Annual Report 2012 1 Contents

CCOORSRSUU Restoring Ability, Giving Hope.

Annual Report 2012/2013 www.corsu.or.ug 2

Contents General Assembly

Message from CoRSU Board President 3 Mr. Aloysius K. Bakkidde President Annual summary 4 Dr. Alice Nganwa Introduction 6 Mr. Jean Pierre Lequeux CoRSU Services: Surgery and Rehabilitation 8 Mr. William Byaruhanga Orthopaedic Rehabilitation Services 9 Dr. Sam Orochi Orach Plastic and Reconstructive Services 12 Mr. Ben Kayongo Male Therapy Services 14 Dr. Emmanuel B.K. Luyirika Orthopaedic Workshop 16 Mr. Victor B. O. Odongo Nutrition Rehabilitation 18 Mr. Jack M. Wavamunno Outreach Services 19 Dr. F. F. Tusubira Community Based Rehabilitation 20 Staff at CoRSU 22 Training 23 The Executive Board Visiting Specialists 24 Working with Partner organizations 25 Mr. Aloysious K. Bakkidde President Our Supporters 27 Dr. Alice Nganwa Vice-president Finances 28 Mr. Jean Pierre Lequeux Treasurer Way Forward: Aims for 2013 30 Dr. Emmanuel B.K. Luyirika Mr. Ben Kayongo Male Mr. Simon Bridger Secretary Mr. Victor B. Odongo Abbreviations Mr. Jack M. Wavamunno

ACHERU Afaayo Child Health and Education Rehabilitation Unit Senior Management AGM Annual General Meeting CBM Christian Blind Mission / Christoffel-Blindenmission Team: CBR Community Based Rehabilitation Mr. Simon Bridger CEO CEO Chief Executive Officer Mr. Matthias Widmaier Admin. Director CoRSU Comprehensive Rehabilitation Services in Dr. Antonio Loro Medical Director COSECSA College of surgeons of East, Central and Southern Mr. Moses Kiwanuka Head of CBR Africa Ms. Christine Tusiime Head of Therapy CSOs: Civial Society Organisations CWDs Child (ren) with Disability DPO Disabled People’s Organisation DRC Democratic Republic of Congo FATO Federation of African Orthopaedic Technology GGP Grant Assistance for Grass-roots Human Security Projects Hon Honorable IEC Information Education and Communication MGLSD Ministry of Gender, Labor and Social Development MMed Master of Medicine MUK MUST Mbarara University of Science and Technology NGO Non Government Organisation Main Editor: Irene Nabalamba OURS Organized Useful Rehabilitation Services Editors: Simon Bridger OPD Out Patient Department Graphics and Layout: Moses Kayoshe Proof reading: Susanne Pflanz PSGs Parent Support Groups Printing: St. Christian Graphics Ltd. PWDs Person(s) with Disability Annual Report 2012 / 2013 3 Message from CoRSU Board President

Message from CoRSU Board President

We have pride in presenting to you some of our success stories of our activities and those who made them possible in the last one year. We realize the importance of communicating our cause to all our partners and government, and this CoRSU Annual Report 2012 attempts to cover the activities of the Rehabilitation Hospital, the Rehabilitation Centre and CoRSU Community Based Rehabilitation program (CBR).

For CoRSU, 2012 was a remarkable year, because, despite the challenges, we managed to get over them and kept our promise to the children with disabilities and their families by changing their lives through surgeries. We carried out a total of 3,965 surgical procedures and out of these 2,500 were on children.

CoRSU is still a young organization but has to bravely accept changes as the Government of Uganda to strengthen they come. During 2012, one of our experienced, professional expatriate service provision through professional, surgeon, Dr. Fulvio Franceschi, transferred to a sister organization technical and material support. (CCBRT) in Tanzania. We remain indebted to him for his tremendous contribution to CoRSU right from its formation to the present level at Finally, with the professionalism of our which we are. The good news is that all was done to get replacement staff led by the CEO, who over the years to ensure sustainability. Two experienced orthopaedic surgeons joined maintained the high standards of honesty and CoRSU and are doing well. dedication and with the commitment of the Board, I am confident we will achieve our aim The Executive Board grew in number when two new Board members of improving the quality of life of people joined bringing the total number to eight. A Finance Committee was with disability and their families. set up under the Board and we are yet to create a few other sub- committees. We thank you all for the support that made 2012 a worthwhile year. Once again, thank In the last four years of CoRSU’s existence, we have made impact in you. the areas of our expertise and many people appreciate what we do. It is in this context that CoRSU won a Tumaini award for the NGO of the year under the health category. I was also humbled by the Tumaini Lifetime Achievement Award, for my personal involvement in efforts to have positive changes in the lives of children with disabilities and Aloysius Kaganda Bakkidde their families. Executive Board President, CoRSU

With the support of CBM we completed the construction of the Private Ward and Administration/Training Complex. The opening of these two buildings paved way for the Therapy Services to expand and for the Private Ward (with 8 self contained double rooms) to operate. Thank you CBM, thank you the architects, engineers, quantity surveyors and the contractor.

We endeavor to reach out to the poor of the poorest, to restore hope and in that light we released a regular newsletter, GiveAbility in December 2012.

We express our huge thank you to CBM, our main sponsor, who has given us enormous assistance to be where we are. In addition, we continue to be supported by: Smile Train, ALTSO, Brussels Airlines staff, and others without whom we would not be able to change the quality of the lives of children with disability. We continue to say thank you. With continued generous and important donations, we can re-emphasize our commitment to the future of CoRSU. We would like to collaborate with 4

We were able to recruit two experienced Annual Summary surgeons for the ever expanding work. The main activities of CoRSU are Orthopaedic and Plastic Reconstructive Surgery; these are supported by Therapy, an active Orthopaedic workshop, a Nutrition Program, a training program, and local CBR project.

The activities at CoRSU both in the Hospital and in the local CBR area have been able to continue with no interruptions. CoRSU’s Community Based Rehabilitation (CBR) in the area around developed significantly providing services in 12 parishes (88 villages) in the area.

The IEC (Information, Education and Communication) training of patients and attendants provides some basic training in relation to nutrition and hygiene as well as issues relating to disability and rights. The program also raises awareness about conditions that can be treated at CoRSU, which has yielded a multiplier effect in terms of disseminating information about the services at CoRSU.

2012 was the first year of the second four year strategic cycle of The Therapy Department carries out pre CoRSU. The underlying tendency of the plan is moderate continuous and post-operative physiotherapy. The growth to ensure longer term stability of the programs. Additionally department also conducts a Cerebral Palsy more emphasis will be placed on advocacy and the seeking of resources (CP) and Neurological conditions clinic once from a broader base of funding organizations. per week. The unit supports the production and provision of appliances and works closely Despite a shortage of Orthopaedic surgeons in the middle of the year, together with the Orthopaedic Workshop CoRSU was able to undertake 3,965 surgical procedures (up from to ensure that clients receive appropriate 3,535 in 2011) of these 2,517 were Orthopaedic and 1,448 plastic devices. The Orthopaedic Workshop reconstructive and other surgeries; this is 10% less than was planned produced 60 prostheses and 560 orthoses but 12.1% more than 2011. Financially we were affected by the very for clients at an affordable cost. stable Ugandan Shilling for the first nine months of the year. Our budget had been calculated on an average exchange of 3,400 UGX to the Euro. In March 2012 the construction phase 2a The reality was that most of the year the rate was around 3,100 UGX was completed. This consists of a Private to the Euro. Salaries of the staff had been increased by nearly 30% at ward with 8 double rooms, to cater for the beginning of the year, as well as the prices from suppliers being surgery that usually is done overseas such increased by similar margins. as hip and knee implants. The income from these surgeries generates a small surplus that The services to children with disability were subsidized at an average can be used towards subsidizing surgery on of 85% through funds made available from CBM, Smile Train and other children with disability. A second building donations, so that all children with disability who are seen at CoRSU can will provide seminar rooms and offices for be helped through an intervention, and receive treatment. 83.23% of the CBR project and the Administration. the surgeries at CoRSU in 2012 were on children. Moving the Administration out of the OPD has allowed the physiotherapy department The sixth CoRSU Annual General Meeting took place on 18th May 2012. to expand in the facilities that were originally The Executive Board of Directors met five times in the course of 2012. planned. A key issue for the Board and all concerned focuses on funding and sustainability of CoRSU in the mid and long-term. Further the Board Smile Train continued to sponsor 272 cleft held several discussions relating to the senior staff development and lip and palate surgeries. CBM provided requirement of expatriate support. With the departure of Dr. Fulvio the major part of the funds to allow us to Franceschi (the Medical Director) in the middle of the year, the Board had provide subsidized treatment of about 2500 to take steps to ensure that clients would continue to receive services. children. Annual Report 2012 / 2013 5 Annual Summary

