Health ,Nutrition and HIV/AIDs Newsletter

A publication of the Health, Nutrition and HIV/AIDs Cluster November 2008 Volume 2 Issue 2

Editorial THE IRC MOVES WITH THE POPULATION TO By Dr. Olushayo Olu, THE RETURN SITES. BY MARTIN NGOLOBE, HEALTH MANAGER, Health, Nutrition & HIV/AIDs Cluster IRC KITGUM Coordinator camps face Although the signing of the Final Peace Agreement (FPA) has stalled, the relative peace witnessed in northern Uganda since tremendou 2006 is still sustained. As a result of this peace, all the IDPs in s challenge Lango have now returned to their villages of origin. However, of building according to UNHCR estimates, as at February this year, only 9% new of the IDP populations have made it back to their original homes, homelands in Acholi Sub region. The slow rate of population return accessing in the sub-region (Acholi) is linked to the uncertainty of the outcome health of the peace negotiation and unavailability of basic social services care, safe such as health, education, water and sanitation in the return areas water and which should serve as a “pull factor” for the lDPs. access to livelihood. The Peace Recovery and Development Plan (PRDP) which was launched by His Excellency, President Museveni present a golden As of July opportunity for all concerned to support peace building and Kinobere Herbert, a Public Health officer, attends to a sick child 2008, 50 population return in the north. Members of the health, nutrition and during an outreach clinic inAkara. percent of HIV/AIDS cluster should therefore seize this opportunity to the embrace the PRDP by supporting the conflict affected districts to he current peace process internally displaced persons effectively implement, supervise, monitor and evaluate the health T between the Lord's population in are recovery strategy and district plans which were recently finalized by Resistance Army and the have moved a way from the IDP the MoH and all the 40 PRDP designated districts. To do this Government of Uganda has created camps to transit sites located in effectively, we must ensure that we coordinate, synergize and an atmosphere of hope in the parishes near their original homes synchronize our efforts and use durable and context specific camps. Lack of an official peace solutions to address health recovery issues in northern Uganda. or direct to their original homes. agreement most people do not yet feel secure enough to move all the In this edition of the health, nutrition and HIV/AIDS cluster While this relative peace has way back to their original home newsletter; we bring you experiences of some cluster members in enabled population movement villages. Those who have left the providing basic services to returning populations in Kitgum district. Turn to page 2 Among others, the newsletter also contains articles on linkages between Sexual and Reproductive Health (SRH) and HIV/AIDS INSIDE THIS ISSUE and introduction of Kangaroo Mother Care in Pader as well as the regular sections on news within the clusterand district highlights. ¨Creating linkages between SRH and HIV Pg.3 ¨Kangaroo mother care in Pg.5 Ladies and Gentlemen, please sit back, relax and enjoy yet another ¨ Referral strengthens its skin clinic Pg.6 edition of the health, nutrition and HIV/AIDS newsletter. ¨More on Hepatitis E Pg.7 Thank you. ¨Health, Nutrition and HIV/AIDs CAP project summary Sheet Pg. 10 1 Health, Nutrition and HIV/AIDS newsletter Continued on page 1 THE IRC MOVES WITH THE POPULATION...... BY MARTIN NGOLOBE, HEALTH MANAGER, IRC KITGUM

