KIHEFO promotes local initiated solutions to fight disease, ignorance and poverty in southwestern Uganda
If there’s anyone with an up-to-the-minute lens on infectious and non-infectious diseases in southwestern Uganda, it would be the man behind the microscope – Mugume Simon.
Simon has worked as the Lab in Charge at KIHEFO’s Laboratory at the General Clinic in Kabale since 2009. He’s trained as a Laboratory Technician, having completed his studies at Mengo Hospital & School of Medical Laboratory Technology in Kampala, and today works closely with his colleague, Rwira Julius, along with other Ugandan laboratory students who fulfill their placements at KIHEFO’s laboratory.
Testing for cases of TB, HIV, syphilis, plasmodium falciparum, diabetes, organ functioning, and so on – Simon sees just about it all at KIHEFO’s laboratory.
But he doesn’t only sit ‘behind the lens’ when it comes to helping patients. Simon is an active participant with KIHEFO’s nurses, medical officers and social counselors to help improve healthcare services and delivery in Kabale – he’s an example of an empowered, mobilized healthcare worker who knows, practices and advocates for KIHEFO’s integrated model that aims to bring people out of poverty and sickness.
‘A Day in the Life’ – Looking for Malaria, HIV & TB
For Simon, work begins bright and early in the morning. He arrives at the General Clinic every morning at 8 am to prepare the lab and lab equipment before patients arrive. When the samples begin trickling, or flooding into the lab – the real work begins.
KIHEFO’s laboratory has testing capacity for malaria, TB, HIV, syphilis and other STI’s, blood sugar, liver and kidney functioning, pregnancy, brucellosis, amongst others.
According to Simon, malaria is one of the most common diseases that he tests for on a daily basis. Malaria is a disease that’s carried and transmitted by mosquitoes that feed from dusk to dawn. When an infected mosquito bites a person, the life cycle of malaria injects itself into the blood, and takes place in the human being. Despite the higher altitude of the Kigezi region, and the markedly colder temperatures, malaria remains a reality for the population of southwestern Uganda.
To test for malaria, Simon analyses blood samples for signs/stages of malaria under the lens. He’s looking for the most common type of malaria in Uganda – plasmodium falciparum – which is also considered the most severe type of malaria (of the four strains). When left untreated, falciparum can cause anemia and cerebral malaria.
For many Ugandans, contracting malaria is the equivalent to contracting the ‘common cold’ in Western countries. But for vulnerable populations, including infants, children under five years, pregnant women, and the elderly – malaria can be deadly.
“Once [someone] gets malaria and if it’s left untreated…it becomes very dangerous for their survival,” Simon explained.
Another serious communicable disease that Simon regularly tests for is TB, or tuberculosis. For TB suspected patients, he conducts a sputum smear test.
“Out of 40 suspects, two [people] have TB,” Simon explained, “Here in Kabale, it’s very common that people don’t finish their treatment…TB is highly infectious and can be easily transmitted.”
TB treatment is eight-months long. For some patients, there’s the issue of distance to health centers, clinics or hospitals for treatment and check-ups. There’s also the reality that treatment doesn’t always get regularly restocked at government health centers. KIHEFO’s TB program is unique because they do regular follow-up with TB patients by making phone calls and offering advice, encouragement and help from afar.
Simon, on behalf of KIHEFO, works closely with the district government’s National TB Program, who come to the laboratory every three months to analyze KIHEFO’s results. It’s no surprise that KIHEFO has a clean record – thanks to the thorough, attentive work of Simon, Julius, and the lab students at KIHEFO.
Simon also performs many HIV tests on a daily basis. The samples arrive from both the General Clinic, and KIHEFO’s HIV Clinic, which operates next-door to the Laboratory. It’s only been in the last decade that HIV tests have become so accessible to Ugandans.
“Before 2005, it was difficult to get the [HIV] test done, and tests were expensive.”
Today at KIHEFO, it costs 2000 Ugandan shillings to be tested for HIV (approximately $0.75 US dollars) – which is half the price charged by other centers in Kabale. KIHEFO is supplied with HIV tests by the Ugandan government.
Simon explained that everyday KIHEFO receives two to three patients who are HIV+ and that “4-5% of the people KIHEFO tests are positive.” This is part of a regional trend. Studies show that the HIV prevalence rate (around 7%) is increasing, particularly among young adults aged 15 to 19 years old.
HIV may not be the only STI that’s threatening health in southwestern Uganda. According to Simon, the prevalence rate of Syphilis is actually more common than HIV, while tests are more expensive and difficult to access.
Working with KIHEFO’s Medical & Social Counselors
When it comes to HIV, Simon works closely with KIHEFO’s medical and social support counselors. Anti-retroviral therapy drugs are very strong, and patients must undergo regular blood testing to ensure they’re not causing harmful side-effects. Together, Simon and counselors are able to identify a particular ART drug best suits the patient.
There are also times when Simon needs to get more involved with KIHEFO’s counselors, usually when he sees something – or doesn’t see something.
Simon recalled the case of a middle-aged couple that came to KIHEFO for HIV testing. He remembered that the wife had “forced” her husband to come for testing, as she suspected that, due to his exhausted physical state, that he was positive. As it turned out, Simon found that they were both HIV negative – yet he knew all was not okay.
He recommended that the husband be tested for diabetes. They couldn’t afford the test, so KIHEFO covered the cost, and in the end, the man tested positive for Type I Diabetes.
Opportunities & Challenges at KIHEFO’s Lab
Simon has worked at KIHEFO’s lab since 2009, and over the past four years he’s seen improvements in testing capacity.
“Every year we are adding tests,” he said, “[But] the problem is that we lack equipment.”
Simon explained that KIHEFO’s lab could benefit from a chemistry analyzer, and improved equipment for testing kidney function. Additionally, capacity to examine “culture sensitivity” would help KIHEFO.
“You see someone having a disease, getting treatment, but they’re not getting better. ‘Culture sensitivity’ allows you to grow bacteria and expose them to different drugs. [The goal] is to identify drugs [for patients] for better treatment.”
These tests are available at Regional Hospitals in Uganda; however, there are many patients, the place is usually “congested” and due to lack of supplies, and medical professional absenteeism – it’s never a guarantee that people be tested.
Simon is glad to have found a home working with KIHEFO. While many of his university student colleagues have since graduated and left Uganda to work in other countries in East Africa, Simon is a proud KIHEFO advocate.
He explains how a large part of what KIHEFO is doing is “medical” – but that the other part is about improving livelihoods and focusing on the poverty that causes the majority of people’s diseases and illnesses (and renders them unable to pay for treatment).
KIHEFO is not only diagnosing and treatment the afflictions of patients, but also engaging rural groups to build onto their indigenous models of micro-savings, and helping them to increase their household savings/income generation.
For Simon, it’s what’s making a real difference in improving overall health.
“When you’re enjoying your work, and you see it has an impact,” Simon said with a smile, “you find it very interesting.”
To learn more about KIHEFO’s work and how you can get involved, please visit our website today – click here.