ACCESS 2018 ANNUAL REPORT EXECUTIVE SUMMARY EXECUTIVE SUMMARY EXECUTIVE Executive Summary

2 3 he African Community Centre for With additional support from our Working with international partners, Social Sustainability (ACCESS) is partners, we have been able to ACCESS has been able to set up T a community-based organisation graduate 24 preschool children and income generating projects, and in the rural district of Uganda called maintained the number of preschool established three patient-centered care Nakaseke. It was founded on the children at 62. We have provided clinics for non-Communicable diseases premise that everyone has a right to scholastic materials for 320 OVCs (NCD) serving over 400 patients. Our a healthy life. Our mission is to work in primary and secondary schools. model has been presented to Uganda with vulnerable people in resource- We held our first graduation for the Ministry of Health and has been limited settings through provision of nurses and midwives in our school, adopted by several partners in the NCD medical care, education and economic 98% passed their national exam with field in Uganda. empowerment to create long lasting excellence, and most of them are change that is owned by the entire employed. We have been able to maintain our community. connection with the community Our medical care services have greatly through training and empowering 122 For the year 2018, we focused on improved. In this year, we treated community health workers who provide strengthening the activities of ACCESS over 3,196 patients and provided support to all our projects. We have in the areas of support for orphans family planning services to 29,614 welcomed new partners and have and other vulnerable children (OVCs), clients including 8,884 youths aged worked on new areas of need based on nursing and midwifery education, 15-24 years in and out of school. The the research findings with our partners. medical care, family planning, number of clients has thus more Our work has been recognized through infrastructure and human resource than quadrupled from 7000 last year. International and local awards. development. ACCESS is now the leading provider of FP services in the Nakaseke district This report details the achievements and provides support for 19 other and lessons learned in the journey of centers in the district. ACCESS through 2018. Executive Summary 3 Content 4 Foreword 5

1 Background 7

2 Activities done in 2018 8 2.1 Support for orphans and other vulnerable children 8 2.2 ACCESS Pre-school program 9 2.3 Education, Medical Care and Income Generation to OVCs 11 2.4 Providing vocational training for OVC 14 Key outputs for OVCs 15 Key outputs for Nurses and midwifery School 17 2.5 Provision of Health care services to rural communitiesn 18 Global Health Education 20 Research fellows 21 CONTENT Pioneering Non-communicable disease care 22 FOREWORD in Nakaseke and Uganda Content Foreword

4 5 3 Other Activities 24 s 2018 ended, we have had ACCESS has since its inception strived On behalf of the entire ACCESS Board 3.1 The Jajja initiative 25 an opportunity to evaluate to establish sustainable programs that of Directors, I take the opportunity to 3.2 Nurturing Local and International Global Health leaders 26 A what was planned for the specifically focus on children and the appreciate our funders for entrusting us 3.3 The Borehole and Solar projects 27 year. Iam very excited to note that our youths who are often disadvantaged with the resources that we use to reach Story from the community: Peace 28 programs have continued to address by their environment. Based on the out to our clients, our clients, staff and the real needs of individuals within the 2018 State of Uganda Population other partners for their contributions community that is served by ACCESS. Report, 52% of the estimated 39 million toward these successes. 4.0 Future Plans 29 Ugandans are children aged less than 5.0 Conclusion 29 The ACCESS School of Nursing and 15 years. The report also shows that My hope and desire is that as you read Midwifery has grown over the years, nearly one quarter of the population this report, you will be encouraged to and continues to provide a unique are youths aged 18-30 years, and that contribute more, if already engaged, or ACCESS in Pictures 30 opportunity for trainees to constantly many of the youths have no meaning­ be motivated to contribute to this noble The Graduation 30 interact with the community throughout ful employment. These facts have cause in some way. The Children’ Party 30 their training. This approach exposes consistently pushed us to build strong Meet some of our staff 32 trainees to the entire spectrum of dis- and sustainable programs for children I hope you will enjoy reading the report. ease presentation and enables train- and the youths. Our efforts are bearing ees to participate in health pro­­motion fruit, but more is needed, as you will Sponsors & Partners 33 interventions. A recent graduation of read in the report. ACCESS-Uganda Community Healthworker/ 34 our pioneer trainees is a clear testimony VHT centred care model of the high standards of our training program. Dr. Fred C. Semitala Chairman, Board of Directors. Note from the Managing Director, ACCESS