Steps have been taken to start a fundraising department at CoRSU under the CEO’s office. The aim is to develop connections with influential business and government leaders; gain knowledge and skills that will help develop the local fundraising potential of CoRSU. In the long-term, we anticipate that the department will assist CoRSU in achieving a local and international fundraising donor base. This is one method of diversifying the income base and it will be a key focus area for us throughout the next strategic cycle.

CoRSU would like to extend a big thanks to our sponsors for their support in 2012. Without their assistance CoRSU simply would not be in position to meet its objectives.

We thank CBM, the main funders of CoRSU’s programs and activities, for the substantial financial support and commitment to CoRSU. Being able to achieve so much in a year has been possible due to the input and participation of our numerous supporters.

CBM Member Associations and their donors who have provided the backbone of the funding, particularly Germany, Italy, Canada, Switzerland and United Kingdom.

Smile Train, and other local donors.

The staff has done a commendable job in the provision of quality service to people with disability. The Board members, who serve on a volunteer basis, ensure that CoRSU moves effectively in the right direction in order to provide quality service to people with disability. It is our sincere belief that the services offered at CoRSU will continue to benefit many more children and people with disability.

Simon Bridger Chief Executive Officer 6

Introduction Our Mission To be a key player in Uganda in CoRSU – Comprehensive Rehabilitation Services in Uganda for preventing disability and reducing People with disability is a locally registered NGO first established in the consequences of impairment, 2006. CoRSU comprises of a well established disability rehabilitation through the provision of accessible, hospital, rehabilitation centre, training program and a community based affordable, appropriate quality rehabilitation program located in Kisubi, . The registration medical, therapy and community of CoRSU with the NGO Board was renewed in 2010 for a period of 60 rehabilitation services for people months from 19th May 2010. with disability, prioritizing children. Every year CoRSU performs over 4,000 surgical procedures mainly on children and other adults with disability .To date we have performed over 12,000 surgical procedures and every procedure performed CoRSU Aims comes with improvement in ability of that particular child/person, Alleviating poverty by improving hence thousands of children have been given better mobility, new the quality of life specifically of hope and inclusion in society. disadvantaged persons living with disability as well as their families.

Realizing the full inclusion of people with disability into community life CoRSU Expands Facilities enabling them to use their legitimate human rights like basic education, A private ward participation in income generating A seminar/CBR & Administration building activities, cultural respect and A fully fledged therapy department tolerance. The new buildings were officially opened on 23rd March 2012 by His Excellency the Vice President of the Republic of Uganda, Hon. Edward Kiwanuka Ssekandi, and His Excellency Klaus Dieter Duxman, the German Ambassador to Uganda. Other guests present during this ceremony included: representatives from CBM, Woman Member of Parliament for Wakiso district, who also represented the Speaker of Parliament of Uganda, Minister of State for Health (General Duties), members from the Rotary clubs, the media and many other dignitaries and networking partners.

In his speech, the Vice President called on all Ugandans, most especially the private and business sectors, to use their corporate social responsibility to support exemplary projects like CoRSU so that it can continue providing specialized health care to people with disability, most especially children. He noted that after touring the wards at CoRSU, it struck his mind that everybody was ‘potentially disabled’.

During the ceremony, the guests were entertained by children with disability from CoRSU and other children from Kids of Africa (a neighbouring partner children’s organization). These two groups of children (disabled and non disabled) were brought together and trained to perform a Bolero by a German Theatre Director, Mr. Frank Martin Widmaier, who volunteered his time and expertise at CoRSU for one week. His Excellency the Vice President of the Republic of Uganda Hon. Edward Kiwanuka Ssekandi officially opens the rd Our Vision new buildings on 23 March 2012. People with disability in Uganda are able to access rehabilitation services that improve their quality of life and that they are fully integrated in society. Annual Report 2012 / 2013 7 Introduction

Staff Profile Odella Eldad, Senior Pharmacy technician

At 61 years of age, Odella Eldad Etyang is still happy to contribute to the wellbeing of the Ugandan population through dispensing drugs. He is a senior pharmacy technician at CoRSU and he has been with the hospital long before it transferred its services from Mengo to Kisubi (over 10 years). He has seen the hospital grow. He begins his day’s tasks by 8:00 am with dusting and tidying his workstation to make for easy maneuvering throughout the day. Together with his assistant he goes on to check and replenish drugs at the dispensing pool and drug store. He supports the purchasing officer and the store manager to make purchases. His main duty for each day is to dispense medicines to the patients, departments and units at the hospital. He is a staunch Christian and he gets his motivation to work efficiently from the Bible (Col 3: 23-24); serving God through serving man and loves the fact that he is part of a hardworking team of medical personnel and administrators that have their hearts set at restoring hope and improving people’s lives.

He believes that his current job is likely to be the last one before retirement and would like to leave a legacy. He hopes that he has set an example of good practice for the young people he has worked with and would like to train individuals with integrity that will uphold CoRSU values. He hopes that more people with disability can access the hospital services, and for CoRSU to expand into a research centre and increase its training programs to benefit all the hospital departments. 8

joint (knee and hip) replacements and CoRSU Services: corrective operations following trauma. A small number of cosmetic surgeries have also Surgery and been undertaken. Some of the income from private patients is used to subsidize further the cost of surgery Rehabilitation and rehabilitation services for poor children with disability.

Overview of the services All Surgical Procedures 2012 In 2012, 3,965 life changing operations were carried out compared to 3,535 operations carried out in 2011. Surgery to children below 18 years continues to be free of charge and the entire cost of treatment for patients with cleft lip and palate is absolutely free.

Main services provided include: Orthopaedic surgery, plastic/ reconstructive surgery, CBR - Community Based Rehabilitation services, Therapeutic services (physiotherapy, occupational therapy, others), Orthopaedic Workshop for the production of disability appliances, Rehabilitation Hostel, Training for professionals and specialists, Nutrition rehabilitation services, mobile surgical outreaches and a nationwide Network of Partners. Procedures Number Percentage Limb Deformities 576 14.53% Expansion of the Therapy Block Clubfoot 666 16.80% The Therapy department was expanded to a full block with the departure of the Administration staff who vacated the therapy rooms Osteomyelitis/Infections 499 12.59% into their own Administration block. Fractures/Trauma 271 6.83% Other Orthop. 505 12.74% IEC - Information, Education and Communication Burns 321 8.10% The sessions that started in 2010 continue to be delivered 3 days a week on a daily basis by the IEC coordinator. Through the sessions, Cleft Lip/Cleft Palate 272 6.86% patients and their caregivers are informed about CoRSU services, Other Plastic 855 21.56% disabilities, nutrition, hygiene among others. This enables us to maximize 3965 100.00% the contact that we have with those who come to the hospital. About 60 people attend each session and in 2012, a total of 3,282 participants were trained. All Surgical Procedures 2012 Private Services: With the existence of the private ward which was officially opened in March 2012, the hospital can now attend to its private patients in an improved environment.

