National Catholic Health Service

NATIONAL CATHOLIC HEALTH SERVICE

Buduburam Refugee Settlement

St. Gregory Catholic Clinic P. O. Box 5, Apam Buduburam Refugee Settlement Central Region Ghana (West-Africa) Tel: +00-233-(0)-302-936-281

Demande de financement de la CLINIQUE ST GREGORY à Accra Accueil

11 octobre 2010 RESPONSIBLE Antoine Delannoy

PROJET GHC 1- Dressing room renovation 869 2- Roof between wards and operating room 354.5 3- Changing room for nurses 199.8 4- 35 staff uniforms 467.25 GRAND TOTAL 1890.6

Les points 1- et 2- permettront l’accréditation de la Clinique par le Ministère de la Santé Ghanéen. Si vous êtes intéressé pour visiter ce projet, contactez Gaëlle Dessus 054-328-7548.

CONTENTS

1. HISTORY 2

2 OUR OBJECTIVES 3

3 OUR IDENTITY 3

4 PROFILE THE AREA 3

5 HUMAN RESOURCES 4

6 OUR SERVICES AND STATISTICS FOR THE FIRST MIDYEAR 2010 5

7 OUR PARTNERS 5

8 REGISTRATION AND ACCREDITATION OF THE CLINIC 6

9 OUR CHALLENGES & OUR MISSINGS 6

10 CONCLUSION 7

1. HISTORY

The Buduburam Refugee Camp was established in 1990 to receive refugees who fled from the civil war in Liberia. It is located in Ghana, Central Region, on the Accra / Cape-Coast highway. Within 16 years after the creation of the camp, the population had risen to 39,000 refugees (UNHCR, 2006) with 16,600 of the population being children under 17 years of age.

LIBERIA GHANA

Presently, 20,000 displaced persons are living on the settlement among which 12,000 are Liberian Refugees registered with the UNHCR and the Government of Ghana.

During the first six months after the inception of the camp, Apam Catholic Hospital initiated medical services to the refugee population; then the UNHCR set up a clinic with Ghana National Red Cross Society (GNRCS) as its implementing partner.

Following a peaceful election in 1997 in Liberia, UNHCR encouraged voluntary repatriation of Liberian Refugees to their country and as a result the clinic stopped operation in 2000.

In 2002, the Archdiocese of Cape-Coast had requested Apam Catholic Hospital to re-open the clinic since the conflict broke out again in Liberia. About 10 Liberian staffs (a medical assistant, some midwives and nurses) were trained by this Hospital and the clinic was re-opened in April 2002. Then, UNHCR re-commenced support to the refugee population, and in this regard began supporting the clinic to provide health care to the refugee community.

In 2008 a massive voluntary repatriation exercise was embarked on by the UNHCR and as a result over 10,000 of the refugees returned home. Some of the Liberian staff of the clinic also has gone back to Liberia since a relative peace has been set up. Most of them have been replaced by Ghanaians.

The clinic was renovated in 2009 by UNHCR and officially handed over to the Archdiocese of Cape Coast on the 6th May 2009.

2. OUR OBJECTIVES

The objectives of St. Gregory Catholic Clinic at Buduburam Refugee Settlement are as follows: . To provide health care to the refugee community in the standards of the UNHCR. . To implement the UNHCR Health Information System for disease prevention, early detection of cases, case management and epidemic control. . To avoid disparity between the locals and the refugee population by mainstreaming the population’s capacity and sense of responsibility for its own health needs through existing local, district and national programmes. . To reduce the spread of HIV/AIDS and STDs through awareness education and home based care and support. . To provide capacity building to the clinic health staff and ensure long term sustainability of the programme. . To recruit qualified staff on GHS (Ghana Health Service) and CHAG (Christian Health Association of Ghana) pay rolls, . To increase the range of medical services offered to the community (ultrasound scan, surgery).