ACCESS has walked a This year, has been a year of Though the walk to In 2003, ACCESS-UGANDA Our mission is to work Our nursing and midwifery journey best told in it’s vision: big discoveries, especially economic empowerment opened its doors to treat with vulnerable people in school continues to narrow To be a center of excellence after the overall country has been rough, the sky is Orphans and other resource-limited settings the gap in the care provided in training and medical care popu­lation description the limit come 2019. vulnerable children (OVCs) through provision of to rural communities in Uganda. This addressed was reported to have a big and offer follow up to medical care, education and compared to their urban in three dimensions inluding number of young people Estherloy Katali Abaliwano People Living with HIV- economic empowerment counterparts. Our graduates edu­cation, health and below the age of fifteen Managing Director-ACCESS AIDS (PLWAs) within the to create long lasting have taken up jobs in the economic empowerment. years. This not only reflectis community of Nakaseke change that is owned by health sector and over 60% Many strategies have been the high dependence rate, district. The clinic receives the entire community. have remained in rural areas, introduced over the years to but also calls for innovative on average 230 patients consistent with the goals of address the problems of the ways to teach and extend per month including an We have continued to the program. community. financial sustainability to the average of 80 children who be true to our mission of families and beneficiaries come in for immunisations being responsive to the ACCESS provides services supported by ACCESS. and vaccination community needs and have throughout the lifespan been joined by a host of of our community: caring like-minded people who for OVCs, rejuvenating the Note from the Managing Director, ACCESS have supported us in youth, empowering women reaching out to even more and supporting the elderly ACCESS through the years. they face get resolved. We I want to appreciate our beneficiaries. (jaajas) who have fallen Having lost my father at a have empowered the CHWs donors, collaborators, board through the cracks of a weak tender age of 8 years, I know with knowledge and tools of directors, staff and friends social support system. BACKGROUND exactly what it means to be to provide the best services and who have been very in need! At ACCESS, we have that we can offer. They are instrumental for the growth

LETTER FROM THE CHAIR OF THE BOARD OF DIRECTORS. OF THE BOARD THE CHAIR OF LETTER FROM purposed to pro­vide holistic supported by a robust team of ACCESS. We are happy to care to our beneficiaries. of medical doctors and be part of the solution to the 1 Background We believe in the breadth of nurses (health), social work numerous challenges faced our services rather than in (social and spiritual welfare), by rural communities. All 6 numbers. We aim to change health educators (disease this would not be possible 7 lives rather than ‘touch’ prevention and early detec­ without your support. In 2006 a Nursing Assistant This report offers a glimpse them. Our model of support tion) as well as financial Thank you! Training Program was estab­ Even though Nakaseke into our work for the year consists of a community advisors (income generation). lished with 8 students, and by remains a very impoverished 2018, our accomplishments, health worker (CHWs) who Nakibirige is a good example Dr Robert Kalyesubula 2011, 280 Nursing assistants district, ACCESS has helped lessons learned, challenges identifies those who are most of what we do. Please read Founder and President had been trained to work to bring positive impact to faced and synthesized in need and follows them up her story in the stories ACCESS, Uganda in 28 districts of Uganda the lives of the beneficiaries recommendations for future to ensure that the problems section. including Southern Sudan. touched. We have progress. transformed lives of OVCs In 2009, a partner that would have otherwise What the International Community can do; Partners for ACCESS (PFA), USA organisation called Partners dropped out of school. We for ACCESS (PFA) was have taken girls who have Here in the United States economic, educational, and We are grateful that so established in USA to been side-lined by the social our team has been im­ preventive care, whereas many generous donors and help support ACCESS in construct of the community pressed with the magnitude ACCESS offers more holistic institutions recognize the generating and managing and given them practical life and quality of support that services that address the integrity of ACCESS’ mission. resources. skills that have empowered ACCESS provides to the needs of the whole person, them to be employed. people it serves. It has not within their own community. Erin Shaw Nahrgang only become an essential, This promises to afford Executive Direcor, PFA, USA integral part of the Nakaseke more durable and healthy community, but serves outcomes. ACCESS’ vision Janice Levin, PhD as an international model is indeed ambitious and Founder and President, PFA of what comprehensive expansive, but because of USA health care delivery should the many partnerships it’s look like. Medical care cultivated, and because in the US operates via it draws on indigenous independent silos that knowledge and resources, separate medical, social, its success is insured. Other OVCs provided with Resty (standing), the Social scholastics (sub index) worker with some of our Index OVCs in secondary school. Female

