The First Mile Community Health Program was established with an aim to strengthen health service delivery in Southwestern Uganda through a bidirectional approach of taking MUST to the community and bringing the community to MUST for capacity building and mentorship.
The program key interventions include student training, research and community engagement towards addressing community health needs in the southwestern region of Uganda.
Dr. Peter Olds, the deputy program director of Centre of Global Health programs-Uganda, spent two days in the community visiting some of the beneficiaries of the First-Mile Community Health Program.
He was accompanied by Assoc. Professor Edgar Mugema Mulogo, the Program director of First Mile Community Health; Mr. Ntaro Moses, the deputy Program director of First Mile Community Health; Dr. Peter Chris Kawungezi, the coordinator of First Mile Community Health; and Dr. Andrew Ainomugisha, the Monitoring and Evaluation Officer.
In Kisoro district, he visited the local government’s top leadership, the district health office, the medical superintendent of Kisoro district hospital, and the highest-level public health facility in the district. He later proceeded to the community of Bunagana Town Council, where the First Mile Program supported a student-led emergency response in July 2022 to curtail effects caused by the refugee influx since March 2022 following conflicts in the neighboring Democratic Republic of Congo (DRC). Here, he had an opportunity to meet the Town council leadership, Local council chairpersons and the Village health teams (VHTs) also known as Village Health Workers of the most affected villages.
In Rubanda district, he visited Muko health centre IV, one of the biggest public health facilities in the district. In Kabale district, he visited Rubaya health centre IV, where he met with other facility leaders of Kamuganguzi health centre III (Kabale district), Mparo Health Centre IV (Rukiga district), and Buhara Health Centre III (Kabale district).
According to the Assistant Program Director of First Mile Mr. Ntaro Moses, through field attachments of Postgraduate trainees (PGs) for experiential learning and sponsorship of community health-focused research projects, the initiative brings MUST to the community. In July this year, with support from the First Mile Community Health Program, DoCH, a team of forty (40) undergraduate medical students and four (4) Master of Public Health (MPH) postgraduate trainees from the Faculty of Medicine (FoM) at MUST, carried out a three-day emergency response outreach in Bunagana town council, Kisoro district. The students decontaminated six villages and health educated individuals at household level in a door-to-door approach.
Dr. Nsabiyumva Stephen, the District Health Officer (DHO) of Kisoro district, revealed that over the years the First Mile Community Health Program has been supportive to the health service delivery in the district. The program directly benefits the community through health promotion and preventive engagements.
‘’Kisoro is one of the delicate districts in Uganda because of its location, it is bordering two countries…. the Democratic Republic of Congo and Rwanda… Whenever there is a crisis in any of those counties, their citizens always run to our side seeking asylum… When these people come to the Ugandan side, they cause a lot of problems to us, particularly on the health side… The influx of these refugees is associated with the spread of diseases resulting from poor sanitation,’’ Dr. Nsabiyumva explained.
He described that refugees do not want to go to the gazette refugee resettlement camps in Nakivale and Rwamwanja, majority of them opt to stay in the compounds and verandahs of the natives in Bunagana town council. In the middle of this year, over 5000 refugees ran to Uganda after war erupted in DRC when the government was fighting armed rebels of M23. These refugees settled in Kisoro causing a shortage of pit latrines prompting both the refugees and the natives to opt for open defecation putting everyone’s life at risk of a cholera outbreak.
‘’We had anticipated a disease outbreak but it didn’t happen. something we attribute to the timely support from the MUST students who decontaminated the affected risky areas in Bunagana town council… they decontaminated the area with chlorine and jik. Previously we were worried because it was a dry season and the rainy season was soon approaching… When Prof Mulogo and his team came to our rescue, we were saved and when the rains came, our areas were safe… We applaud the work done by the team because it saved us a lot,’’ He appreciated.
Dr. Nsabiyumva requested more support since refugees are still entering Uganda due to the ongoing crisis in DRC and the situation has worsened again.
In the meeting at the office of Bunagana town council, VHTs from six villages of Gatsibo, Kara, Kanyampiriko, Kibaya, Nyarutovu, and Bunagana credited the interventions done by First Mile Community Health Program during the times when they were overwhelmed with health challenges due to the influx of the refugees in the area.
Mr. Emmanuel Mbonye the town clerk of Bunagana Town council revealed that as a new town council, they are facing many challenges, especially in revenue collection which limits them in service delivery including construction of public pit latrines and garbage collection.
‘’The town council collects most of its revenue from the imports and exports from DRC … they are all currently on hold because of the security crisis in DRC… Due to this, we are unable to meet all the needs of our communities, and when refugees come… it becomes worse… We are happy that we got First Mile Community Health Program on board to help us in improving the health status of our town council… especially in areas we were constrained both financially and in manpower,’’ He reported.
‘’First Mile brought Medical students that carried out door-to-door awareness sessions about sanitation, medical education, and personal hygiene to the people staying in the villages that make-up Bunagana town council… Students taught the residents about primary health care activities such as deworming children and having a clean and covered pit latrine these activities are still practiced by the residents now… students also left medical notes in local languages to guide residents on nutrition and health aspects,’’ Mr. Benon Maniraguha the Coordinator of VHTs enlightened.
Ms. Ruth Mujawimana, the Deputy Mayor of Bunagana Town council stated that initially, they were praying to God to bless them with rain for agricultural benefits. However, the prayer changed when refugees stormed their areas because of the fear that the running water would spread fecal matter to all the areas. When MUST students came to our rescue and decontaminated the area where open defection was frequent, they were able to pray for rain again.
In his remarks, Dr. Peter Olds appreciated the district leaders and the VHTs for welcoming him and the team to Kisoro and for actively participating in First Mile activities whenever they are called upon. He also credited Prof Mulago and his team for implementing the bottom-up approach while attending to the communities’ health needs.
He added that working with MGH and MUST has been a privilege to the communities in Southwestern Uganda especially Kisoro District which is vulnerable because of the refugees that always come from DRC.