The Private Ward comprises of 8 self-contained double rooms. This ward mainly caters for patients undergoing major surgeries like total

Procedures Number Percentage Adult Male 401 10.11% Adult Female 317 7.99% Child Male 1864 47.02% Child Female 1383 34.88% 3965 100.00% Annual Report 2012 / 2013 9 Orthopaedic Rehabilitation Services

In 2013 the plan is to increase and improve Orthopaedic the arthroscopic surgery for the knee and shoulder joints, to increase the number of total joint replacement, to widen the curative Rehabilitation Services services for children with hand deformities following cerebral palsy. This will be made possible with the help of different visiting The year 2012 has been very impressive for the orthopaedic side of the surgeons coming from Europe and North hospital. Two important achievements have to be underlined; the first America; these specialists will undoubtedly one concerns the medical staff manning the department, the second increase the quality of services and widen one regards the services offered by the hospital. the range of clinical indications for surgery.

During the year and with the availability of more orthopaedic surgeons, In mid 2012 the department lost the regular the number of total operations increased to 2,517 in 2012, compared expertise and the outstanding skills of Dr. to 2,259 operations in 2011. The department has continued to act as a Fulvio Franceschi, one of the minds behind referral centre for, amongst other disabilities, complex and neglected the setting up and construction of CoRSU clubfoot, limb deformities, osteoarticular infections and for injection- Hospital. He left Uganda after having been related lesions of the lower limbs. More children were sent from here for almost a decade. He is now working South and a number of patients from the Democratic Republic in a neighboring country. A great appreciation of Congo, mainly for injuries following major road traffic accidents or for what he has been able to do for so many war-related injuries. patients in Uganda must really come out from all the staff manning the orthopaedic Newly Recruited Orthopaedic Surgeons: department. Dr. Fulvio currently visits CoRSU In the last 5 months of the year three new orthopaedic surgeons have 2 times a year to perform surgical procedures joined the department namely: Dr. Michael Mukasa, Dr. Robert Ayella that he alone can perform. and Dr. Francis Nyiiro bringing the total number of full time specialists to five. This outstanding numerical increase has widened the range of Future Plans available services; the number of clinic days has risen to 3 days per There is need to set up a proper, dedicated week and the number of operating days has increased to four days unit for the patients suffering from bone and per week. This will translate into lower waiting time at the outpatient joint infections in order to give them the best clinic and in reducing the waiting time of the operation lists. In practical available services in the region, improving terms this means more space for outpatient assessment and more slots the curative options, especially the surgery for surgical operations. for the reconstruction of the limbs. Orthopaedic Staff: At the end of the year, staff included: five orthopaedic surgeons, two medical officers, one clinical officer, three orthopaedic officers, five physiotherapists, two orthopaedic technologists, one shoemaker and more than twenty nurses. Arthroscopic Services In 2013 we will start a new surgical service - arthroscopy. This is a type of keyhole surgery that is quite new in Uganda and that will be made increasingly available to children and adults suffering from knee problems at the start. However, the plan for later in 2013 is to offer arthroscopic surgery also for shoulder diseases and to start the arthroscopic reconstructive surgery of the anterior cross ligament of the knee, aiming especially at young adults and sportsmen/women. The development of these services have been supported by Embassy of Japan in Uganda, GGP section and CBM. Joint Replacements: In 2012 about 30 total joint replacements were carried out, with the hip joint being the most common condition worked on. With the existence of the Private Ward, the aim is to increase this number to 40 in the year 2013, considering that the hospital can now offer quite good post-operative services in its private wing. 10

Orthopaedic Procedures 2012 Tamia Four year old Tamia is the first born of the four children to her parents. Her family lives in one of the Kampala suburbs. According to her mother Prossy, Tamia was born normal but at about two years she developed bow legs.

A friend of the family referred them to CoRSU in early 2012. Corrective surgery was done and one year down the road Tamia’s legs are straight and well Procedures Number Percentage corrected. Limb deformities 576 22.88% Clubfoot 666 26.46% Osteomyelitis/Infections 499 19.83% Fractures/Trauma 271 10.77% Other Orthop. 505 20.06% 2,517 100.00%

Orthopaedic Procedures 2012

Procedures Number Percentage Adult Male 221 8.78% Adult Female 118 4.69% Child Male 1,294 51.41% Child Female 884 35.12% 2,517 100.00%

Tamia before and 1 year after surgery Annual Report 2012 / 2013 11 Orthopaedic Rehabilitation Services

Gremmy Paul Gremmy was born healthy, but at the age of 3 years he developed Paul was born with clubfoot thirteen knock knees. According to his mother Christine, he was born with years ago in central Uganda. His mother normal legs but as he grew, they took on an X like shape, knocking also had clubfoot but was operated on each other as he walked. His parents thought he would outgrow before Paul’s birth and attributes the this stage with time but the legs curved in further. boy’s disability to the fact that she had it herself. As he grew up, Paul always felt Gremmy was not immediately taken to hospital because of limited pain as he walked, the feet would swell resources and ignorance about the medical condition of his legs and bust open causing painful wounds. until his aunt offered to bring him to CoRSU. Surgery was done Because of this he could not do simple to correct the deformity. “In such cases we arrest growth of the home chores like fetch water and digging. bones temporarily with plates and screws to allow for growth He is a great footballer and likes to play in the right direction” explains Dr. Paul Muwa, an orthopaedic with others but the kids at his school surgeon. feared playing with him because of the disability of his feet. This segregation A few days after the operation Gremmy started physiotherapy affected him psychologically, causing him to mobilize the knee joints. Before surgery Gremmy would isolate to underperform in class. Paul’s turning himself from the neighbouring children because of the disability of point was ten months ago when he was his legs but presently he enjoys playing with fellow children and referred to CoRSU where corrective doing house chores. surgery was done to correct the deformity. For the first time in his life he “Am happy that I can go to school now and fetch water for my can now do house chores and wear shoes, mother” he says shyly. His mother is grateful to CoRSU and cannot something he has always admired on hide the joy that fills her heart to see her child walking normally other children. Not only did this surgery and doing things he had started hating to do. enable Paul walk without pain, but made his mother the envy of village.

Gremmy before and 1 year after surgery

Above: Paul before and 10 months after surgery. Below, Paul undergoing treatment 12

mouths wide following years of inability to Plastic and eat anything requiring mouth opening and chewing. The surgery, though complex and delicate, gives patients a renewed lease to Reconstructive Services life. During the year over 10 such operations were performed.

The department of plastic and reconstructive surgery has continued to treat patients with an improved service. In 2012, 1,448 plastic and reconstructive surgical procedures were performed by the team. Anthony For 5 years, from the age of 1 year, CoRSU continues to receive steadily increasing numbers of referrals Anthony had difficulty opening his mouth. from all over the country and across the borders besides those from This continued to worsen to the point CoRSU’s network partners seeking plastic/reconstructive surgical when the gap between his front teeth was attention. These are mainly by word of mouth referrals from the many just 9mm. For 4 years, he survived on a satisfied clients as well as from medical practitioners some of whom liquid diet using a straw. Several years of have visited CoRSU as clinical observers. searching for a solution brought them to CoRSU where he had surgery to release his Clinical attachments: locked jaws in early January of 2012. This Medical students and surgeons in training are welcomed and surgery was performed by experienced accommodated well within the activities of the team. These have left surgeons from Ghent University, Belgium, with a wealth of experience garnered from the wide spectrum of cases who regularly support CoRSU surgeons we see and handle at CoRSU. There was a total of seven doctors both with complex head and neck surgery. Ugandans and non Ugandans who were attached to the department After the surgery Anthony could open his durring 2012. mouth wide, over 4cm for the first time in 4 years. He is doing well and his speech, Departmental staff: dental hygiene as well as nutrition state The department staff includes two specialist plastic and reconstructive have tremendously improved. surgeons, one medical officer and 1 clinical officer.