45 65 93

Class levels Nursery Primary Secondary

39 91 47

Male ACTIVITIES DONE IN 2018 ACTIVITIES ACTIVITIES DONE IN 2018 ACTIVITIES 2.0 2 Activities done in 2018 2.0

8 9 2.1 Support for orphans and other vulnerable children 2.2 ACCESS Pre-school program

e currently have over 680 OVCs and economic empowerment to the family. he preschool program was Many items/ gifts have been given for the identified for support in Nakaseke. We are happy to note that the academic established by Grace Herrick, a 16- community members which include: knitting W Each year our team led by the performance among our index OVCs has been T year old girl from USA who noted machines, tailoring machines, scholastic social worker, works with community health very good. For example, out of 11 students a gap in children 2-5 year olds who had no materials, preschool learning materials, workers (CHWs) to identify orphans and supported in primary, seven of 10 got first formal education. We have so far registered preschool t-shirts, clothing, shoes, basic other vulnerable children who are in need grades and only one got second grade. Out of 62 children for this program this year who needs like soap, sugar and more funds. of support. We always have more requests the seven OVCs in senior one; six passed with attend from far and nearby areas. Those from than our resources can accommodate. This first grade and one got second grade (marker far are transported by bus and those from There is a growing trend of support from calls for a process of selection, which is quite of performance). We also have students in nearby walk to ACCESS. The children learn within Uganda which is very critical for tough but inevitable. We entertain a delicate senior four and senior six who are waiting for how to sing, dance, pray, share with others sustaining the programs we run. This year balance between level of vulnerability and their results. This performance is not typical of and watch television. They play, eat and drink, we had the Managing Director of Airtel potential to achieve. Once the CHWs, students from rural areas. and with the aid of three teachers learn how (the largest telecom in Uganda), Mr VG to count, read, write and speak English. The Somasekhar and his team visit us and donate ACCESS staff and community members select These great results have been achieved program graduated 24 children on the 15th of several items along with 10 sewing machines the OVCs to be supported, the successful through a combination of regular supportive December 2018, and they are now ready for to kick start income generating projects for candidates are taken on for full support visits from the social worker to the guardians, primary school next year. the guardians of our children. This same year by ACCESS and they become the ‘index’ teachers and the students. The CHWs also we have had the Managing Director of KLM child. We then take on all the other children provide continuous follow up and support We also provide medical care and screening Uganda (Mrs Lukia Otema) and her team visit (below 18 years) in the family of the index for the OVCs. Our sub-index OVCs are also services (sight, hearing, dental and infections) us twice with great tidings to the OVCs child as ‘sub-index’ OVCs. This year we have doing very well even though we are not able to all the supported children in our project. supported 42 index OVCs and 403 sub- to offer detailed follow up to all of them due The preschool project has received a index OVCs. The index OVCs receive the full to limited resources. The challenge is some lot of recognition and support from both package of scholastic materials, school fees, of them change (migrate) from one place/ international and local sources. medical care, regular psychosocial support relative to another making follow up complex. OVCs enjoying end of year party at ACCESS, Uganda