from IDP camps to transit camps and so as to facilitate complete return mother to child transmission of villages of origin, most of the health HIV/AIDS through counseling and services in the district are located in This has been done through a number testing of and provision of nevirapine Kitgum town or mothercamp. Few of strategies. For instance, support to Between January to July 2008 a total health facilities in return areas have the District Health Office in provision of 14,000 people out of which 4,000 been opened leaving most of the of health care services in nine health are children under 5years of age return areas with poor access to centres of (Palabek Ogili, Palabek Kal, receivedcurative care , 500 infants health care. However gagging from Palabek Gem, Loborom, Mucwini, vaccinated against meseals, 4,000 health facilities supported by IRC Agoro, Padibe, Paloga and Potika), pregnant women provided with ANC staffing level is between 35 and 45 as Weekly outreach activities with health services, ITNS, counseling and testing recommended by HSSP II. facility staff to (Oboko in Potika, Akara for HIV. in Mucwini,Ocettoke and Ayoma in Early 2007 donor partners supported Labuje,Apyeta and Paluda in Palabek Other partners providing outreach MoH and the districts to provide Ogili andPawena in Palabek Gem sub services in the district include; incentive package to health International staff with the aim of Committee of the Red attracting and retaining Cross. them. This package managed to increase the The program works staffing level by only 1% in closely with the district the entire district. health administrative structures through The IRC and other supporting the humanitarian agencies are establishment and providing basic health care training of health unit to the population in the managment new sites and return areas committee, Village through organization of health teams, Parish outreach services albeit development difficulties. Major committees and challenges being faced in Nicholas Engwau a Public Health officer, talks about Hepatitis in conducting joint this mode of service Pawena, Palabek Gem sub county. support supervision delivery isirregularity . The with district and health services being accessed by the counties). Sub district officials. population in return sites are mostly preventive with only once a week The basic package of health services Challenges faced in improving access curative services through outreach. delivered during outreaches are to health care in return sites and health education, clinical services, village of origin include:Low staffing The IRC working within the return and vaccinations, reproductive health care level across all IRC supported health resettlement strategy is following the and referral. units, frequent absenteeism of health population it serves with access to staff, lack of space for consultation at basic services like health, clean water, The reproductive health care services outreach sites and heavy patient case protection of people's rights, are focused on antenatal care, load during outreaches as some of the livelihoods, recreational activities, prevention and treatment of sexually patients are drawn from the and programs for children and youth transmitted infections, prevention of neighboring districts of Gulu. Turn to page 4 2 Health, Nutrition and HIV/AIDS newsletter CREATING LINKAGES BETWEEN SRH AND HIV/AIDS IN

NORTHERN UGANDA. BY MOLLIE FAIR, GRACE LATIGI & PRIMO MADRA

ver twenty-years of armed development in northern Uganda. workers. O conflict in Northern Uganda Five reasons to link HIV/AIDs and SRH caused a gross disruption of the health interventions 5. Millennium Development Goals: system, drastically affecting access to 1.Common root causes: Both HIV/AIDS Addressing sexual and reproductive health care and health outcomes for and poor SRH are driven by many of the health and HIV/AIDS issues are the region's population. One of the same root causes, including gender essential to achieving development vulnerability of northern Uganda's inequality and poverty and social goals and ensuring reconstruction and population is reflected in poor Sexual marginalization of the most vulnerable. development in the north, which and Reproductive Health (SRH) Addressing those core Issues in Would benefit the entire country. indicators with high HIV sero- northern Uganda would benefit both prevalence compared to national HIV/AIDS and RH indicators. One of the main reasons for the lack of averages (see chart) below. Although integration between HIV/AIDS and SRH policies and programs often highlight 2. Common target audience: The is that, practical ways to link the the importance of SRH and HIV/AIDS, majority of HIV infections are sexually services are not clear to most service they are often treated as two separate transmitted or associated with providers and programming staff. The intervention areas, and frequently pregnancy, childbirth and Framework for Priority Linkages opportunities to create linkages breastfeeding. Programming in one developed by IPPF, UNFPA, WHO, and between them are overlooked. area should be mutually reinforcing of UNAIDS3 provides some uidance (see the other area. In the last few years, there have been Figure 1. Framework for Priority Linkages several calls for increased efforts to 3.Reduce integrate HIV/AIDS and SRH. In 2004, stigma: UNFPA and UNAIDS convened a high- Integrated level global consultation and made the programs may “New York Call to Commitment” calling help to for the integration of HIV/AIDS and reduce stigma SRH; this was followed in June 2005 associated with a UNAIDS policy position paper with stand-alone “Intensifying HIV prevention.” In a HIV resource-constrained health system Facilities, serving a vulnerable population, as is improving access the case in Northern Uganda, there are and uptake of multiple benefits that could result key services. from further integration of SRH and This is critical for reaching Figure 1) by recommending four HIV/AIDS, accelerating healthy Marginalized, hard-to-reach priority areas where linkages should be populations, and high-risk implemented: populations. 1) Improve access and utilization of 4.Cost-effectiveness: HIV Counseling and Testing services Improved integration can (HCT), with particular emphasis mean more relevant and cost-effective placed on removing barriers that programs with greater impact. Along prevent young people from accessing the same lines, integration helps to HCT. Address shortages of health care During HIV counseling, information on SRH, particularly dual protection Continued on page 4 3 Health, Nutrition and HIV/AIDS newsletter From page 3 CREATING LINKAGES BETWEEN SRH AND HIV/AIDS IN

