KIHEFO promotes local initiated solutions to fight disease, ignorance and poverty in southwestern Uganda
A small group of pregnant women waited under the shade of the registration tent on a bright Sunday morning. They wore their ‘Sunday best,’ either coming or going to church services in the town-centre of Kabale, Uganda. The mothers-to-be had arrived at KIHEFO’s first-ever ‘Ultrasound, HIV & Syphilis Screening Clinic’ (organized in collaboration with Toronto-based partner organization, TO – the WORLD) to receive maternal health services, including antenatal care and counseling.
“The goals of the pilot-clinic are two-fold,” explained Dr. Geoffrey Anguyo, Executive Director of KIHEFO, “to identify pregnant mothers at risk by using portable ultrasound technology and to conduct testing for HIV/AIDS and syphilis.”
KIHEFO promoted the pilot-clinic through churches and community groups, encouraging pregnant women from Kabale to access the free maternal health services. In turn, over fifty women registered, and received pre-testing counseling, HIV/AIDS and syphilis testing, and ultrasound technology scanning.
TO – the WORLD medical volunteers were able to ‘loan’ a portable ultrasound machine for use in the pilot-clinic; although KIHEFO aspires to obtain its own equipment in the future to provide mobile health screenings in rural Kigezi – where maternal health services are needed the most desperately.
According to statistics provided by the World Health Organization (2012), Uganda currently has the 20th highest rate of maternal mortality, and the 15th highest rate of infant mortality in the world. In rural Kigezi, the majority of pregnant women do not receive antenatal, natal and postnatal healthcare services, with only 30% of births taking place in healthcare centers, attended to by health professionals.
The prevalence rate of HIV/AIDS in the Kigezi region is 6.4% – amongst the highest numbers reflected in the country. Furthermore, the epidemic is spreading to from urban centers into rural communities. According to the Kabale District Health office (2010), a total of 16,122 people in the region, of whom 1036 are female, are currently receiving HIV care, although an estimated 35,000 more are living with the disease, undiagnosed and without treatment. This situation is creating major health risks for pregnant women, and their children who are also vulnerable to becoming infected.
Why Ultrasound Technology, HIV/AIDS & Syphilis Screening?
Ultrasound imaging can provide useful information related to a woman’s pregnancy throughout all three trimesters, which becomes beneficial to identifying risk and potential pregnancy complications, and best preparing/supporting the mother to give birth – ideally in a hospital or clinic setting.
Furthermore, the World Health Organization (2003) recognizes ultrasound technology as ideally suited to developing countries, as it is relatively low-cost, low input, and easily maintained and transported, which is suitable to providing services to rural populations.
Dr. Anguyo believes that access to ultrasound scanning will increase the number of women seeking medical counseling and support throughout their pregnancies, and ultimately, reduce the high numbers of maternal mortality in Kigezi. Women are motivated by the incentive of “seeing” images of their babies. When women seek out medical services, this also allows health professionals the opportunity to do HIV/AIDS and syphilis screening, and if positive, provide treatment to the mother, which reduces the transmission of disease to their babies.
“The test results only take fifteen minutes,” Simon explained. “If the woman tests positive for HIV/AIDS, we’ll start her on antiretroviral medication immediately – and this means a 90% reduction in the chance she’ll pass the disease onto her baby.”
Risk of Syphilis is Rising Worldwide
Dr. Mike Silverman, one of TO – the WORLD’s volunteer physicians who participated in KIHEFO’s pilot-clinic, has experience working in multiple international health outreach camps in Zambia and Zimbabwe. Dr. Silverman reports that nearly ½ million people die annually due to syphilis – a disease that he referred to as “completely preventable” and easily treatable with “just a shot of penicillin.”
He explained that while there’s a 45% risk of mothers with HIV/AIDS passing on the disease to their child, the transmission risk of spreading syphilis from mother to child is nearly twice as high. While donor agencies have invested extensively in HIV/AIDS prevention programs, there’s been less attention placed on the risk of syphilis, which is seen as “less sexy”, and as a result, the disease continues to spread.
Despite these challenges, Dr. Silverman has seen the success of other HIV/AIDS and syphilis screening programs rolled out in Zambia and Zimbabwe, reflecting that “transmission rates were dramatically reduced” as a result of the work done.
Similarly – Dr. Geoffrey is hopeful that KIHEFO’s pilot-clinic using portable ultrasound technology, and increasing testing of HIV/AIDS and syphilis amongst pregnant mothers, will also help to improve maternal health and reduce transmission in the Kigezi region.
“How can this model work in rural communities? This is the question we’re trying to answer and build on today,” said Dr. Anguyo.
“Distance remains one of the greatest barriers for pregnant mothers [to access health care]. So we want to bring these services to them instead.”
To learn more about how you can help support KIHEFO’s vision, please – click here.