The manpower and exuberance of the department has been further complemented by the two MMed plastic surgery students of MUST, Dr. Darius Balumuka and Dr. Martin Tungotyo. They are showing great promise in reconstructive surgery and their input both academically and in terms of operations they contribute to has led to a great improvement in the services offered. Anthony before and after surgery Management of chronic ulcers: Hypospadias Surgery: The number of patients presenting with chronic leg ulcers – wounds Following a master class instruction in that take more than 12 weeks to heal is on the rise; on average we hypospadias surgery for one of the surgeons, receive about 3 patients presenting with this condition in a month. Their the results of hypospadias surgery has management, generally known to be slow and with varied results, has improved to meet the increasing numbers been greatly improved by CoRSU’s use of the vacuum assisted closure of patients coming to the hopsital. 54 (VAC) method. This method makes use of graded negative closed hypospadias procedures were performed in suction pressure applied to the wound enhancing tissue granulation 2012. hence faster healing. With the VAC method, we have managed to treat difficult chronic ulcers with satisfactory results in a much shortened Cleft surgery: hospital stay. Free surgery to all persons presenting with cleft lip and palate is still offered at the Locked jaw conditions: hospital, thanks to our supporters Smile Train. With great support from the regularly visiting head and neck surgery During the year, 272 cleft surgery procedures team from Ghent University, we have an improved head and neck were performed. surgery service. The greatest impact of this has been in the area of treating the “locked jaw” condition (see Anthony’s story). Several children with “locked jaws” have sought treatment for their condition far and wide. The cause of this condition is generally unknown although sometimes can be by infections or trauma. Management of this condition has seen great results, with patients being able to open their Annual Report 2012 / 2013 13 Plastic and Reconstructive Services

Plastic Procedures 2012 Patricia Patricia was burnt by fire from a charcoal stove early 2012. She sustained deep burns to the chest, right hand and left arm. She was taken to a local hospital for wound care. However, as the wounds healed, the scars constricted at the armpit and wrist joints. She could Procedures Number Percentage not stretch her right hand. Her parents Burns 321 22.17% did not know what to do until a member of their church referred them to CoRSU Cleft Lip/Cleft Palate 272 18.78% through our partner Cheshire Other Plastic 855 59.05% Home. The burn contractures (scars) were 1,448 100.00% released through surgery followed up with intense physical therapy to enable Plastic Procedures 2012 her regain full use of both arms. Through physiotherapy and a hand splint, Patricia is now able to use her hands and perform basic life functions independently. She dreams of being an air hostess one day.

Procedures Number Percentage Adult Male 180 13.10% Adult Female 199 14.48% Child Male 556 40.47% Child Female 439 31.95% 1,374 100.00%

Benita Benita was born with a complete cleft lip at a health center in Kabale district. Her parents had never seen such a disability before. They were distraught and confused. They did not know where to turn to for advice until they were referred to CoRSU by a family friend. At three months of age, Benita had her lip repaired. She can now feed easily unlike before and her parents are happy about the results of the surgery.

Patricia before and after surgery

Benita before and after surgery 14

Challenges Therapy Services Some of the clients do not adhere to therapy instructions, and also do not return when issued follow-up During the year, the Therapy department expanded from being housed appointments; this may be one of in 2 rooms to their own facilities in a full block due to the construction the causes of these clients having of an administration block. The expansion of the physiotherapy block relapses. enabled the hospital to provide a range of therapy services like speech There are delays in some of the therapy, occupational therapy, electro therapy, individual therapy appliances that the department rooms and sessions which were not possible before. Children with is out-sourcing. This prolongs the disability, particularly those with cerebral palsy, will be provided with rehabilitation time for clients. stimulation exercises, early learning experiences and play. Future Plans The Therapy team now consists of 4 physiotherapists, 1 physiotherapy Therapists have started emphasizing assistant, 1 occupational therapist and 1 speech therapist who are need for follow-up with clients responsible for the assessment and treatment of clients attending the as well as discussing with CoRSU therapy clinics at CoRSU. CBR workers and other partner organisations regarding how best to During the year, the department provided the following services: support these clients.

1. Physiotherapy Develop occupational and The therapies performed include: speech language sections of the Manual Therapy (Exercise Therapy, Manipulations and department. Mobilizations) Massage TENS (Transcutaneous Electrical Nervous Stimulation) Therapy Sessions 2012 IRR (Infrared Radiation Therapy) 2. Occupational Therapy Occupational therapists use the “occupations” of Self-Care: eating, grooming, dressing, and toileting Work: effort that is exerted to do or make something or perform a task Leisure: free, unoccupied time in which one chooses to do something they enjoy (i.e., hobby, TV, socializing, sports, reading, writing, listening to music, traveling, etc.) Service delivery in numbers So as to increase independence, enhance development, and/or prevent disability. To achieve these goals occupational therapists also have to Therapy Sessions adapt to the task or the environment. Orthopeadic 3,805 3. Speech and Language Therapy (SLT) Plastics 552 This was developed in response to the growing number of clients coming Neurological 1,732 to CoRSU who had communication and swallowing disorders. The aim of Others 122 speech therapy is to reduce the devastating effects of communication 6,211 and swallowing disorders. The weekly SLT clinic at CoRSU started being conducted every Monday morning in October 2012. The therapist uses techniques such as oromotor exercises, phonetic transcription and Crutches and Walkers 596 breath mechanism control to improve on speech and communication Wheel chairs 4 of the clients. 4. Paediatric clinics These are conducted by a volunteer paediatrician, Dr. Anna Loro, twice monthly. Assessments are done and medication prescribed for children (with disabilities) with conditions like cerebral palsy, epilepsy, malnutrition, congenital deformities and other paediatric conditions. The paediatrician also works with the CoRSU nutritionist to monitor and follow up the nutrition status of the clients. Annual Report 2012 / 2013 15 Therapy Services

Daniel Sanyu Daniel was born prematurely at seven months of pregnancy. As a “I want to play with other children, walk result he acquired developmental delay making him take long to to the shop, help my mom and go to reach his mile stones like sitting. school like other children…” says Sanyu. It was only when he turned one year that Daniel could sit albeit She speaks in sobs and intervals, one can unstably. His grandmother (with whom he stays) was worried barely make sense of what she is saying. that her first grandchild would become the family burden who But when you stay in her company for would have to be looked after all his life, but all that has changed long, everything slowly begins to make now. Daniel was brought to CoRSU when he was one year and sense. Sanyu has Cerebral Palsy (CP). four months. He could not crawl, stand, walk, hold anything in his According to her mother Lydia, Sanyu hands or talk. presented with a weak neck at birth. According to Isaac (occupational therapist), Daniel underwent Her mother bathed her in water with therapy that involved teaching him how to crawl, stand and banana leaves in an attempt to cure her eventually walk. “We also trained him hand function so now he which was in vain. Sanyu later suffered can use his hands to hold toys and play just like any other child”. from malaria that left her weaker with Amazingly Daniel can sing though he has speech difficulties. floppy arms and legs. At the age of Through speech therapy, there is hope that he will keep improving two she could barely crawl. Her mother and eventually be able to talk and communicate properly. took her to Mulago hospital but was It’s been eight months since Daniel started doing therapy exercises made to wait for over a month with to improve his quality of life and the therapists are certain he can no treatment. Tired of queuing up, Lydia only get better. His family are also very happy about his progress gave up on her daughter. Besides, she did and think that with time Daniel will be able to live independently. not have money for transport to go to Kampala every Thursday. It was not until she met a lady friend who referred her to CoRSU that she regained hope that Sanyu could be helped. When they first came to CoRSU, Sanyu could not stand or walk. She was carried on her mother’s back every time she needed to move. After straightening her legs with a series of casts Sanyu was trained on how to stand and walk. “Our target is to see her walk independently. She practiced in parallel bars to strengthen her leg muscles. She is now using a walker as she does not have good hand function yet to use crutches” explains Musa, a physiotherapist. Sanyu walks with the aid of a walker, has regained her self-confidence and she is not afraid of trying things out. She is happy and hopeful that some day she will be able to walk independently and not have to rely on others for movement.

