Agnes (not her real name) comes from Kengoma village, which is 8 hours walk from Bwindi. When she was two years old, she was brought to BCH with severe muscle wasting and very thin, weighing only 4.7kgs or 10 lbs - less than half the normal weight of a child of her age. She also had horrible wounds and injections abscess. Agnes was referred to Bwindi from another health facility where she had been getting treatment for two and a half months and had not been improving.After careful assessment by our team she was found to have Tuberculosis, HIV and severe malnutrition. Agnes' born to a very young mother, and she was also HIV positive and had been abandoned by her husband and family members. We took care of both Agnes and her mother providing them with food while at the Hospital.
The Hospital provides health services for a population of 100,000 people. We see about 40,000 at the Hospital each year in outpatients and about 4,000 require admission, not including maternity cases. On any day, our clinicians can be dealing with accidents, burns and cancer. They look after people with pneumonia, HIV/AIDS and heart failure.
We have clinics at the Hospital for diabetes, epilepsy and high blood pressure as well as services for dental and eye problems. The most common cases that we see in our outpatient department include HIV, diarrhoea and malaria. A doctor or clinical officer sees patients quickly, and while they wait, they get education from our HIV expert patient, malaria prevention nurse or a member of the dental team. If someone is ill enough to require admission to Hospital then we have clean (although overcrowded) wards with 122 beds. We have an x-ray machine, ultrasound scans and a laboratory.
The Hospital has a community health insurance plan that asks all people in the area to contribute $5 per person per year to the cost of their health care, and with this, they pay only a nominal charge each time they use Hospital services. This innovative approach to cost sharing has helped improve access for all people; including the very poorest, and enables everyone to plan and take responsibility for their family health instead fearing the cost of health care and avoiding seeking medical care.
The cost of providing all of this care is only $5.80 for each person in the area per year. This is a very small amount compared with the United States, where $6,700 is spent annually on health care for each citizen. But this still means that to subsidise the patient contribution towards our services we need to raise around $200,000 each year. Helping people like Agnes is certainly a good thing, but it costs a lot of money. This community is a long way from being able to afford to pay the full cost of the health care it requires.
The Hospital has made plans for a new adult ward with room for 30 men and 30 women, including quality isolation facilities for people with tuberculosis and other infectious diseases, and oxygen for people who are seriously ill. We are looking for a donor to support this project. Any contribution, however large or small, will go directly to helping those most in need.
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