flats. It has taken many years to reach this stage
due to some major challenges when the engineer commissioned to do the
work kept demanding more money and, when refused, locked the
building. It was very frustrating to see it standing empty when we have
pressure on accommodation. The answer to our prayers was surprising –
our lawyer recommended that we just break in to the building and finish
off the work ourselves which is what we did.
The Mothers’ Waiting Home is under construction. We plan to start the
School of Nursing Dormitory project in the next few months.
Renovation of the surgical ward continues as funds allow. We have recently
received back a building previously occupied by Equity Bank and will probably use
this initially to help ease accommodation pressure.
j) Hospital Shop and Restaurant.
These are rented out as commercial enterprises. Longer term we wish to review
the provision of shops, restaurant facilities and consider other innovations such as a
Bakery.
14]
WORLD HEALTH ORGANIZATION PROGRAMMES
Participation in the World Health Organisation African Partnerships for Patient
Safety Scheme has led to a number of tangible improvements in patient care. We
ran a Sensitisation Day in February and then a 2-day training seminar in March to
amplify the programme and this proved very successful with excellent
implementation of action points generated. We submitted an abstract paper and were accepted for an oral presentation at
the second International Conference on Prevention & Infection Control in Geneva in June. We were unaware that we were
in a competition in the “Implementation Academy” section of the conference where there were presentations from China,
Germany, Malta etc. and were delighted that Kisiizi won first prize!
Subsequently we were invited to participate in the new Surgical Unit-based Safety Programme and Dr. Gabriel Okumu, our
Consultant Surgeon, has been to Geneva to the strategic planning meeting and to Harare for a follow up.
We are researching best approaches to apply patient safety principles and health promotion messages to our regional
communities and will feedback to WHO and interact with other projects in 4 other centres worldwide.
15]
HEALTH PROMOTION
We are hoping to produce more local-language videos here in Kisiizi to facilitate getting key health promotion messages to
our communities. We have the potential to reach over a quarter of a million people in the next couple of years.
16]
UGANDA : UK HEALTH ALLIANCE
We have a number of links with this important initiative instituted by Lord Nigel Crisp who produced the influential Crisp
Report a few years ago. Dr. Ian Spillman is a voluntary in-country director and supporters of Kisiizi including Professor Ewan
Wilkinson are involved in the Alliance committees. We hope that these links will improve co-ordination of support for health
programmes in Uganda and also that we will be able to demonstrate the work and roles of church hospitals who provide
much of the healthcare to poor rural communities in sub-Saharan Africa.
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
11
Vision for the future
We are very aware of the economic pressures affecting our communities with many families struggling to educate or even
feed their children. We are committed to developing our health promotion, family planning and community services in
partnership with the local government services, Church and other organisations. We wish to utilise the extraordinarily large
number of patients in our Health Insurance Scheme in the above programmes and seek to integrate all these activities with
our mental health outreach, primary care teams, Hope Ministries etc. to maximise the effectiveness of each. We will utilise
our links with WHO to share our experience and to learn from others.
The new Mothers’ waiting home under construction will help us reduce the overcrowding on the maternity unit which partly
results from problems in other hospitals in the region causing more mothers to choose to come here. More importantly it will
reduce morbidity and mortality by ensuring high risk mothers are able to access medical services without any delay.
We are introducing staff appraisals and hope the process proves constructive and increases professionalism and enjoyment of
work. On-going improvements in infrastructure will continue as funding allows. Focus on improving specific areas such as
High-Dependency and Palliative care services will evolve.
Acknowledgements and heartfelt thanks
Kisiizi Hospital is God’s hospital and thankfully through all the challenges He has remained faithful. We are grateful to our
Staff who serve in caring for the patients with skill and compassion, and to our partners and supporters who have stood by
us, prayed for and encouraged us, and given financial help to sustain and develop our ministry. The discrepancy between
the local economy in our area where most people are subsistence farmers, and the cost of services or goods from Kampala or
beyond, is huge. For example, we currently charge a fee of 3,000 Uganda Shillings [UGX] for an adult out-patient
consultation [equivalent to about 75 pence in sterling] but the cost of a part for our blood count machine in the lab is
500,000 UGX with a bill of 450,000 UGX for the Ugandan technician from Kampala.