Mrs Otema, KLM Mr VG Somasekhar, Airtel Uganda Some of the gifts from Airtel BUILDING CAPACITIES BUILDING CAPACITIES

10 11 Grace Herrick We have also been very privileged to have with Sam from the Grace Herrick, the young lady and founder of 2.3 Education, Medical Care and Income preschool the pre-school project come to ACCESS with her friends and their parents. This was a great Generation to OVCs day of celebrations! New methods and tools of learning were introduced with great joy. e screened and Our students also come Our children now have more than enough identified over together at the end of the toys to play with, they have music and books W 600 OVCs for year to celebrate and share that make learning so enjoyable. support. Children supported experiences with each other. by the ACCESS program They meet the staff members receive support in the form of ACCESS and are free to of medical care; income ask questions and learn generation projects as well more about the organisations as regular follow up by the and ways in which they can community health workers. contribute to make their Ms Katherine and As with most things in life, the preschool has community a better place. the team cenjoying the some challenges. Key among these is the per­formance by lack of a permanent shelter. When it rains, the children in the the shelter from the tents is not enough and ACCESS tent. the program gets disrupted. Sadly, some of the children come in without parents which hinders their learning. 2.2.1 Providing Medical Care for OVCs

The ACCESS clinic, the mobile team and VHTs provide medical care to OVCs through visits to the clinic, mobile outreach and through first aid care by trained VHTs. Children are also cared for through annual medical camps organized in collaboration with Nakaseke Hospital and other pharmaceutical companies.

The ACCESS medical team, VHTs and social worker pay particular attention to OVCs living with HIV. We currently care for children living with HIV by sending them to ACCESS antiretroviral therapy and ensuring that they receive regular home visits. Mothers during beading and sweater knitting practice

James the in-charge of SCHOLARSHIPS Lifecare Clinic examining one

WHO PEN II PROTOCOL of the OVCs.

12 13 One of the preschool 2.2.2 Working with Village Health Teams 2.2.3 Working with International partners caretakers with (VHTs) to set up income generation to ensure that basic skills are imparted to her piggery project. projects for OVCs and their families schools in Nakaseke

Working with VHTs and other partners, Medical Students from Canada have we train guardians and provide them with developed a training program with basic life income generating projects including cows, skills which are taught in different schools. goats, pigs or chicken rearing, as well as The main focus is on secondary schools setting up plantations and small-scale shops. where all students, including those who are directly supported by ACCESS and those who The preschool program now has a training are not, are taught about issues related to program in tailoring for the preschool hygiene, reproductive health, dental care and Farming Income generation families and guardians, using machines nutrition. About 400 students have received 10% project types donated by Airtel and Grace Promise Inc. training in these basic life skills. The students Saloon In addition; many guardians receive weekly are now also involved in the reproductive 10% classes in beading and sweater knitting. health program. Boutique These income support programs augment 20% the livestock and agricultural income- generating projects ACCESS provides to the families of pre-schoolers.

Goats Piggery 10% 40%

Chicken 10% Key outputs for OVCs 420 orphans received medical care through medical check ups

620

403 OVCs visited and mapped OVCs OVCs for support received scholastic materials

Some of the ACCESS dream girls in practice NCD-TRAINING BUILDING A BUILDING A NETWORK

2369 14 15 2.4 Providing vocational training for OVC who are youths received adolescent friendly reproductive health services unable to continue with formal education

e work with VHTs and other e recruit them and offer trainings community leaders to identify and in tailoring and hairdressing for W select vulnerable girls from the W a period of 6 months. Out of community for vocational training every year. the 30 girls who graduated in 2018, one is a The beneficiaries are girls ranging from 14-18 teacher of tailoring in Nakaseke Vocational years of age. These young girls dropped out skills centre, three have their own boutiques, of school due to various reasons like loss of a one owns a hair salon and the rest work in parent who was providing school dues. different areas of Uganda.