Daniel undergoing his therapy 16

Orthopaedic Workshop Orthopaedic Workshop 2012

Wheelchairs, 4 Orthoses, 563

Brief about the services: Crutches & The orthopaedic workshop compliments other services in Walkers, 596 rehabilitation through fabricating and fitting different devices for children and other people with disability. A number of services are being rendered at the workshop and currently it is graduating to provision of artificial upper limbs with Prostheses, 58 the help of senior technologists from Mbale and Tanzania. Repairs & Others, Devices, 9 309 List of services Orthopaedic Workshop Lower limb prostheses (above knees, below knee, through Orthoses 563 knee, symes, hip disarticulation and others) Prostheses 58 Upper limb prostheses (trans radial or trans humeral limbs) Positioning Devices 9 Corrective devices (ankle foot arthosis, knee ankle foot Repairs & Others 309 arthosis, wrist drop splints and others) Crutches & Walkers 596 Accommodative devices (calipers, arch supports and insoles) Wheelchairs 4 Walking aids (knee pads, crutches and others) In the period of the three years that the workshop has existed, the staff has gained a lot of experience and expertise with support of visiting specialists from Tanzania. There is a remarkable increase in the number of patients receiving our services. The workshop received a sewing machine for our custom made shoes which will add quality to our work. Future Plans The workshop plans to continuously train its technologists in response to the changing technology, participate in FATO conferences, develop exchange programs with sister organizations in the field of rehabilitation, master the expertise in upper limbs technology and improve the quality and service to our clients.

George at his new sewing machine Annual Report 2012 / 2013 17 Orthopaedic Workshop

Diana Eric Smiling at everyone, she walks up and about at the Orthopaedic Eric was born without a foot on his left workshop. She has such an angelic smile one would find it hard to leg. His big toe was on his shin instead. believe the misfortune that befell her two years ago and changed His father blamed this on the mother her life completely. Diana (5 years) was run over by a vehicle and sent her away with all four other while on the road when she was three, sustaining several injuries children. “When I first saw Eric after birth to both lower limbs. “It was early in the morning and I had already I panicked but was counseled by the nurse left for work when Diana and her sister ran to the shop to buy at the hospital. It was not until my uncle some decoration material. Unfortunately the shop was closed. in brought me to CoRSU that I It was on their way back home that an unknown man driving a got peace of mind” says Maureen, Eric’s big truck knocked them both” narrates Milly her mother. While mother. When he was first brought to the Diana’s legs were completely crushed, her sister sustained a few hospital he could not stand or walk. He injuries. Diana was rushed to a referral hospital where bilateral would only sit and crawl if he needed to amputation was done. After wound care Diana was referred move. Eric underwent surgery to remove to CoRSU for artificial limbs. Her mother had lost all hope that the big toe and underwent rehabilitation Diana will ever stand, walk or run again. But at the Orthopaedic to full recovery. He was given an artificial Workshop she was measured and given artificial limbs for both limb to aid him walk because he was too limbs. Today Diana enjoys her life and plays with her friends. “I young to use a normal prosthesis.“ I was have been treated well at CoRSU and am grateful for what you afraid that my child would never be able have done for Diana because thanks to you she can now walk to to walk but he was given the artificial leg school like other children” says Milly. and now he walks like other children. I am very grateful to CoRSU for this” Maureen adds.

Eric before and after surgery

Diana before and after surgery 18

Nutrition Rehabilitation Irene CoRSU regularly receives malnourished children requiring surgery. Irene weighed 3.6kgs at birth. She was With availability of a nutritionist, such children are nursed to gain the born with a complete cleft lip and cleft necessary weight for surgery. During the year, 110 children received palate. Due to this condition, it was hard nutrition rehabilitation and were able to undergo surgery. for her to feed normally and her mother did not know how to feed a baby with The nutritionist carries out home visits to malnourished children under such a condition. Everyone around her the CBR program; in addition, she disseminates nutrition information to gave her different ideas on how to go mothers and other attendants through the IEC program at CoRSU and about it. After three weeks she was also attends the cerebral palsy clinic in the physiotherapy department. referred to CoRSU by a mother whose child with the same condition had been Summary treated at the hospital. At one month Irene was malnourished, weighing only Days in program Children Adults 2.6kg. Clad in baggy pants, her skin was SAM - Severly malnourished 321 21 1 loose, her ribs revealing and she crying MAM - Moderately malnourished 1943 70 8 all the time. She was put on nutrition rehabilitation so that she could gain at NOMn - Need nutrition supplement 219 21 6 least 3kgs required for the surgery. Her Total 2483 112 15 mother was advised to re-start breast milk expression supplemented by milk prepared by the nutritionist. After one month under supplementary feeding and monitoring, Irene was operated on and Cedrick healed well. Her mother was trained Cedrick was born with a cleft lip and cleft palate weighing 3kgs. and educated on how to prepare feeds Within a space of two months, he had dropped to 2.7kgs. His for the baby before discharge. She is so mother out of desperation took him to a nearby hospital from happy and appreciative of CoRSU for where she was referred to CoRSU. On arrival, Cedrick was everything that was done for her child. malnourished and increasingly losing weight as the mother fed him on cassava flour porridge mainly. The child was admitted on the nutrition program where he was put on supplementary feeding for three weeks and gained enough weight required for surgery.

This experience changed not only Cedrick’s life but that of the mother, too. “He looks better, the eating habits and mood have all improved. Those who saw him before we came to CoRSU can barely recognize him because he has put on weight” notes Ann, his mother. Ann was very glad to meet other parents with children with similar challenges and learnt how to feed her child. Irene before and after surgery

Cedrick before and after surgery Annual Report 2012 / 2013 19 Outreach Services

Outreach Services

Plastic/Reconstructive Surgery outreaches During 2012, plastic/reconstructive outreaches took place in two locations – 3 times to Kagando Mission hospital in Western Uganda and once to Gahini Hospital in Rwanda.

Generally visits consist of an outpatient clinic to assess patients who the local staff request help with, followed by 3 days operations in the hospital. These visits are valued by the local staff as we are able to help them with challenging patients and provide teaching in the difficult circumstances of a rural hospital setting. In 2012 the outreachs also had the added dimension of enabling the MMed students to gain experience in a different setting. They have found it invaluable learning how to assess patients in more basic settings and making decisions about what is possible under such challenging circumstances. Orthopaedic Outreaches With the departure of Dr. Fulvio Francesci, who left CoRSU to join our sister organisation CCBRT in Tanzania, the number of orthopaedic outreach services went down.