3. OUR IDENTITY

The clinic is part of the National Catholic Health Service (NCHS) which is responsible of 27% of health care deliveries in Ghana and is owned by the Catholic Archdiocese of Cape-Coast.

The Vision of the NCHS: to continue Christ’s healing Ministry in bringing healing to the greatest possible number of people in the provision of total quality patient care through healers with good ethical and moral standards; who are conscientious as well as professionally competent, motivated and united in their common respect for fundamental values.

The Mission of the NCHS: to provide high quality health care in the most effective/efficient and innovative manner, specific to the needs of the communities we serve and at all times acknowledging the dignity of the patient.

The Goal of the NCHS: to provide and sustain health care services for the poor, neglected and marginalized segments of the society. The service will seek to empower the people it serves to take ownership of their own individual and collective health needs.

Motto: In God is our Help and our Health

4. PROFILE OF THE AREA

The clinic caters for refugees and the local Ghanaian Community within its catchment’s area (127,777 inhabitants living in Gomoa-East District).

It is situated 44 kms from Accra, along one of the used roads in Ghana going to Cape-Coast where trade is important. There are a lot of quarries within Gomoa-East District. However, the industrial sector is not much developed. Most of the people living in the countryside are farmers or run their own micro-

4 business. The crops grown on the area consists mainly of vegetables, oil palm, coconuts, cassava, plantain, pineapple and yam. As a tropical area, people are directly exposed to malaria. 5. HUMAN RESOURCES

42 Clinic Staff:  14 Liberian refugee volunteers,  27 Ghanaians,  1 French international volunteer. Plus two annexes:  Nutrition Program  HIV AIDS Program The breakdown of the clinic staff is detailed in the table below:

NB Medical Doctors (PART-TIME) 2 Medical Assistants (PART-TIME) 3 Volunteer Nurses 3 Registered Nurses 3 Clinical Assistants 4 Nurse-aid 1 Registered nurses/midwives GRUHEDEM (PART TIME) 3 Registered Midwife (CHAG) 1 Community Midwife (GHS) 1 Aid Midwife volunteers 2 Community Health Nurses 4 Medicine Counter Assistants 3 Laboratory Technicians 2 Cleaners & Maintenance & Security 5 Ambulance driver 1 Referral Liaison Officer 1 Administration 3 TOTAL 42

The two part time visiting medical doctors conduct daily medical examinations. They are sponsored by Point Hope, an American NGO supporting the clinic.

Nine Ghanaians receive monthly salary from the Government of Ghana (four Community Health Nurses, two Midwives, one Laboratory Technician and two Registered Nurses).

6. OUR SERVICES AND STATISTICS FOR THE FIRST MID YEAR 2010

 OUT-PATIENT DEPARTMENT, EMERGENCY: 5179 medical examinations,

 IN-PATIENT DEPARTMENT (admissions): 91 patients,

 MATERNITY: 137 deliveries, 1128 antenatal consultations, 121 ultrasound scan performed and 0 maternal death,

 LABORATORY SERVICES: 5333 analysis performed, 1808 patients,

 MEDICAL REFERRALS: 200 patients,

 PUBLIC HEALTH (campaigns in endemic, pandemic diseases as TB, Malaria, and HIV/AIDS...),

- MATERNAL CHILD HEALTH: Vaccinations program: 2825 immunizations, Child Welfare and Nutrition Programme: 207 malnourished children being followed up by the clinic with supplementary food, medical check-up... for the first six months 2010, 140 women using specific contraceptives in June,

- HIV/AIDS/STD PROGRAMME: 46 patients receiving Anti-Retroviral Treatment, 561 HIV tests performed after voluntary counselling, 81800 male condoms, 2094 female condoms delivered,

- TUBERCULOSIS CONTROL PROGRAMME: 15 patients on treatment in June, health talks on sensitization and prevention,

 PSYCHATRIC CARE: 24 patients followed (drug addicts, post war traumatisms...)