NORTHERN UGANDA. BY MOLLIE FAIR, GRACE LATIGI & PRIMO MADRA

(against HIV/STI and unwanted . The policy requires both HIV/AIDS care. Patient flows in health pregnancies) should be provided. HIV parental and child consent for HCT to facilities are not planned to link the Counseling and Testing (HCT) should be provided to a child of 12 to 17 two systems together. Frequently, be routinely provided in Antenatal years. For a child below 12 years only HCT is provided in one corner of the care (ANC) as well as Sexually parental consent is required. The HCT health facility and ANC at the opposite Transmitted Infections clinics, while policy provides for HIV Counseling and corner with little communication linking to ART and other post-test Testing services to be provided between the two units; or services are care. routinely in health facilities, provided on different days of the particularly in TB, STD, and ANC week, requiring a client to come at 2) Promoting safer and healthier sex. clinics. least twice to access services from This will not only promote both units. reproductive health, but also prevent The implementation of this remains HIV. Condom promotion for dual limited mainly because most health There is an urgent need for Ministry of protection especially for PLWHA workers are not trained to provide HIV Health to revise the existing service should be scaled up. Women's counseling. Moreover, most health guidelines with a view of supporting empowerment and programs to facilities, especially in the war service providers to link SRH and prevent and respond to GBV also affected northern Uganda, are HIV/AIDS care better. Program contribute to HIV prevention. There understaffed and as a result even if managers need to plan with a view of should be a common approach to IEC the health care providers have the ensuring thatHIV/AIDS program programs that address both SRH and knowledge and skills, providing HCT benefit from SRH programs and vise HIV/AIDSmay not be considered a priority or versus. Health facility managers the quality of counseling may be should take time to organize patient 3) Optimize the connection compromised due to heavy work load. flows that are conducive for greater between HIV/AIDS services and STI Health workers in ANC clinics do not linkage. And finally but not least, Services. HCT should be a routine test consider HIV/AIDS care as one of their health care providers need to realize in STD care, and screening for STIs core functions while providers at HCT that their role is to provide a holistic should be part of HCT. clinics consider SRH as none of their care to their patients and not just business. Therefore, it is necessary to mechanically doing their component 4) Integrating HIV/AIDS services with change provider attitudes towards with little concern to the general need maternal and infant care. For patient management. of the patient Example making PMTCT services From page 2 part of antenatal care, or utilizing RH Existing Standard Operating THE IRC MOVES WITH clinics as avenues for disseminating Procedures (SOPs) are also weak in ...... By Martin Ngolobe, Health information and/or providing services helping service providers to Manager,IRC Kitgum for HIV/AIDS.Effective referral practically link HIV/AIDS care with Across the district, only IRC and pathways between RH clinics, HCT SRH. This is because these SOPs have International Committee of the Red and chronic car clinics should be been developed in isolation, without Cross provide outreach services to established to ensure that a patient reference to each other. HCT new sites yet the demand for this utilizing one service is directed to the protocols do not adequately services is high Other as appropriate. emphasize the need for the provision of information on SRH during HCT Uganda's revised HCT policy counseling sessions while Family encourages HIV counseling and Planning (FP) job aides do not provide testing for young people including sufficient guidance on providing 4 Health, Nutrition and HIV/AIDS newsletter GOAL UGANDA INTRODUCES KANGAROO MOTHER CARE IN PADER BY GOAL TEAM IN PADER

