Circular - December 2015
We have to remind ourselves that Acheru is primarily a rehabilitation unit. It’s not a hospital, we are not there to provide services which are available at hospitals or clinics, but we have to consider each case individually and think about what will happen to the child if we don’t intervene. An example of this was Atiam Flavia, rushed to our Minakulu unit with a broken arm following a fall from a tree and with an untreated broken jaw from an earlier accident. Her nearest clinic could only provide first aid, and it was then left to Acheru to deal with manipulation and casting and also arrange a referral to a dental surgeon. There are functioning hospitals in the north but it’s a big area and for many people their only access to effective medical treatment is our Minakulu unit or our outpatient clinics. We hope this may change in the long term which is why we decided not to build a bigger inpatient unit there, but for now the need exists and we will try to deal with it, providing outpatient services or arranging referrals to our Acheru base at Kabembe or to local hospitals.
A more typical case was Auma Linda, a two year old girl brought to Minakulu suffering swelling to the left lower leg and pus discharge around the left ankle joint. This was diagnosed as Chronic Tuberculosis Osteomyelitis Left Tibia and treatment was Sequestrectomy and biopsy, tuberculosis treatment, antibiotics, and appropriate exercises. From suffering constant pain she has now made a good recovery, but often cases are neglected for so long, or much worse, treated by a witch doctor, that the child suffers terribly and by the time they are brought to us treatment and rehabilitation can be very lengthy.
We can’t control Acheru from a distance, so the process continues of handing over more responsibility. For some time now Acheru has been managed by their own Board. I helped them put this structure into place, the understanding being that Africare would continue as the funding agency so long as the work continued in line with our agreed aims. Together we want to maintain high clinical standards, ensure the neediest are helped, and develop our Christian witness. We provide the finance, Acheru provides us with reports and accounts, and the latest step has been the move to a fixed budget. The last stages of development are a pumped water supply and a small workshop to support the Community Based Rehabilitation programme. Funds have been transferred out for these, and we now provide a fixed sum each month for all running costs. Thanks to the generosity if donors we’ve been able to guarantee this for three years, simplifying our administration and giving more security to Acheru staff who sometimes feared for their jobs in times of financial uncertainty. We believe it is a generous budget but we are also encouraging Acheru to develop relationships with other organisations who may be able to give additional help. We want to try to secure the future of the work and reduce the dependence on Africare.
However, for the foreseeable future the relationship with Africare is central to the work of Acheru and we maintain this by having people go out to Uganda from time to time to assist with different aspects of the work or to evaluate it – not just for ourselves but for the Acheru Board as we all want to see the work realise its full potential. To help maintain our relationship with Acheru we wanted to bring Joyce and Harriet here in October and it was a big disappointment when they were refused visas, but we haven’t given up and will try again, possibly aiming for next summer.
Most of the reports and statistics we see relate to the surgical patients, but Community Based Rehabilitation remains central to the work and we hope this is something which can be expanded in the future. It’s in the community, often in hard to reach areas, so the results aren’t often seen in the way that we see dramatic change with surgical patients, but we know that many families depend on this work, people living in deprivation, severely disadvantaged by having a disabled child, and the CBR programme can bring hope – through giving guidance or encouragement, arranging treatment or care, perhaps providing practical help such as mobility aids or other needs.
The workshop will be primarily to enable production of appliances and we hope many children will benefit. During October there were 38 home visits – the number was limited by the condition of the roads following heavy rain. Several children were found who needed medical intervention for disfiguring conditions and this was arranged with results which will dramatically change their lives. It shouldn’t have needed Acheru to deal with such cases, but the fact is all other treatments sought by the families had failed but with Acheru’s intervention both have been successfully treated.
In October a total of 78 inpatients and 87 outpatients were treated, and 24 children underwent surgery at CoRSU.
I finish with a picture of some of our ‘fixator’ patients who are very happy to be at Acheru.
We want to continue to make a difference.
Thank you, Brian Dorman

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