We would also like to thank the Board Members, the District Health Officer and his team, UPMB colleagues, IRCU support
teams and all Kisiizi Donor’s/Partners (Kisiizi Partners, Friends of Kisiizi United Kingdom, Ireland and United States of
America, St. Paul’s Church and other friends in Dublin, Dorkas, THET [Tropical Health and Education Trust UK]; Royal
Berkshire and Countess of Chester Hospitals, University of Chester, Cheshire & Wirral NHS Mental Health Trust, Jamie’s fund,
Peace Corps USA, Spencer Trust, Child’s Trust, WHO and Churches and Friends both in Uganda and overseas for their
commitment to supporting the work at Kisiizi. We would not have been able to achieve the current progress without this
support.
We hope and pray that God will continue to show you His favour and blessings.
Rt. Rev. Patrick Tugume
CHAIRMAN BOARD OF GOVERNORS
Dr. Ian Spillman
MEDICAL SUPERINTENDENT
Date:
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
12
HOSPITAL SERVICES / STATISTICS
CURATIVE SERVICES
Outpatients Attendance
2011/2012
Category
New attendance
Re-attendance
Total Attendance
Referrals to unit
Referrals from unit
2012/2013
New attendance
Re-attendance
Total Attendance
Referrals to unit
Referrals from unit
0-4 years
Male
1579
415
1994
59
0
Female
1819
517
2336
55
0
5 and over
Male
5709
2336
8045
586
0
Female
8691
2346
11037
840
0
3842
952
4794
2
0
4018
1409
5427
8
0
8917
2686
11603
40
3
12539
4229
16768
38
1
45000
40000
35000
30000
25000
2010-11
20000
2011-12
2012-13
15000
10000
5000
0
0-4 male
0-4 female
5 and over
male
5 and over
female
totals
Maternal Child Health and Family Planning
2009/2010
2010/2011
2011/2012
2012/2013
Category
New ANC attendance
ANC re-attendance 4th visit
3755
3951
3158
738
1917
621
3561
1454
Referrals to unit
Referrals from unit
First dose IPT (IPT1)
Second dose IPT (IPT2)
194
0
3110
1456
1182
0
4164
1970
88
0
2780
1930
2
0
2729
1986
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
13
Contraceptives Dispensed
167 new users, 80 revisits in 2011/2012
2009/2010
Number
Dispensed
at Unit
34
54
00
00
707
100
Category
Oral : Lo-Femenal
Oral: Microgynon
Oral: Ovrette
Oral: Others
Condoms
IUDs (Copper T)
Injectable
Others:
2010/2011
Number
Dispensed
at Unit
42
58
6
6
76
2
194
3
2011/2012
Number
Dispensed
at Unit
0
18
0
0
144
17
50
18
2012/2013
15
31
15
0
144
22
136
83
Others
Category
Female Sterilisation (tubal
ligation)
Male Sterilisation (vasectomy)
Implant new users
Implant revisits
Implant removals
2009/2010
Number
21
2010/2011
Number
2
1
14
19
0
1
6
8
1
21
2009/2010
Number
3132
1523
2010/2011
Number
2011/2012
Number
2012/2013
Number
3424
1613
2834
1479
60
2011/2012
Number
28
2012/2013
Number
163
3
65
10
8
0
TETANUS IMMUNISATION
Pregnant women TT vaccine
Dose 1
Dose 2
Dose 3
147
459
249
3318
1740
195
Dose 4
Dose 5
37
25
82
45
85
55
53
36
Non-pregnant women TT
vaccine
Dose 1
Dose 2
Dose 3
Dose 4
Dose 5
Number
Number
210
28
7
0
0
241
26
5
5
0
Number
86
0
1
0
0
Number
915
804
0
0
0
CHILD IMMUNISATION
BCG