ccording to UNICEF surveys, 12 % are difficult and costly. The power With great enthusiasm from the A of all infants born in Uganda from supply is intermittent, so the hospital and midwifery school staff, 1998 to 2005 were of low birth- equipment does no work properly. Kangaroo Mother Care was weight (LBW) as a result of either Under such circumstances good care implemented in the maternity ward preterm birth or impaired prenatal of preterm and LBW babies is immediately, much to the delight of growth. LBW infants contribute difficult: hypothermia and the mothers who had been separated substantially to high rate of neonatal nosocomial infections are frequent, from their infants in the special care and infant mortality, whose frequency aggravating the poor outcomes due unit and distribution corresponds to those to prematurity. Frequently, and Prior to the introduction of this of poverty. Preterm and low birth usually unnecessarily, babies are programme, premature and low birth weight represent more than a fifth of separated from their mothers for weight infants were separated from the estimated 47,000 neonatal deaths medical care, depriving them of their mothers and placed in a cot with a each year in Uganda, and survivors are necessary contact [Kangaroo Mother hot water bottle in an effort to keep at high risk of morbidity. Therefore, Care a practical guide, 2003, World their temperature stable. The infants Health Organization, Geneva]. that survived were slow to recover and With child survival being a priority weight gain was poor, so mothers and area for GOAL Uganda, a programme infants remained in hospital for an to reduce infant mortality and Extended period of time. The mothers morbidity saw the implementation of became despondent waiting for the a Kangaroo Mother Care (KMC) infants to be well enough to go home. Programme in Paderd istrict. In KMC Furthermore, these infants were at the baby is continuously kept in skin- high risk of nosocomial infection and to-skin contact with the mother (with were deprived of optimal breast help, in some cases, from the father, feeding, stimulation, safety and love. Grandmother or aunty) and the baby Mothers, and sometimes their is usually breast-fed exclusively. It is families, are now actively involved in usually initiated in the hospital, but the specialized care required for their when the infant is stable and the low birth weight infants. mother is confident it can be continued in the home. the care of such infants becomes a With assistance from Dr Nils Bergman burden for health and social systems. (a world authority on KMC), GOAL located two experts to support the As causes and determinants of introduction of KMC at Dr Ambrosoli impaired foetal growth and preterm Memorial Hospital, , in birth are largely unknown, effective September 2007. Dr Lucy Linley and interventions are limited. Moreover, Sr Karin Moore, from Mowbray modern technology is either not Maternity Hospital in Cape Town, available or cannot be used properly in South Africa, facilitated a KMC the current context of Northern workshop for doctors, midwives and Uganda. Incubators, for Instance, are the Midwifery Tutors of St Mary's often insufficient to meet local needs Midwifery School. and purchase of the equipment and spare parts, maintenance and repairs Representatives from the Ministry of Health also attended the workshop. 5 Health, Nutrition and HIV/AIDS newsletter From Page 5 GOAL UGANDA INTRODUCES KANGAROO MOTHER CARE IN PADER. BY GOAL TEAM IN PADER

The advantages of KMC for the mother and baby were shorter than average of 47 mothers have included encouraging proposed, but later this improved with Days in maternity before discharge. bonding, adequate time for encouragement and support for the Deaths of premature babies have observing the baby, reduced baby mothers from the staff in maternity reduced considerably. Since January crying, and more active there has been an average of only one participation by the mother death per month, where as prior to the regarding baby care (in comparison introduction of KMC the hospital staff to the babies being in a cot under estimate an average of four deaths per the care of the nurse). It has been month for premature babies. It is still seen that for the babies, they grow early days and the midwives and the more quickly, spend more time with mothers are continuing to become their mothers, and are kept warm so more familiar with the they sleep for long hours. implementation of KMC, and so this Additionally, there are advantages statistic may improve even further.The to the Midwives, which include a head of the midwife reduced workload, reduced school has been delighted with the numbers in the nursery, and fewer results and says that KMC is here to deaths. stay in Kalongo Hospital.

KMC was a new technology for the KMC is a powerful, easy-to-use, low- mothers and challenges included ward. In October a new larger group cost and sustainable method to mothers initially fearing that the was admitted to the programme, and promote the health and well being of babies might suffocate, and by January 2008 KMC became an infants. It is socially and culturally mothers complaining a little about accepted practice in the hospital. acceptable in the Uganda context and the weight of the baby on the chest with such a positive impact on child as they were not used to it. The duration of stay at the hospital for survival, implementation of KMC However, these issues were quickly premature babies has been greatly should be encouraged throughout the overcome, KMC was implemented reduced. KMC babies took an average country with enthusiasm, and the six babies of 25 days in maternity before being improved and were discharged. discharged after improving and [Http://www.unicef.org/infobycountr Initially hours of contact between gaining weight. Babies that had not y/uganda_statistics.html been on the KMC programme took an