62 attending the preschool

400 Secondary school students trained in livelihood skills 42 OVC (index) received full 60 board services dream girls trained in The graduate dream vocational trades bringing girls set up their saloons the total to 90 while the rest are all employed Our first group of graduands of the Nursing and Midwifery school with the tutors, leaders and guest of honor NCD CENSUS

Miss ACCESS and her

IMPROVING KNOWLEDGE IMPROVING fellow winners.

16 17 Key outputs for Nurses and midwifery School

mong other achievements, the arlier this year, the first Miss ACCESS nursing students performed very Scholarship Pageant was held in 1. Number of students increased from 162 in 2017 to 212 in 2018 A well in the national sports events as E Nakaseke. This was produced and well as the academic seminars. Ten of our hosted by Lanial Maddan, a masters of 2. 2 new staff have been recruited for the Nursing school students have received awards from Shyanna public health student from Touro University Ganji, a Nursing student from Canada, to set California with a goal of raising scholarship 3. 8 needy students offered scholarships up a research program. The school had a money for students of Nursing and Midwifery. privilege of hosting several visitors who have It was a very colourful occasion. Below are 4. Construction of a new library and classroom for the students further boosted their academic excellence. our current beauty queens who visit our community projects on a regular basis and 5. Special community based courses offered by international partners represent ACCESS. 6. 54 students graduated with 98% pass rate in our first national state exams

7. Participation in National sports and academic debates

8. Maintenance Parents association and the School Guild

9. Special community research (Shyanna) program set up for Nurses and midwives Female he common conditions seen include, e were unfortunately not able to malaria, respiratory tract infections, hold a medical camp this year T peptic ulcers, hypertension, enteric W through which we often see over fever, diarrhoea, road traffic accidents, 1500 patients from the community. We hope urinary tract infections, pelvic inflammatory to organize one in 2019. 28 142 43 1142 181 121 284 disease and candidiasis among others. age 0-11 month 1 – 5 6 – 15 16 – 25 26 – 35 36 – 45 46 years & above We immunized 624 children below 5 years Working with VHTs and other stakeholders of age, in accordance with the National from government hospitals and clinics, we 35 85 53 174 95 77 136 immunization program guidelines. We also have trained over 102 VHTs (including 30 dewormed over 300 children and provided youth) in the provision of family planning them with vitamins. services. Through this effort, over 27,442 women and 2,172 men received family planning services in 2018. Below are some of the details of the services provided to the Male community: PROVISION OF HEALTH CARE HEALTH OF PROVISION 2.5 PROVISION OF HEALTH CARE HEALTH OF 2.5 PROVISION

18 19 2.5 Provision of Health care services to rural communities FP Methods Total FP Services Provided CYP per FP Service Male Condoms 60047 500 n 2003, the original Lifecare Center clinic his may be a reflection of our target was established at ACCESS. Since its population as well as a reflection of Female Condoms 980 8 I inception, OVCs, PLWAs, women and T the health seeking behavior in our Pills 1266 84 children as well as members of the general area. Women tend to come for medical care population have benefited tremendously early while men only come to hospitals when Emergency Pills 60 3 from the services provided. they are very sick. We are trying to reverse Noristorat 24 4 this trend by providing targeted health Through a combination of our static clinic, messages to men. Norigynon 2 0 regular outreach and direct support through Depo-Provera 7397 1849 our trained VHTs, we are able to offer a variety We also cared for more adults than children of both preventive and curative services. In in the pharmacy because most of the Sayana Press 5260 1315 2018, individualized records were kept on all children attend a different clinic on Fridays Implanon - 3 Yrs 5094 12735 of our participants, which had enabled us to for immunization where most of their care track their health and wellbeing. This year we is provided. We only see the children if they Jadelle -5 Yrs 4345 16511 managed 2,596 patients in the pharmacy and come for medical checkups and end up with IUCD -10 Yrs 1239 5699 the clinic. Of those treated, 1941 (75%) were an infection, or when they are very sick and females while 655 (25%) were male patients. require medical attention beyond the routine Tubal ligation 92 920 immunizations. Below is chart of patients Vasectomy 2 20 visiting our pharmacy. Table showing family planning (FP) methods provided along with the couple years of protection (CYPs) Global Health Education Research fellows RESEARCH FELLOWS RESEARCH