 PHARMACY: open 7 days in a week, and operates 24 hours each day,

 NATIONAL HEALTH INSURANCE SCHEME: 1636 patients are currents beneficiaries of this scheme. 6

Five beds are used for detainees (i. e. observation for only 24 hours before referral to the next level). Five beds are also available at the Male’s Ward, five at the Female’s Ward and seven at the Children’s Ward. The clinic renders services seven days in a week, twenty four hours in a day.

7. OUR PARTNERS

From 2003 till the date, the administration of the clinic is run by two French NGO, called FLM (Fraternité Laïque Missionnaire) and DCC (Délégation Catholique pour la Coopération, a member of France Volontaires). Several medical doctors, nurses, administrators have been posted at the clinic as international volunteer, rotating every two years. The others partners of the clinic are the UNHCR (United Nations High Commissioner for Refugees), Ghana Refugee Board, Ghana Health Service of Gomoa-East District, Apam Catholic Hospital, Point Hope, the Archdiocese of Cape Coast and the National Catholic Secretariat, implementing partner for the UNHCR.

The clinic is recognised as member of the Christian Health Association of Ghana (CHAG).

8. REGISTRATION AND ACCREDITATION OF THE CLINIC

The clinic was registered with the Private Hospitals and Maternity Homes Board of Ghana in December 2008, then accredited by the National Health Insurance Scheme (NHIS) in August 2009. The clinic is fully integrated into the Ghanaian Health System proving health care under the health insurance scheme to both the NHIS registered Liberian refugees and Ghanaians.

Please, see the record on the national official website: D:\NHIS ACCREDITATION FOR HEALTH CARE PROVIDERS (1ST BATCH RESULTS).htm

9. OUR CHALLENGES & OUR MISSINGS

The main challenge of the Clinic is to guarantee improved access to health care to the refugee population and the Ghanaian locals while ensuring simultaneously the long-term sustainability of the institution.

Here are our challenges in this purpose:  To recruit a permanent Medical Doctor on the pay roll of the Ministry of Health through the Christian Health Association of Ghana,  To acquire an ambulance and a utility vehicle (the present ambulance of the clinic has done over 296,420 kms, and ceases functioning now and then). The ambulance is used for the referrals and the immunization campaigns to reduce child mortality. Cost: 71,614.28 Gh¢ (= 39,292.75 Euro) for a new ambulance,  Scarce of funding to intensify public health campaigns to combat HIV/AIDS, Malaria and others diseases for reaching the 6th Millennium Development Goals,  Inadequate funds and logistics to meet the care and support for psychiatric patients,  Inadequate care and nutritional support for the most vulnerable patients, especially the chronically ill and the disabled,  To establish an operating room for performing surgical procedures (we still need to be procured with an autoclave 20 litters. Cost: 2,800 Gh¢ (=1,536.28 Euro),

 To improve maternal health (Millennium Development Goal 5) and to reduce the child mortality (Millennium Development Goal 4) through setting up a new Maternity Unit and a Pediatric Ward with a direct access to the operating room for sub caesarean sections. Cost: 176,978.97 Gh¢ (=97,103.42 Euro).  To be procured with additional laboratory equipments (microscope, incubator, haematology auto analyser, electrophoresis machine, malaria test kits). Cost: 28,160.00 Gh¢ (=15,455.54 Euro).

We request as well office administrative materials (printers, photocopier, etc), even second-hand, to the stakeholders of the clinic to reach these goals.

10. CONCLUSION

The clinic continues to be the major functioning health facility on the settlement, for providing health care to both the Refugee and Ghanaian Communities. The clinic plays a pivotal role in public health education and sensitization campaigns on the settlement, is the biggest health facility for Gomoa-East District (127,777 inhabitants) and the first to open an operating room.

The main daily challenge remains, that’s to guarantee improved access to health care while ensuring simultaneously the financial long-term sustainability of the institution.

We thank all the donors and partners who ever assisted the clinic, or supports our activities regularly.