GULU REFERRAL HOSPITAL STRENGTHENS SKIN CLINIC BY MICHEAL CHANKARA, WILLIAM ONYAYI AND CELESTINE OLANGO FROM GULU

ermatology is one of the fields of broadened the diagnostic and for psoriasis Planter Kerotoderma Dmedicine which is constantly therapeutic horizon. and severe evolving. Different techniques are Lasers are now used for depilation and atopic being incorporated into the field for removing tattoos without leaving dermatitis. making the service more productive. scarring; Photodynamic therapy is The skin clinic Genetic studies, the use of increasingly being used to treat skin in Gulu immunosuppressive agents and the tumors, narrowband ultraviolet has referral rapidly expanding laser therapy has replaced other forms of phototherapy hospital has Turn to page 8 6 Health, Nutrition and HIV/AIDS newsletter MORE EFFORTS NEEDED TO ERADICATE HEPATITIS E BY DR.SOLOMON FISSEHA WOLDETSADIK AND PAULINE AJELLO WHO IN GULU

epaitis is a general term meaning In diseases with oral-fecal the possibility of multiple factors; the H inflammation of the liver and can transmission, person-to-person poor environmental hygiene, the be caused by a variety of different secondary transmission can amplify communal hand washing from one viruses such as hepatitis A, B, C, D and the spread and sustain the outbreak basin, poor access to safe drinking E. Since the development of jaundice is longer. A retrospective cohort study in water and the unsafe storages for a characteristic feature of liver disease, Saudi Arabia on person to person drinking water at household level all a correct diagnosis can only be made transmission through oral-fecal route contributed for the ongoing outbreak. by laboratory analysis of patient's for bacillary dysentery has found that A preliminary report by a team of blood (serum) for specific antigen or the secondary attack rate (AR%) within experts3 has documented an 80% antibody against a particular virus. families ranged between 7.7% and 80% prevalence rate in the most affected within households and neighboring communities with only one third Hepatitis E is caused by infection with villages depending on the exposure to reporting clinical the hepatitis E virus (HEV). It is a water other risk factors especially crowding. signs of jaundice. borne disease transmitted via the Crowding was a major risk factor that It was also found faecal-oral route. Contaminated water amplified transmission of bacillary that samples from1 or food supplies have been implicated dysentery within families, Bushira et al two surface water 1 in major outbreaks. (1999)1. The prevalence of anti-HEV sources and hand antibodies, uses of lavage from HEV river water for patients to be drinking and weakly positive for cooking, personal HEV. 2 washing and human excreta Given the disposal were all rampant practice significantly of communal associated with hand washing, the 3 high prevalence poor sanitation of infection, and the crowding Corwin et al in the affected (1999)2. district, contamination of 4 A closer look to drinking water or the current food by the outbreak in patients affected Kitgum signifies by HEV is likely

Continued on page 9 5

8 9 10 11 1 1. A family practicing communal hand washing and eating. Communal hand washing is one of the ways through which Hepatitis E is transmitted. 11 6 2. A woman lifting the Local brew Kwate to an unknown destination for consumption 3. The woman displays her Kwate after being asked to do by a community health worker 4. Poor hygiene. A family displays Gumboots together with plates in a home made drying rack 5. Community leaders involvement:8 Community leaders move around homes checking on the household hygiene 6. Experience sharing visit: The District Health Team (DHT) from Gulu on an experience sharing visit in Kitgum district, the first district to report cases of Hepatitis E 7.The DHT team from Gulu meeting with the RDC of Kitgum district 8.The minister of Health, Dr. Stephen Malinga gives a community talk on Hepatitis E at Ogako HC 11 9.The minister of Health, the area MPS with community from Acholi and Karamoja region touring a return site 7 7 Health, Nutrition and HIV/AIDS newsletter From Page 6 GULU REFERRAL HOSPITAL STRENGTHENS......