VHTs trained to provide family planning GLOBAL HEALTH EDUCATION HEALTH GLOBAL and monitor ACCESS projects.

20 Lusanjja HC 2 378 21 he provision of family planning e also cared for more e have trained professional Mifunya HC 2 325 services is extremely important adults than children in the health workers from 19 T because Uganda has the W pharmacy because most W clinics within 6 subcounties Kiggege HC 2 0 second highest fertility rate in the of the children attend a different clinic of Nakaseke. They have also been given Lifecare Center 2 1936 world with an average of 6.1 children on Fridays for immunization where skills and equipment to provide better per woman. High fertility rates have most of their care is provided. We services to the community. The photo Kikamulo HC 3 1354 also been correlated with high levels only see the children if they come for shows the training and the figure below Kapeeka HC 3 275 of poverty and poor child care. It is medical checkups and end up with an shows the number of referrals from thus important that women are given infection, or when they are very sick and VHTs to the different health units where Semuto HC 4 599 an opportunity to have the number require medical attention beyond the they get services. Bulyake HC 2 257 of children they can take care of routine immunizations. Below is chart of comfortably. This may be a reflection patients visiting our pharmacy. Namusaale 347 of our target population as well as Biddabugya HC 3 781 a reflection of the health seeking One other key ahievement is the behavior in our area. Women tend to involvement of youth in the family Kyangato 392 come for medical care early while men planning and sexual reproductive Kirema HC 3 211 only come to hospitals when they are health programs. The youth take part in very sick. We are trying to reverse this outdoor activities and are also given an Kabogwe 643 trend by providing targeted health opportunity to get services through our Kalege HC 2 742 messages to men. outreach programs. Below are some of the youth. Nakaseeta HC 2 450 Nakaseke Hospital 635

Kikandwa HC 2 534

St. Johns Bukatila HC 2 675

Lt. Col Dr. Baata HC 3 238 VHT referrals completed at health facilities at completed referrals VHT Total Referrals completed PIONEERING NCD CARE PIONEERING NCD CARE

22 23 Pioneering Non-communicable disease

care in Nakaseke and Uganda 1. 3,196 patients received medical treatment

2. 1,462 patients received laboratory services orking with the Else integrated NCD care at Nakaseke NCDs in Nakaseke and are following Kröner-Fresenius Hospital, ACCESS (Lifecare Clinic) up with patients on a regular basis 3. 36 health professional experts trained (NCD and Family planning ) W Stiftung (EKFS), we have and Semuto Health Centre IV. through the different clinics and by set up the EKFS Patients Centred We trained 20VHTs and equipped the VHTs. 4. A well-stocked Barceló Pharmacy with outreaches to clients of all ages Care Centre for Non-Communicable them with Information, Education Diseases (NCDs). and Communication (IEC) materials Other services provided by the 5. 122 VHTs trained in family planning and non-communicable disease(NCD) care in the form of an innovative tool Lifecare Clinic include the use of ECG NCDs are a growing problem among called Pocketdoktor developed by machines (machine that examines 6. 29,614 clients received regular family planning African countries and are projected our colleagues from Germany. These the heart) for heart screening and to become a major cause of death books are very easy to understand ultrasound scans for following up 7. Availability of Ultrasound scan and ECG services if nothing gets done at the present and can easily be carried in the and monitoring pregant women to time. Diseases like diabetes mellitus, pockets. We have adopted and ensure that they have safe deliveries. 8. Mobile outreaches conducted to the community hypertension, lung diseases and translated the books in the local We have set up radio programs and cancer are silent killers. They catch language with very good results conduct regular outreach to engage 9. Establishment of an 3 NCD clinics treating 350 patients on a regular basis the patient unawares and may be too from the feedback we get form the the different stakeholders from the advanced to treat by the time they community. community to avail themselves 10. Radio program set up for patient education are discovered. The best way is to of these resources. In addition we screen for them and treat them early Additionally, we trained 18 Clinicians have a call-in line at ACCESS where 11. Expanded our services to 3 new sub-counties and 19 health units when found. who are now able to screen, prevent patients can call in wheneever they and optimally manage patients need information or have a health 12. Established a 24-hour call-in line for patient support We have so far managed to set with NCDs. We are also carrying problem.

