April 2024 report: Preparing for work in northern Uganda, and news of Acheru patients Napak: We continue to consider how we can establish work at Napak; we are all agreed on the need, and we are looking at the practicalities. Acheru has already established links with potential partner organisations there, one dealing with the welfare of disabled children and another with their spiritual needs so through them Acheru staff can quickly be directed to children who need help. It is clear that nothing like Acheru's work has been carried out there, so the need is great; if we can establish an effective presence, we can potentially help very large numbers. We have a lot of experience to bring to bear on such a situation. Visits already made to the area have resulted in children being brought back to Acheru for treatment, but that's only warranted for those requiring surgical intervention. For example, they've already seen large numbers of children with cerebral palsy or club feet and it's unrealistic to bring them back to Acheru, what's needed is an outpatient centre similar to the unit we had at Minakulu. Acheru staff plan to make another trip there soon, but Joyce says they're waiting for the rains to start as it's presently the hottest time of the year there making travel or work very demanding. Joyce sent me the following report after a school visit to Acheru. Advocacy continues to be a very important part of our work, raising awareness of disability, helping change attitudes and preventing so many of the problems we see due to neglect. 'We had students from Wellstar Bright secondary school at the unit and they donated scholastic materials, clothes, soap, sugar and other basic materials to the Acheru patients and the carers. They later on had a word of prayer and shared encouraging words with the children and their carers. Thank you so much for the heart of supporting the vulnerable children. Visitors like these restore hope and courage to the children and their families'. Wellstar Bright pupils visiting Acheru Some of the gifts brought by the pupils I received the following report from Acheru. The girl has now been successfully treated, but consider the years she spent with this condition before being brought to our attention. There is still so much unnecessary suffering, which is why I attach so much importance to the community work which raises awareness of the services we provide. 'Nantake Mariam is a 14 year old girl who was found in one of our outreaches conducted at Rapha Medical centre in Gomba district. She was presenting with hyper extended left knee and right ankylosed knee. These were as a result of chronic osteomyelitis which she had for the previous 5 years before the onset of the presenting condition. The previous condition was managed from Mulago National Referral Hospital and there after didn't have financial support to continue with the management of the condition. Mariam was the taken to Corsu Hospital on 19/01/2023 where she was assessed and examined by the orthopaedic surgeon and booked her for surgery of the left femur (left femur ilizarov) on 28/2/2023. While at Corsu hospital, Mariam had left femoral shortening osteotomy and left knee capsulorraphy and external fixator done. From there she was discharged back to Acheru where she had post-operative care done and then continued with follow up appointments by the surgeon. She again had a minor surgery for fixator adjustment on 24th May, 2023. She still continued with strut distractions of the external fixator and then had it removed on 18th July, 2023 and applied a plaster of paris cylinder cast and then she was discharged back home from Acheru.' Mariam was again reviewed by the orthopaedic surgeon on 24th, August, 2023 and she was allowed fully weight bearing without crutches. She is now a happy girl and doing well. Nantake Mariam Report from Robert, our orthopaedic clinician: 'Samara, a baby girl of 2 years old, was brought to Acheru on 20.4.2023 with a complaint of exposed bone and deep wounds on the left leg. Mother says she had sought medical attention from different health facilities where she didn't get well and then taken to hospital but she had no funds to pay for treatment. When Samara was brought to Acheru she was assessed, examined and diagnosed with chronic osteomyelitis of the left tibia and bilateral left leg ulcers. She was referred to CoRSU hospital and underwent surgery, with treatment to facilitate tissue growth. She then underwent further surgery (debridement and split skin graft) and was discharged back to Acheru for postoperative care and to have a complete healing. Samara has now got rid of the infection and the ulcers healed well, however leaving some deformity but her treatment continues to correct this'. I can't imagine what this child suffered due to failed attempts at treatment, and I was particularly concerned that a hospital seems to have failed to treat her because the family couldn't afford to pay. All the reports I receive reinforce the need for the work we are doing not just in treating disability but in raising awareness. The clearest witness we have is a successfully treated child, perhaps previously regarded as cursed, walking back into their village. Nassozi Samara Return to full Acheru website