been operational since 2006, however pityriasis Versicular, Psoriasis and PPE Awareness creation. not so many people know about how due to HIV. It is therefore paramount that the Gulu important it is to have a skin clinic but also many are not aware of the skin In total the clinic sees 30 patients, this referral hospital administration clinic operations at Gulu Referral compared to the target population of rethink of availing a permanent and hospital. the region served by the clinic is conducive room for both the patients etremely insignificant. Dermatologic and the clinic staff and purchase cases constitute less than 6% of the Dermatology drugs for the Patients total OPD attendance. and if support can be provided by The skin clinic in doesn't go without challenges, the patients and the health workers both face a problem Tinea Capitis of lack of space to enable consultations Managed by 3 Dermatologist patients take place. with skin problems can now access free The clinic also f a c e s a problem of lack Vericus Vulgaris skin services and treatment once a of drugs f o r t h e patients as w ellas week as an out patient. partners equipments and funds to enable the Most patients present with superficial purchase of the above and for fungal infections like Tinea Capitis, From page 7 MORE EFFORTS NEEDED TO ERADICATE HEPATITIS E BY DR.SOLOMON W FISSEHA AND PAULINE AJELLO WHO IN GULU

and hence contributing for the The Government of Uganda, state of safe water sources. It was prolonged outbreak and its spread to especially the districts in the north noted that more than 90% of the the neighboring districts. By the mid and humanitarian partners should sources visited have a sanitation November 2008 Kitgum district has consider the current outbreak and the inspection score of less than 5/10 reported 8975 cases and 134 deaths. frequent outbreaks of cholera which means the water sources are However more than 90% of the cases seriously and take measures to extremely exposed for contamination. were reported from 5 sub counties address the root causes rather than This was further supported by the which are adjacent and close to the focusing on treating the symptoms. significant proportion of water initial point of the outbreak sources contaminated with bacteria The major challenge in the control of including faecal coliforms, with only The number of cases being reported communicable disease with oral-fecal 48% of the house holds and 33% of the from Kitgum district has started to transmission is creating the shallow wells free from decline, however there is still a awareness in the community to contamination by faecal coliforms practice the standard personal and 1 potential for its extension to the other East African Medical Journal [East Afr. Med. sub-counties and neighboring environmental hygiene and providing J.]. Vol. 76, no. 5, pp. 255-259. May districts. By the mid November 2008 safe sources for drinking water. An 1999. Pader had reported 57 cases while assessment conducted by the district 2Trans R Soc Trop Med Hyg. 1999 May- Gulu and Amuru had reported 8 water and Health offices in Gulu in Jun;93(3):255-60.. 3 confirmed cases. 2007 revealed a dire situation of the Hepatitis E epidemic in Kitgum district, 8 Health, Nutrition and HIV/AIDS newsletter PICTORIAL The Uganda Health, Nutrition and HIV/Aids Cluster Retreat March 08

The Head of OCHA Mr. Tim Pit addressing the A group picture of the Uganda Health, Nutrition Retired WHO Representative for Uganda Dr. Health,Nutrition and HIV/AIDS cluster meeting and HIV/Aids (HNHA) Partners George Melville addressing the cluster members before the official opening of the retreat before he declared the ceremony opened.

The Health working group in a group discussion The Karamoja group Dr. Bagambisa - MoH, Dr.Talamoi, Rachael Scotts UNOCHA,Ms.Pamela Komujuni OPM and Dr. Emmanuel Obura-NPO/HAC WHO Lira.

The District Health Officers from Lango, Acholi and Karamoja meet to chant a way forward The Nutrition working group in a group The HIV/AIDs working group

After all its time to relax: Dr. Michael Lukwiya of The DHOs of Lira and Gulu districts share a light Rechael Goldstein Former Head of UNFPA Gulu WHO enjoys his phone conversation, next to him moment with WHO staff chats with other partners is Pauline from UgandaAids Comission 9 Health, Nutrition and HIV/AIDS newsletter 10 Health, Nutrition and HIV/AIDS newsletter Continue to page 11 IN AND OUT

Dr. Moses Ongom recently left WHO office in Moroto for further studies. Moses Joined the WHO/HAC team in Febrarury 2007 as the National Professional Officer/Health Action in crisis in Karamoja. Moses has been very instrumental in strengthening the coordination of the Health, Nutrition and HIV/Aids Cluster in Karamoja region

Dr. Moses Ongom Mr. Innocent Komakech has been appointed the National Professional Officer with the WHO Office in Moroto. Before moving to Moroto Mr. Innocent was the National Professional Officer for WHO in Pader district. While in Pader Innocent played a very significant role in ensuring that the Health, Nutrition and HIV/Aids cluster partners were well coordinated

Mr. Innocent Komakech Dr.Isaya Musinguzi has been newly appointed National Professional Officer, Disease Control for WHO office in Pader district. Before joing WHO Pader Dr.Isaya worked as the Assistant District Health Officer for district in-charge of data managment, Human resource and quality of health services. He has also done a number of consultancies with UN agencies and other NGOs. Dr.Isaya holds an MPH