Polio 0
Polio 1
Polio 2
Polio 3
DPT-HepB+Hib 1
DPT-HepB+Hib 2
DPT-HepB+Hib 3
Measles
2009/2010
3511
1759
2566
2404
2294
2567
2478
2349
2151
2010/2011
4095
2253
2718
2504
2377
2715
2518
2549
2275
2011/2012
3798
2260
2253
2318
2281
2282
2327
2314
2187
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
2012/2013
3335
2096
2122
1977
1935
2066
2066
1914
2014
14
IN-PATIENT ADMISSION DATA
(A)
List of Wards
2011/2012
(B)
Beds
(C)
Admissions
(D)
Deaths
(E)
Patient
days
(F)
Average
length of
stay
=E/C
Children’s Ward
Medical Ward
Surgical Ward
Isolation Ward
Maternity Ward
Mental Health
Special Care Baby Unit
39
32
46
29
34
25
10
1829
1354
1620
545
2352
354
373
37
65
25
43
4
1
41
9824
7203
8959
3406
12130
6362
3633
5.4
5.3
5.6
6.2
5.1
17.9
9.7
(G)
Average
Occupancy
= E / No.
of days in
month
27
19.7
24.5
9.3
33
17.4
10
(H)
Bed
Occupancy
= G x 100 / B
Rehabilitation
45
129
0
1913
14.8
5.24
11.6%
Totals
260
8184
175
47269
139
52%
Children’s Ward
Medical Ward
Surgical Ward
Isolation Ward
Maternity Ward
Mental Health
Special Care Baby Unit
39
32
46
29
34
25
10
2094
1677
1520
542
2143
296
396
25
51
25
31
5
3
40
10563
10489
9011
3897
9625
4662
3913
5
6.3
6
7.1
4.3
16
10.8
29
29
25
11
25.4
13
10.7
74.4%
90.6%
54.3%
38%
74.7%
52%
107%
Rehabilitation
45
156
0
2057
13.2
6
13%
Totals
260
8824
180
54217
8.5
139
53%
69%
62%
53%
32%
97.7%
70%
100%
2012/2013
ADMISSIONS
3000
2500
2000
1500
2010-11
2011-12
1000
2012-13
500
0
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
15
Maternity Services and Special Care Baby Unit (SCBU):
2009/2010
Category
Admissions
Referrals to unit
Referrals from unit
Deliveries in unit
Caesarian sections
Deliveries HIV positive in unit
Deliveries HIV positive who swallowed ARVs
Live births in unit
Babies born with low birth weight (< 2 . 5 kg)
Live births to HIV positive mothers
Babies (born to HIV positive mothers) given ARVs
Still births [fresh]
Babies admitted with Birth Asphyxia in SCU
Maternal deaths
2010/2011
2348
52
1
2067
454
72
69
2003
291
74
73
47 [34]
185
7
2011/2012
2577
48
1
2483
664
102
101
2735
291
86
86
38
2012/2013
2589
77
0
2583
871
116
108
2926
289
111
111
[17]
134
6
39
2143
107
0
1910
486
100
98
1931
155
99
99
[27]
116
4
39
247
5
Kisiizi continues to act as a referral centre for Maternity services in the area and we are committed to offering high standard
quality services.
Kisiizi receives referrals from as far as Ntungamo, Kanungu, Kabale and Rukungiri Town. TBA’s (Traditional Birth Attendants)
and Midwives from lower level units continue to refer high-risk cases and problem deliveries to the hospital. We will collect
patients in a hospital ambulance when called.
We are now linked to the Maternity Hub which is a partnership with UK institutions and has led to us having an obstetric
registrar supporting quality improvements on our unit.
Surgery:
The surgical service continues to attract patients from a wide geographical area. We have recently opened our new
operating theatres which are excellent.