up three NCD clinics that provide out research on the major causes of 2018 for services care Medical outputs for Key 13. 106 medical outreaches conducted to support VHTs and patients The illustration shows the age bracket of the jajjas under our program Female

age 65 – 70 71 – 80 80 years and above Male OTHER ACTIVITIES OTHER THE JAJJA INITIATIVE THE JAJJA 3 3.1

24 25 3 Other Activities 3.1 The Jajja initiative

n Nakaseke and Uganda e currently at large, elderly people support 40 jajjas I (jajjas) have very limited W in three sub- support yet they are very counties and provide them vulnerable. Uganda has no with basic provisions like social support services for sugar, salt, soap, breads and the elderly yet some of them other basic needs. We also are the only ones available to provide regular medical care take care of the orphans. The counselling and guidance jajja initiative services people on top of the regular home 65 years and above. We visits. have identified 90 jajjas in our area of service, however, Some of their houses are in we have not been able to extremely poor condition support all of them due to and almost every elderly has budget constraints. a problem in obtaining basic needs like clothing, medical care, sugar, salt and other basic needs. 3.3 The Borehole and Solar projects supported by Barcelo’ Foundation

or a long time, the The community decided to ACCESS provides solar We have been able to follow people of Wakataama, give us land to set up the panels to families in areas up with our beneficiaries and F a small village in Kiito borehole near a primary without electricity. We are happy to report that the sub-county (new to ACCESS, school so that over 100 prioritize families with children now show better about 160 kilometres from families and over 200 pupils children who attend school concentration levels, also Kampala) had to walk for could get ACCESS to clean and are most likely to benefit evidenced by their improved very long distances to obtain water on a regular basis. from the light. academic performance. services. During our regular medical outreach, the turn- Indeed, water is life! We now The children use the solar out of women and children have a consistent turn-out of light to read and revise their was often low. participants and the children books. This year, four solar report that they have more panels were issued to three We later discovered that the time to read their books and sub-counties, bringing the families (mainly women and concentrate. We thank the total of solar panels given children) had to walk very Barcelo Foundation very out so far to 17. long distances to get water much. for home use. International volunteers work with VHTs to conduct home visits to ACCESS supported OVCs in Nakaseke District NURTURING GLOBAL HEALTH LEADERS HEALTH GLOBAL NURTURING THE BOREHOLE AND SOLAR PROJECTS THE BOREHOLE