Dr. Isaya Musinguzi Lucy Kachapila (Mrs.) Has been newly appointed Child Survival and Development Specialist Health and Nutrition with UNICEF Gulu Zonal Office. Lucy holds RCNM, DPeads, Bcur IetA, Msc, MBA. Before joining UNICEF she worked as a registered nurse and midwife and as a clinical pediatrician, the MoH headquarters as a Community Health Manager and as Deputy Director of Nursing services for Malawi. Lucy retired from civil service and joined UNICEF Malawi country office as a Project officer for IMCI/ECD. She later became a Child Survival Specialist and a Coordinator for all Child survival issues in the country Lucy Kachapila office and Government

Dr. Asmamaw Bezabeh has been newly appointed HIV/AIDs Program Manager with Visions in Action (VIA). Prior to joining VIA, Dr. Asmamaw was working in Ethiopia as Care and Treatment Officer for Family Health International in provision of comprehensive HIV/AIDS prevention and care packages in a resource limited settings. Dr.Asmamaw has a Medical Degree (MD) from Addis Ababa University Dr. Asmamaw Bezabeh Carol Elliott has been newly appointed Visions in Action Country Director. Carol is a British citizen who has worked as a consultant for World Vision, VSO, Save the Children and UNESCO in Cambodia and Mozambique. She has also provided technical support in the development and implementation of national strategic plans and policies including (but not limited to): Education, Good governance, HIV/AIDS, OVC, Child protection, Youth, land mine survivors and people with disability. Carol holds a Masters in Management and Professional Studies in Education from the University of Southampton Carol Elliott

From page 10

11 Health, Nutrition and HIV/AIDS newsletter DISTRICT HIGHLIGHTS A GLANCE AT GULU AND AMURU DISTRICTS IN ACHOLI SUB REGION

Demographic Achievements M ajor Health indicators: Immunization Constraints characterizes Gulu VHT programme Human Total Population: coverage of 50% Indicator Achievements resources for 362,147 44 Functional 2008 health is still health units DPT 3 112% poor Estim ated under 5 Human resource Measles 116% years: 88,036 (25% of coverage 24% Deliveries in H.U 65% population) A very active OPD Utilization per Capita 1.7 health, Nutrition and HIV/Aids Cluster Amuru VHT programme Human Total Population: coverage of Indicator Achievements resources for 22,161,9 31.5% 2008 health is still 34 Functional DPT 3 115% poor Estim ated under 5 health units Measles 116.2% years: 44,767(20.2% Human resource Deliveries in H.U 26% of population) coverage 65% OPD Utilization per Capita 1.5% A very active health, Nutrition and HIV/Aids Cluster

IMPORTANT WEBSITE AND RESOURCE EDITORIAL BOARD MEMBERS MATERIALS

Disaster Management Centre. Resourceful information on educational, Dr.Olushayo Olu, Ms.Pauline Ajello training courses http://epdwww.engr.wisc.edu/dmc Health, Nutrition & HIV/Aids InformationAssistant Cluster Coordinator WHO-Gulu Office UN Web and Gopher Servers. Information about the UN: jobs, conferences and news http://www.un.org/textindex.html Dr.Godfrey Bwire, Dr. EricAlainAtegbo David Baldwin's Trauma - very extensive site on trauma related issues Ministry of Health Nutritionist UNICEF Uganda http://gladstone.uoregan.edu/~dub/trauma.html Dr.Filippo Ciantia, Emergency Medicine - Medical resources http://galaxy.einet.net/galaxy/Medicine/Medical_Specialities/Emergenc Counrty Director y.Medicine AVSI Uganda Global Health Disaster Network http://www.pitt.edu/HOME/GHNet/GHNet.html

For More information regarding the Health, Nutrition and HIV/AIDS newsletter, please contact

Dr. Olushayo Olu, WHO Counrty Office, P.O.Box 24578 , Email: [email protected] Mobile: +256 752 721962 OR Pauline L Ajello, Information Assistant WHO Gulu Sub Office Mobile:+256 772 721963, Email: [email protected]

This publication has been made possible by the following

12 Health, Nutrition and HIV/AIDS newsletter