During the year, 2 outreaches where carried out, one to Kagondo Hospital in Northern Tanzania and another to DRC. In 2012 the following outreach activities were undertaken: 1 Visit of one week to Kagondo Hospital in Northern Tanzania for clinical assessments, surgery and follow up. 1 Outreach camp in Bunia DRC for clinical assessment. 1 Visit of one week to Gahini Hospital, Rwanda 3 Visits of one week to Kagando Hospital, Kasese, for clinical assessment, surgery and follow up. 54 Orthopaedic surgeries on outreach. 100 Plastic surgeries on outreach.

Handover of new Landcruiser for outreach sponsored by CBM donors 20

Local CBR by Category of Community Based Disability Rehabilitation

The CBR – Community Based Rehabilitation program has made great strides to transform the lives of some children with disabilities in Southern Wakiso District. The program area was also expanded to 3 new parishes. To date the program areas covers 12 parishes namely Kabale, Kisubi, Kitala , Nalugala, Kitende, Janyi, Lweza parishes and Central, Katabi, Kiwafu and Kigungu wards. In total the program covers 88 villages with an estimated population of 197,400 people and Categories of Disabilities in the Local CBR 47,920 households. In 2012 a total of 381 new clients were identified, Programme assessed and offered appropriate interventions. Physical Disability 397 Activities carried out Cerebral palsy 172 The CoRSU CBR team was involved in the following activities, namely: Epilepsy 42 client identification and assessment, health promotion, conducting Visual impairment 36 disability awareness campaigns, referrals, provision of assistive devices , parents’ training, eye screening, staff training , IEC Disability awareness Learning Disability 15 at CoRSU, PSG capacity development, CoRSU Network partners’ Hearing impairment 6 dialogue meetings and forum, epilepsy treatment, and supporting the Others 234 CBM child sponsorship program. Total No. of Clients 902 Impact created by CBR interventions 381 new clients identified and assessed 237 referrals made 168 clients were offered corrective surgery which reduced the impact of disability 126 assistive devices distributed to CWDs to facilitate per- formance of the activities of daily living 7 CoRSU CBR workers and 11 network partner staff trained in social inclusion and monitoring CBR activities at community level. 20 primary schools and 10 health facilities were sensitized about disability prevention and CoRSU rehabilitation services 309 persons with visual difficulties assessed and offered eye treatment. 1 set of IEC materials developed to enhance disability aware- ness and prevention at the hospital 105 IEC sessions conducted and 3,382 attendants sensitized Future Plans Develop CBR Data base Develop a tool for monitoring Parent Support Groups ( PSGs) Facilitate formation of 2 new Parent Support Groups in Lweza and Nalugala parishes. Develop 3 -4 sets of disability awareness materials (IEC mate- rials) Extend CBR services to 3 villages in Kasanje sub county ( Buleti, Sokolo central and Lulongo) Annual Report 2012 / 2013 21 Community Based Rehabilitation

Christine Ian Christine is a 5 year old girl from village. She was Ian is a 10 year old boy from Nakigala diagnosed with bi-lateral knock knee deformity. It is reported village. He was diagnosed with that her parents neglected taking her to the hospital thinking as varus deformity (his right leg bending she grows, the condition would correct. Unfortunately it got outwards). He developed the condition more severe and resulted into severe pain in the joints and she at the age of 2 years after receiving an had difficulties in walking at the age of 3. Her parents abandoned infection from a clinic. A month later, her and now her aunt takes care of her. In April 2012 Christine there was swelling and pus discharge was identified by a CBR worker who assessed and referred her for from the right lower leg associated with corrective surgery to CoRSU rehabilitation hospital. She received a lot of pain and started turning inwards. surgery in May 2012, followed by home based exercises provided He could not walk thus dropped out of by the CBR worker. 11 months down the road, she is now able school. In January 2012 Ian was identified to walk to school without any difficulty, participates in home by a CoRSU CBR worker who assessed activities and her social life too improved. and referred him for treatment to CoRSU hospital. He received surgery in March 2012 followed by intensive physiotherapy and continuous home therapy by the CBR worker. Later Ian was back on his feet and today attends school regularly, helps in home activities and socially interacts with other children.

Christine before and 11 months after surgery

Ian before and 6 months after surgery 22

Staff at CoRSU Staff Profile Dr. George W. Galiwango, CoRSU is blessed to have a team of meticulous and dependable staff that works diligently towards serving children and people with disability. We have had an increase in the number of staff from 130 to 145 by the end of 2012.

Two orthopaedic surgeons were recruited to meet the demand for orthopaedic services at CoRSU. One doctor who was sponsored to become an orthopaedic surgeon completed his training and started working at CoRSU in August 2012. Staff at CoRSU by profession Technical and Support Staff 32 Management and Administration 13 CBR Workers 7 At only 35 years of age, Dr. George W. Galiwango, is the head of Plastic and Social Workers 5 Reconstructive Surgery department at Therapy Staff 7 CoRSU. By 8:30am he is already at the Other Medical Staff 8 hospital. He begins his day’s tasks with Nursing staff 56 paper work, followed occassionally by a brief meeting with his colleagues. Specialists in Training 5 Every morning, together with the Doctors & Orthopaedic Officers 6 team, he conducts a ward round to Orthopaedic and Plastic Surgeons 6 check on the in-patients, after which he attends to the outpatients. He 145 spends a considerable amount of time in the theatre performing surgery. “He is a good doctor, he has all the time for those who seek his services and follows them up to make sure that they are helped, “I have never seen him get tired of seeing patients” comments one of the staff. On top of attending to patients, Dr. George is an honorary lecturer for the Mbarara University of Science and Technology, Master of Medicine plastic and reconstructive surgery course. Dr. George is a Fellow in Plastic and Reconstructive surgery of COSESCA. He dreams of seeing CoRSU develop into the number one hospital for persons seeking quality plastic and reconstructive surgery in the country.

General ward nurses Annual Report 2012 / 2013 23 Training

department of surgery at Mulago hospital and Training also instructed on microsurgical techniques in lower limb reconstruction at CORSU.