26 27 3.2 Nurturing Local and International Global Health leaders

CCESS over the We established an We have hosted several Because of all this effort years has been integrated NCD care clinic international students who and investment, the ACCESS A fortunate to conduct in collaboration with the have greatly contributed team has contributed to six research with some of its Ministry of Health and to our program. In addition, peer reviewed publications international partners. In Nakaseke Hospital where we were also able to host this year. 2017, ACCESS worked with patients with NCDs can four medical students from international partners to receive all of their services Makerere who spent a week conduct a survey on self- from under one roof. with us at ACCESS. reported noncommunicable We continue to conduct diseases (NCDs). A total of several on-going research Dr. Richard Munana is 16,000 people evidencing projects in maternal currently serving as a Fellow non-communicable diseases and child health, family under the mentorship of Dr. such as hypertension, planning health systems Benjamin Bodnar from Johns diabetes mellitus, chronic strengthening. Hopkins University. He has airway diseases and chronic been very instrumental in kidney disease participated setting up the NCD clinics from 3 sub-counties in and ensuring that the Nakaseke . curriculum of NCDs gets widely shared. Borehole during digging and installation level and final levels We have a lot in store for • Expansion of the Early • Expand patient centred care 2019 and are looking childhood project to other interventions throughout to making more impact areas of Nakaseke the district and train both in our community. May of professional and lay health the planned activities are • Engagement of youth workers in provision of the outlined below. and women in all project same. activities, with focus on family planning • Work with partners to build capacity in research and • Training more Nurses and scale-up best practices at midwives for rural areas. ACCESS.

• Support Education and IGA projects for OVCs

• Expansion of the clinic and setting up a fully equipped laboratory to offer more services to people. THANK YOU! THANK

Peace with two small jerricans going to fetch water for the family. STORY FROM THE COMMUNITY FROM STORY 4.0 Future Plans

28 29 Story from the community: Peace 5.0 Conclusion

aving lost her mother to and no one knew who her father was These are called the sub-index HIV, ACCESS could not have because her mother got pregnant children. Though we do not provide H come in at a better time than when she was drunk. Since ACCESS the whole package to them they do when it did for Peace. intervened in Peace’s life in May 2018 get medical support, counselling, her life has been greatly improved. and their guardian has been trained ACCESS and all it partners has seen Peace, who is now 5 years old, was by ACCESS to set up an income identified by Resty our social worker ACCESS now supports her with generation project in form of a tremendous growth over the last year on one of the days she was visiting school fees, scholastic materials and garden. We believe that in about the villages. Resty was informed medical care in and out of school. three years this will help the family with better monitoring of the services that Peace had just moved to her We have been able to enroll her get enough income to support the grandmother’s place because her in the HIV-care clinic where she other children. provided to our beneficiaries. mother had just passed away due to receives regular medical care. Resty HIV and excessive alcohol intake. visits her at least once every month, Our CHW visits the family every week talks to her and her teachers to and sends us a monthly report on She later found that Peace was get an update on how she is doing how they are doing. It is stories such We are very grateful to our donors struggling with going to school in school and how she can be as these that give meaning to our because her granny of 55 years now supported. work. When we last visited Peace she for enabling us expand our reach to had 4 children whom she could not said she wanted to be a mother so support with a meagre income from During holidays she comes to the that she could take good care of her needy communities. selling alcohol. Nakafeero Florence, Lifecare Clinic for a medical checkup children when she grows up. our community health worker for the and interacts with other children Kisango area later confirmed that we support. This helps to build a Peace was also living with HIV-AIDS lasting bond. Peace has 3 siblings. ACCESS IN PICTURES ACCESS IN PICTURES ACCESS ACCESS in Pictures

30 31

The Graduation

The Children’ Party

ACCESS-Uganda Community Healthworker/ VHT centred care model

School Pre-school Skills Building

ACCESS-UGANDA MODEL ACCESS-UGANDA OVCs MODEL ACCESS-UGANDA

34 Nursing & Midwifery IGAs 35

Life Care Center Community Outreaches Community Healthworkers IMPRINT

ACCESS Uganda is a social venture and a community based organization. Tax ID (TIN): 1002370757 · Registered in Uganda © 2019 ACCESS Uganda c/o Dr. Robert Kalyesubula Nakaseke District Internet: www.accessuganda.org [email protected] Graphic Design: Helmut Kraus · helm69.com

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