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Circular - March 2013
I’m writing this letter from South Africa. Hazel and I travelled here from Uganda to see Alan and Sara Clegg, and he was able to arrange for us to use a house near his own. It’s a chance to take time to absorb what happened on our visit to Acheru. Seeing it all again brought home to us the responsibility we’d taken on in building it, and the responsibility we now have to all the workers and patients.
We travelled out to Uganda late in January. The journey wasn’t quite as straightforward as we’d hoped. We had been given an additional luggage allowance, so wanted to bring as much as possible for Acheru. Joyce had told us about medical supplies which they couldn’t obtain locally. We packed six suitcases, plus three pieces of hand luggage, having been assured by the travel agent that it would all be consigned direct from Belfast to Entebbe. We found otherwise when we got to the airport, and were told we would have to collect it all on arrival at Heathrow Terminal 1 and transfer it to Terminal 5 ourselves. The transfer is by train, but baggage trolleys can’t be wheeled through to the platform. This meant toing and froing till all nine pieces of luggage were on the platform. Then we found that short trains were used in the evenings, so everything had to be moved further along the platform. When the train stopped, it was a scramble getting everything on before the doors closed. Thankfully at Terminal 5 several other travellers helped us get it all off before the train left.
We arrived very late at Entebbe, so stayed in a guest house to await collection by Sam Mutumba the next morning. After breakfast I sent Sam a text message reminding him to come for us, but fortunately he remembered, as the text only reached his phone 12 hours later, when we were all at Acheru.
First impressions were favourable, everything looked good. The site is maturing, more grassy areas prepared, flowers planted, paths edged by hedges, and we also saw a number of chickens, dogs, cows, goats and squirrels. We’ve built all we want to build there for now. There is potential for more, but only with a partner as we don’t want to overreach. From now on the emphasis will be on caring for children, but before being able to say that development is complete, I went round with Sam, talked to the staff, and drew up a list of all the details which need to be dealt with to bring it all up to the standard we want.
We still have some development money left, so hope we can deal with all outstanding work. Much of it is straightforward, the biggest job is completion of the second big underground water tank. We had got estimates for a borehole, but it would be on someone else’s property so as well as the cost, I could see difficulties in the future. Having seen how quickly water tanks fill from gutters after a shower, I believe most of our needs can be met from rainwater collection. We now need to ensure that rainwater is collected from every roof on the site.
The purpose of our visit was to meet with the staff and management committee, review all that has happened, ensure we all continue to share the same vision, and to look at our strategy and where we go from here. We’re in a recession where it’s not easy to raise funds, but money has come in, the work at Acheru has been blessed, and is achieving all we could have hoped for, and all this has been done very cost effectively. It’s a good basis for our future work together. The work makes a big impression on many people, not just the patients and their families. It’s seen by visitors too and this has resulted in a lot of help from volunteers, some of them overseas students on placements at Uganda Christian University. They help with medical, educational, and spiritual work in Acheru, and their efforts are much appreciated. Those I’ve spoken to are impressed by what they’ve seen; there is such an obvious change in the children who are treated.
As well as looking at any work still to be completed, we thought about vehicle replacements. We’re now going ahead with buying a pick up to replace the old one at Acheru, and a twin cab pick up for Sam Mutumba’s use to replace the car he’s been using for some years now. Something more robust is needed as he will be doing much more travelling to coordinate Acheru work in the north. We had also considered replacing the minibus used by Acheru for transporting patients. It gets a lot of use, clinic runs, ferrying patients for surgery etc, but is still in reasonable condition so we can defer replacement – this will help, as cars aren’t cheap in Uganda. Buying new would be well beyond our means, and buying something which has already been used in Uganda means it will have led a hard life. The best option is to buy from bond – the stocks of used cars imported from Japan. They are older, but it’s the best compromise; this is how most cars come into Uganda.
While a lot of work can be done in Acheru, many surgical cases are referred to CoRSU, who have a big children’s hospital at Kasubi specialising in orthopaedic and plastic surgery. Their services are subsidised but the costs are still a significant concern for us. We want to keep Acheru as full as possible, so inevitably this means increased costs as we refer more children for surgery. We have been told by staff at CoRSU that the children we bring them are among the most serious cases they see, with some conditions they’ve never seen before. This is a good indication that Acheru is fulfilling its aims in finding the neediest children, and providing care for those who couldn’t otherwise be helped. We believe that without our intervention, many of our patients would go on to suffer terribly, perhaps leading to amputation or death. We are determined that no child will be refused treatment because of cost. We have a wonderful facility at Acheru and want to get maximum value from it.
We have been planning for some time to do more work in the north, establishing a permanent presence there instead of clinics every two months as before. There were discussions and agreements, and money was raised to get it all started. Acheru is now ready to recruit a team of workers for the north, but problems have arisen. Some of the facilities we’d been promised are no longer available, and this has caused uncertainty. Having come this far we’ve decided to go ahead but at least to start with we wont be able to have the hoped for inpatient unit. The emphasis will be on outpatient and community work, with surgical patients being referred to Acheru. It’s not ideal but the need is great and this is the best we can do at present.
Talks continue with local government in the north, and it’s still hoped we can develop a good working relationship, but the only way to find out what is possible is to get the work started. We will be monitoring it all closely, and evaluation will be based on the numbers helped. Patients requiring surgery can be sent to Acheru, outpatient work can be done with, for example, cerebral palsy and club feet, so many children could be helped. We’re not putting up buildings, our investment is primarily in personnel, so we can be flexible if we see a better way to proceed, but at least we’ll be there doing something.
The story of one girl indicates a problem faced by Acheru. A deaf and dumb Moslem girl, Baluka Zaitini, living in a mud hut in a very poor area, had her leg badly broken in an accident on 10th November 2012. She was taken to a traditional bone setter, and the external wounds eventually healed. But infection set in, and she was in a lot of pain so her mother brought her to the hospital in Mukono on 15th January. They X rayed her leg and you can see the results of the bone setter’s efforts. Infection was bad and likely to develop into osteomyelitis.
The hospital realised it was a case for Acheru and sent for Sam Mutumba. Surgery at CoRSU was booked for 23rd January, with the girl to be brought to Acheru a few days earlier, but they didn’t turn up. Clearly she was suffering, and was only going to get worse so Sam had to try to track her down. He found where she lived, and went on 31st January with Hariett, our community based rehabilitation worker and the local chief to try to persuade the mother to bring the girl for treatment. She was admitted to Acheru and we’ve just heard that surgery was successful. Community leaders, like local chiefs, are very important people in their own areas, so it means a lot when they understand what we’re doing and are supportive. Their help can be important in finding children, and convincing relatives to bring them for treatment.
This story is all too common and shows the importance of community work in educating people, tracking down those needing help, and providing follow up. Harriet also has other responsibilities, and as Acheru grows the demands on her time are such that we may need to consider another CBR worker.
Many people are involved in this work. It’s been reinforced many times that this is an effective practical manifestation of the love of Christ, and I commend to you the efforts of the Acheru staff who clearly have a vision for their work which goes far beyond what could be expected if they regarded themselves simply as employees.
I want to give my assurances to our donors and supporters that those at Acheru are doing everything possible to ensure that your help leads directly to changed lives. We have challenges to face, and depend very much on your support but I’ve again had the chance to see for myself how much has been achieved.
Thank you for your help in making this possible.
Brian Dorman
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Baluka Zaitini, and X ray after traditional bone setter

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