In November, the 2 students were invited Building Capacity of staff and others to India for a month long clinical attachment Training and capacity building remain central to CoRSU’s work to bring at the Choithram hospital burns unit, Indore, sustainability to the rehabilitation services provided. CoRSU’s staff Madhya Pradesh, India. This presented obtain both “on the job” and external training opportunities to enhance them with a great opportunity to see and their professional standards to a higher level. In addition CoRSU offers participate in acute burn wound management, training to individuals, community groups and other organizations to an aspect CoRSU does not offer. support the development of their skills knowledge and awareness needed to serve more children and other people with disability. During The next in-take of candidates to the MMed the year CoRSU provided internal and external training for: CoRSU staff, will be in August 2013. parents, caregivers of children with disability, community volunteers and external trainees. Other trainings: In February 2012, eleven participants Orthopaedic Internal and External Training were trained in Information, Education and Every year CoRSU sponsors one candidate to pursue a masters in Communication (IEC), a training program for orthopaedic medicine. In 2012 a suitable candidate was identified and patients and caretakers at CoRSU. This training sent to attend the course. was aimed at improving the communication At the end of the year, 3 doctors were in training for a four year MMeD capacity of facilitators for this program. The training in orthopaedics at MUK. participants acquired skills in customer care, Three students from Mulago received clinic attachments to acquire public speaking, presentation and developing experience in paediatric orthopaedic medicine. simple teaching materials. The medical director (an orthopaedic surgeon) went to Dubai to attend a short course in total hip replacement. In the same vein, another The CBR department carried out training orthopeadic surgeon went to Nairobi to attend a short course on on monitoring rehabilitation services to total knee replacement. In addition, the medical director attended a promote the efficiency of community conference in Switzerland in September and presented two papers. workers. A total of 7 CoRSU CBR staff and 11 Two orthopaedic surgeons attended a COSCESCA meeting in Addis other participants from partner organisations Ababa and presented two papers. Three orthopaedic surgeons were trained. received Internal training in Arthroscopy by Dr. Michele Trevisan (orthopaedic surgeon) at the end of October 2012. Overview on training A special training on infections was conducted by Dr. Ingebjoerg Anne- Doctors on clinical attachment to CoRSU 10 Naess (Consultant in Orthopaedic Surgery) in June; three orthopaedic Training to become Orthopaedic surgeons 3 surgeons were trained. Training to become Plastics Surgeons 2 Two refresher courses/trainings on clubfoot management and Attended international medical/science treatment using the Ponseti method were organised and held in April 3 and May 2012. Twelve participants attended the training including: conferences orthopaedic officers, medical officers, physiotherapists, one nurse as Trained in joint replacement 2 Attended a COSCESCA meeting in Addis well as participants from partner organisations. 2 Ababa Plastics Training Trained in Arthroscopy 3 Orthopeadic surgeons trained on The MMed plastic and reconstructive surgery program of Mbarara 3 University of science and technology accepted its pioneer students in infections January 2012. This program is being conducted at CoRSU with a senior Attended refresher course for clubfoot 12 plastic and reconstructive surgeon, Dr. Andrew Hodges, as the training treatment using the Ponseti method director. At the end of 2012, the candidates successfully completed Trained in IEC 11 their first year of study. Trained on monitoring rehabilitation 17 services We receive significant external tutoring on the course by invited Community Volunteers trained 90 international instructors who regularly visit CoRSU for this purpose. In Institutions sensitized about disability the past year, we were visited by the Ghent head and neck surgery 30 team headed by Professor Hubert Vermeersch; Mr. Tom Potokar prevention and CoRSU services Parents sensitized on Disability and Mr. Opoku from Interburns who run a course on management of 163 burn trauma; Mr. Tim Goodacre on secondary cleft surgery and a team management and Prevention Clients and caregivers trained in the IEC of surgeons from the University of British Columbia, Canada, who 3,382 run a course on lower-limb reconstruction in conjunction with the program 24

Visiting Staff Profile Sylvia, CBR Specialists

Each year blesses us with specialists who visit CoRSU and help us to improve the quality of life for our clients. Surgeons and therapists were among those who visited us this year. We are grateful to the following among others for sharing their expert knowledge and experience at CoRSU in 2012:

Prof. Hubert Vermeersch (Plastic Surgeon, Head and Neck Surgeon) Prof. Kristiane Van Lierde (Speech Therapist) Mr. Tim Goodacre (Consultant Plastic Surgeon, Cleft Surgeon) Mr Tom Potokar (Consultant Burns and Plastic Surgeon) Patience, flexibility, understanding and above all compassion are Dr. Opoku (Consultant Plastic and the four main attributes that have helped her to do her job well. Burns Surgeon) Sylvia Nafuna, is a 27 year old Community Based Rehabilitation Dr Luc Van Doorne ( Maxillofacial worker with CoRSU. She has been working with the hospital since Surgeon) 2010 and is responsible for children with disability in 2 parishes, namely; Kabale and Central Ward of Entebbe. By 8:00 am, she is UBC team - Dr. Nick Carr, Dr. normally in her office doing paper work or attending meetings but David Keith Ward, Dr. Jordan she spends most of her working time in the community. Her work Haythorwaite and Dr. Mark Hill. involves training and sensitization of the community members Dr. Vik Devaraj (Plastic Surgeon, about prevention and management of disability, identifying, Sarcoma and Hand Surgeon) assessing and referring CWDs to CoRSU hospital, doing rehabilitation exercises with clients while training their parents Dr. Ingebjoerg Anne-Naess to do the same, training parents and caregivers to make assistive (Consultant in Orthopaedic Surgery) devices that require local materials and doing follow up visits Dr. Wilhelm Kemmer (Orthopaedic for clients who have been to the hospital. She says that she finds Surgeon, CBM) several challenges working in the community such as unshakable Dr. Michele Trevisan (Orthopaedic cultural beliefs and superstitions, language barriers and poverty. Surgeon) However despite all these, she finds her job very rewarding especially when she gets positive results such as seeing a child with Ms. Irene Hartman (Physical a disability (especially cerebral palsy) who was totally dependent Therapist) on others, begin to manage certain activities of daily living on their own, or when parents of children with disability who were previously indifferent to their children become proactive in the rehabilitation program and above all the appreciative children and their parents who often say how much their lives have been changed. When she is not working, she loves sightseeing and reading. Annual Report 2012 / 2013 25 Working with Partner Organizations

Working with Partner Organizations

Compared to the previous years the number of network partner organizations slightly went down. This was mainly because some organizations lost funding and couldn’t continue with their activities. However, the total number of patients sent through network partners increased.

Our network partners identify patients from their respective areas, transport them to CoRSU and follow them up until the completion of treatment. At present, CoRSU collaborates with 30 partner organizations on 4 different levels in 4 countries. In 2012, 6 dropped out and 3 new partners were brought on board. Networking Partners 2012 A. Partners supported by CBM:

Benedictine Eye Hospital Tororo Butiru Cheshire Home CoRSU CBR program Katalemwa Cheshire Home OURS Mbarara Synergie Simama (Bunia, DRC) Usratuna (, ). B. Partners backed by other NGOs or support group:

AVSI Uganda Acheru Mukono Kagondo Hospital Tanzania IDIWA Little light Anna (slums) Missionaries of the Poor Mengo Mukisa Foundation Namutamba Rehabilitation Centre Nkokonjeru Cheshire Home Retrak Uganda – The Tigers Club (Kampala) Rukungiri NKD GOD Children Soft Power Health Jinja Uganda Society for Disabled Children (USDC) Watoto Child Care Ministries Zest4kidz. EDYAC Adina Foundation Plan Uganda. C. Partners whose focus is on adults:

AAR Health Services Ltd Ghent University Interaid Uganda Salini Construction Bujagali Watoto Church Reconstructive Surgery Project. 26

Profile of a partner: Plan Uganda Plan Uganda went into partnership with CoRSU in May 2012 to support medical and community based rehabilitation for children with disabilities. This is part of Plan Uganda’s bigger five year program funded by NORAD 2011-2015 mainly focusing on;

- Empowering children and their caregivers on how to prevent disability Some of the children supported by Plan - Strengthening prevention, response and reporting of child Uganda abuse cases and referral for appropriate assistance and Through partnership with CoRSU, services Plan Uganda’s staff were trained in - Building the capacity of children, caregivers, education community based rehabilitation, officials and child protection professionals on prevention of early detection, identification and violence prevention of disability including - Strengthening existing local structures and mechanisms for management of post operation care. child protection including community child protection 20 parents support groups were committees, local government structures such as probation established and 1,468 (827 boys/ and social welfare offices, local councils and anti-violence 641girls) supported through community children’s groups in schools based rehabilitation services. Medical - Supporting child protection agencies to improve rehabilitation of CWDs through CoRSU coordination in child protection service provision has helped more than 47 children - Ensuring an effective national child protection system (17girls and 31 boys) to regain mobility that is fully supported by the state including improvedO ‘forCC peopleRR withS SdisabilityUU’ through corrective surgery conducted collaboration as well as cooperation between statutory by CoRSU with support from Plan child protection agencies and CSOs concerned with child Uganda. protection. Map of Uganda Showing Network Partners CoRSU Network Partners 2012 S.E.M. SUDAN