2010 – 2011
1444
3105
4549
Major cases
Minor cases
Total
2011 - 2012
1492
2288
3780
2012/2013
1348
3271
4619
Major Surgical Procedures
Including laparotomies, caesarian sections, prostatectomy, hysterectomy, hernias etc.
Major Operations
1507
1600
1348
1400
1206
1200
1000
875
686
800
550
600
400
200
2010-11
212
152
2011-12
2012-13
444 480 459
203
0
gynae
obs
general surgery
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
TOTAL
16
Eye Department.
We are grateful for the support of the Ruharo Eye Clinic in Mbarara and their mobile eye surgery team.
30 patients underwent cataract surgery and 6 had minor ophthalmalogical surgical procedures.
OUT-PATIENT EYE CLINIC PATIENTS
2011/2012
144
10
0
253
87
21
1231
1746
Cataract
Glaucoma
Trachoma
Refractive errors
Trauma
Foreign body
Other
TOTAL
2012/2013
107
23
0
257
54
34
1249
1724
HIV Counselling and Testing, PMTCT and ART, Hope Ministries
PMTCT SERVICES
2012/2013
2733
112
Pregnant women tested for HIV
Pregnant women positive for HIV
HCT SERVICES2011 / 2012
Category
No. of individuals < 5 years
No. of individuals 5 - <18 years
Male
Male
HIV counselled
HIV tested (from lab register)
Received HIV results
HIV positive (from lab register)
HIV positive cases with confirmed TB
HIV positive cases started on CTX
(Cotrimoxazole) prophylaxis
Female
52
52
06
0
04
48
48
07
3
03
83
191
191
07
1
01
Female
228
400
400
21
1
02
No. of individuals 18 years
and above
Male
Female
1080
2866
1157
4164
1157
4164
135
250
24
8
12
55*
* incomplete data
ART SERVICES 2011/12
Category
No. of individuals < 5 years
No. of individuals 5 - <18 years
Male
Male
Eligible for ART
Clients on ART
HCT SERVICES
Category
05
06
05
08
Female
18
12
2012 / 2013
HIV counselled
HIV tested (from lab register)
Received HIV results
HIV positive (from lab register)
HIV positive cases with confirmed TB
HIV positive cases started on CTX
(Cotrimoxazole) prophylaxis
ART SERVICES 2012/2013
Category
Eligible for ART
Clients on ART
Female
06
11
No. of individuals 18 years
and above
Male
Female
88
165
45
123
No. of individuals < 5 years
No. of individuals 5 - <18 years
Male
Male
248
248
248
28
2
22
Female
105
104
25
0
11
112
112
18
0
7
Female
226
226
226
27
1
4
No. of individuals < 5 years
No. of individuals 5 - <18 years
Male
Male
13
31
Female
14
29
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
13
21
Female
18
32
No. of individuals 18 years
and above
Male
Female
2019
5394
2019
5394
2019
5394
155
256
14
25
80
157
No. of individuals 18 years
and above
Male
Female
218
393
323
707
17
Dentistry
No. Of pts treated
2009-2010
1,253
2010-2011
1,707
2011 - 2012
1,694
2012/2013
1721
Dental extractions
858
911
1,364
1532
175
Conservative treatment - fillings and scaling
Others
Dental x-rays
Root canal treatments
209
156
114 fillings
29 scaling
125
24
8
256
189
Recently Mr. Ben Turyomurugyendo, Dental Officer, has left and been replaced by Mr. Muhereza Barham. The Dental unit
continues to serve providing an important service. We conduct Health Education to promote dental health and hygiene.
Mental Health
Demographic characteristics
Sex
Male
Female
Age in years
0-4
5 and above
Percentage %
44.7
55.3
3.1
96.9
SUPPORT SERVICES
Laboratory.
Staffing in the Laboratory has generally remained stable. We are arranging for a
consultant from Chester to visit and help set up microbiology culture and
sensitivity testing and other improvements to our lab services.
2011/2012
Category
0-4 yrs
Malaria blood smear
TB sputum
Syphilis screening
Other Lab. Tests
2012/2013
Malaria blood smear
TB sputum
Syphilis screening
Other Lab. Tests
No. of tests done
5 yrs&>
Total 7160
Total 315
Total 334
18291
3335
10
8
11
0-4 yrs
8317
435
258
1669
121
0
3
7
No. Positive
5 yrs&>
Total 194
Total 31
Total 45
925
346
74
29
152
Imaging department
The input over the past few years received from visits from and to Chester has
enhanced the quality of imaging produced. However we have had the
disappointment of the departure of one of our staff in whom we had invested a lot
in training. The consequence is that we will have to be much more rigid in future in
bonding staff to stay if they are given such support.
X-Ray
The X-ray continues to be an important diagnostic tool at Kisiizi. We are very glad
the service has been functional throughout the year. We only have one static
machine and hope in future to obtain an image intensifier to support work in theatre etc.
X-Rays taken:
Department
2009-2010
2010-2011
2011/2012
2012/2013
Out-Patients
1086
1012
1171
1033
In-Patients
1254
1264
1717
1862
Totals
2340
2276
2888
2895
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
18
Ultrasound
2 sonographers provide the service.
Ultrasound scans performed:
2010-2011
2011/2012
2126
2996
2012/2013
3030
THE FUTURE
Having come through a stormy time, Kisiizi is now moving forward with new vision. It has
the potential to truly be a centre of excellence and a real witness to the love of God particularly in the ministries to those
members of our community who may be forgotten or ignored, such as the mentally ill, those with disability needing
rehabilitation, the poor and orphans etc. Our vision is to integrate our community and hospital services, to partner more
effectively with the Church and local Government, and to develop our health promotion activities.
People
We seek to care well for our Staff, and in return expect a professional and committed attitude.
We continuously pray that God will provide staff that are committed to the Hospital Christian beliefs as this is paramount in
upholding the core values of our founders and fulfilling God’s Mission for Kisiizi.
Communication
Communication within the Management team had been a problem but is now working well. The committee meet to pray and
look at the calendar every Monday morning, sharing plans for trips etc to ensure maximum benefit is achieved. Main
business meetings occur fortnightly, with focus meetings as required.
Systematic Review
A systematic review of our services such as drug procurement, stores etc. is beginning as there are clearly inefficiencies.
Data capture and analysis is poor and has to be improved or Kisiizi is at risk of losing funding for a number of important
projects.
We hope to further develop our website, allowing editing to be conducted from Kisiizi to keep it up to date. Andy Simpson,
of Stamford Web Designs, has assisted in the planning for this.
We thank God for His faithfulness in the past, His presence with us today , and His promises for the future.
We entrust the future of Kisiizi Hospital and its Staff and Community to God.
Appendix 1
Board of Governors
Chairman
Nominee Kinkizi Diocese
Archdeacon Rubirizi
Nominee North Kigezi Diocese / Community representative
Nominee North Kigezi Diocese
Nominee North Kigezi Diocese
Nominee Kigezi Diocese
Nominee Ankole Diocese
Nominee North Kigezi Diocese
Nominee West Ankole Diocese
Ex-Officio Members
District Health Officer Rukungiri
Hospital Administrator
Ag. Principal Nursing Officer
Ag Finance Manager
Deputy Medical Superintendent
Medical Superintendent / Secretary
COU Kisiizi Hospital Annual Report 2012/2013, www.kisiizihospital.org.ug
Rt. Rev. Patrick Tugume Tusingwire
Rev. Can. Enos Komunda
Ven. Can. David Kahindi
Can. Ben Rullonga
Can. Mary Aliza Dutki
Mr. Charles Byabakama
Rev. Charles Biryatwita
Dr. Stephen Twinomugisha
Can. Sam Ruharo
Rev. Can. Rutaraake
Dr. Rutahigwa Elisa
Mr. Moses Mugume
Sr. Kate Rwomushana
Rev. Patrick Bagorogo
Dr. Gabriel Okumu
Dr. Ian Spillman
19