Usratuna Juba

Lachor CORSU AVIS

Synergie Simana Zest 4 Kidz CERBC Kumi DRC Namutamba Butiru Cheshire Home Nkokonjeru EDYAC SOVHEN Tororo / BEH Soft Power IDIWA Kagando ACHERU KENYA Networking Partners CORSU OURS Kampala NB: Kisiizi Katalemwa Cheshire Home CERBC: Centre for Education & Community Based Missionaries of the Poor Rehabilitation USDC IDIWA: Intergrated Disabled Women Activities Bukoba / Kagondo Mukisa Foundation EDYAC: Empowerment of Disadvantaged Youths & Children RWANDA ACTV USDC: Uganda Society for Disabled Children TANZANIA Watoto Childcare Ministries ACTV: ENHAS Annual Report 2012 / 2013 27 Our Supporters

us a hand both materially and financially Our Supporters in 2012/2013; we couldn’t mention each and everyone’s name. Your support made a difference in the lives of many children with disability. We would like to thank you, our donors, for supporting us during the year 2012. Your support has ensured that children obtain free surgery at CoRSU which has changed their situation and improved the quality Tumaini Award: of life as well as opening new opportunities especially in terms of CoRSU Rehabilitation Hospital was the winner their education after surgery and rehabilitation. Your commitment to of the Tumaini Awards 2012: NGO category support CoRSU is very much appreciated by those who benefit from of Health. CoRSU was recognized for its our services, namely the children. outstanding efforts to enhance the well being of children in terms of health. The CoRSU Through the support of our partners, CoRSU Rehabilitation Hospital was Board President won the Tumaini individual able to provide 3,965 surgical procedures in 2012. This has resulted award for his efforts to help children with into improved quality of life of children and other people treated. disability. International donors CBM Member Associations - CBM Germany - CBM Italy - CBM Canada - CBM UK - CBM Switzerland

Other organisations and individuals have also supported us throughout the year including: - Smile Train USA - Heart for Children / Herz fuer Kinder (through CBM) - ALTSO USA - The staff and friends of Brussels Airlines (Mr. Louis Vuylsteke, Ms. Tinne Verstrepen, Ms. Bianca De Backer, Mr. Phillipe Gobin and others) - Children of the world (Enfants du Monde) in Belgium Local donors We appreciate the support rendered to us by different individuals and organizations here in Uganda including: - Mr. and Mrs Shyam - The Vice , Hon. Edward Kiwanuka Ssekandi - Nnabagereka Development Foundation (5 wheel chairs) - Father’s Heart Mobility (5 wheel chairs) - GGP (Grant Assistance for Grass-roots Human Security Projects) Embassy of Japan in Uganda - Members of UNICEF Uganda Coffee Club - Federation of Uganda Employers - Kisubi Brothers University And many individual donors.

We would like to extend a big thanks to everybody who rendered 28

Finances

CoRSU Income Sources 2012 Income (UGX) Amount (UGX) Percentage c/f 2011 22,014,755 0.38% Patient Fees 1,476,467,018 25.47% CBM 2,982,441,448 51.45% Smile Train/Other 321,219,759 5.54% donations Release unspent 286,854,612 4.95% From Reserves 200,274,753 3.46% Exchange gain 211,040,455 3.64% Diverse income 296,305,738 5.11% 5,796,618,538 100.00%

Running Expenditure 2012 Expenditure Amount (UGX) Percentage (UGX) Personnel 1,858,701,905 32.07% Administration 121,784,152 2.10% Utilities & 175,579,368 3.03% Property Consumables & 1,014,313,195 17.50% Maint. Subsidies & assist 123,045,090 2.12% devices - direct Transport 147,299,074 2.54% Awareness/PR/ 57,530,210 0.99% Outreach Training 156,924,485 2.71% Financially we were affected by the very stable Ugandan Shilling for Outreach and 2,912,500 0.05% the first nine months of the year. Our budget had been calculated on an Diverse average exchange of 3,400 UGX to the Euro. The reality was that most Equipment 591,217,438 10.20% of the year the rate was around 3,100 UGX to the Euro. Salaries of the Capital Develop- 341,128,290 5.88% staff had been increased by nearly 30% at the beginning of the year, as ment well as the prices from suppliers being increased by similar margins. Bad Debtors 8,817,500 0.15% Unspent donor 369,650,000 6.38% c/f 2013 Allocation to 827,715,335 14.28% Reservces 5,796,618,542 100.00% Annual Report 2012 / 2013 29 Contents

CoRSU Capital Investment 2011

CAPITAL (UGX) Vehicles (Equipment) 226,759,844 25.61% New Equipment 317,578,014 35.87% Construction 341,128,290 38.53% 885,466,148 100.00%

Vehicles: CBM provided funding for the purchase of a Landcruiser for outreach activities. A second-hand Landcruiser was purchased for the sponsor child program of CBM which is based at CoRSU. Equipment: Advance payments were made on an Image Intensifier (C-Arm) as well as the purchase of diathermy and other equipment. Construction: This was the completion costs for the construction of the Private Ward and the Seminar/CBR/Administration block. 30

Way Forward: Aims for 2013

Results and Indicators from the Log frame for CoRSU 2012-2015: Preventive, Curative, Rehabilitative and Educational Services for people with disability in Uganda.

Results Indicators Children and people with disability receive quality surgery, which reduces • 1700 patients receiving plastic surgery per year by 2015 and/or alleviates a disabling condition. • 3400 patients receiving orthopaedic surgery per year by 2015 • 100 patients receiving other specialist reconstructive surgery per year by 2015 Children with disability receive appropriate rehabilitation services in terms • 3000 patients receiving post surgery rehabilitation per year of physiotherapy and occupational therapy, care and if required receive • 1500 patients receiving nonsurgical rehabilitation per year appropriate orthopaedic appliances and assistive devices to reduced and/or • 1000 orthopaedic devices developed and/or provided per year alleviated disability. • occupancy level of hostel of 90% People with disability (physical and visual impairment) and their families • 100 patients for orthopaedic or plastic surgery IAT to CoRSU per year receive appropriate support and counseling through a CBR program to • 300 clients regularly supported through CBR per year improve their quality of life in Kampala and Wakiso District. Trained personnel/human resources with good qualification and competence • 1 to 2 persons qualifying as specialists (Orthopaedics or Plastic) per year. (4 in are available to provide the required services. training) • 1 to 2 persons qualifying in Therapy (PT, OT, ST) per year. (4 in training) • Continuous education courses both in-house and externally Health Promotion and Prevention and Rehabilitation at national level • Number of patients referred by networking partners through a network of service providers with whom we are working to • Number and type of Network partners provide outreach services, referrals and follow up for orthopaedic and plastic • Media material distributed or disseminated interventions. CoRSU Rehabilitation Hospital is expanded to have a private ward; Therapy/ • staff increased from 120 in 2011 to 150 in 2015 Administration unit; Training/CBR building and a further ward of 32 beds all • building and equipment phase 2 finalized by Nov.2014 equipped, furnished and in use. People with disability have equal access to services and facilities and are • Cooperation with three key players whose aims are to foster inclusion for PwD. included in society, be it education, training, human rights, medical and other services. To ensure adequate funding in order for CoRSU to provide life changing • Mobilisation of 60% of budget as subsidy for services provided to children with intervention and to improve the quality of life for people with disability disability. particularly children. Annual Report 2012 31 Contents 32

CoRSU Services:

Orthopaedic surgery

Plastic/Reconstructive surgery

CBR - Community Based Rehabilitation services

Therapy services (physiotherapy, occupational therapy, others)

Orthopaedic workshop for the production of assistive devices and artificial limbs

Rehabilitation Hostel

Training for professionals and specialists

Nutrition rehabilitation services

Mobile surgical outreaches

Nationwide network of partners CoRSU Info DVD, 11 mins. Available from CoRSU or at: www.corsu.or.ug Main Supporting Organisations: