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April 2015 Report
Brian Dorman, Africare’s secretary, writes:
We’ve always tried to be objective about what we are doing in Uganda, as it can be all too easy to let enthusiasm override judgment. With this in mind, we are always glad of expert views on what we’re doing. Una Brownlie, an immensely experienced medical missionary, and her sister Phyllis Campbell, a doctor, went to Acheru in January, not simply to look at the work for Africare, but to carry out a full evaluation, reporting to the Acheru Board. They looked at all aspects of the work, travelled to the north, went on community visits, and had one to one interviews with staff and workers. They then met with the Acheru Board to discuss their findings and recommendations.
Management of Acheru is the responsibility of the local Board and Management Committee, and Una and Phyllis discussed some weaknesses with them which are now being addressed by increasing the staff representation on an Executive Committee. The Acheru Board were in agreement with their comments and conclusions, and the report was then sent to us. We have now discussed this at a Board meeting at which Una and Phyllis went through their report, answered questions, and gave us a valuable insight into the work and the individuals involved.
Arising from their report, there are issues which need to be dealt with by Acheru staff and management, but also issues for Africare. We didn’t want to react too quickly, but have tried to gather additional information before having another Board meeting at which we can discuss proposals. We all want to do our utmost to support the work at Acheru, and the report seems an excellent basis for resolving problems, making improvements, and preparing for the future.
Acheru has changed a lot in the short time since it opened. In developing a Christian witness through the work it had been the aim that Acheru maintain a Christian family atmosphere, but Una and Phyllis saw that, with 37 inpatient beds, Acheru was now more institutionalised, and could no longer function as a ‘family’. We know that the staff hold to the original aims of the work, and we will be looking at this closely to ensure that what is done at Acheru continues to go beyond the physical needs of the children.
There were encouragements and challenges from the report and it will take time to deal with it all. We were reassured on our two major concerns about the work, firstly relating to clinical standards against a background of increased numbers and restricted budgets. We were told that all staff were giving 100% commitment and that standards of treatment and care remained high – whatever else we do at Acheru will be to little effect if people don’t have confidence in the care we provide. We will now be doing our utmost to ensure standards are maintained and we will also be looking for ways to improve.
Our second concern was something which had worried us for some time. Acheru was established as a rehabilitation unit for disabled children – with a broad view of disability including cases resulting from untreated injuries or neglect. We made clear that we didn’t want Acheru to be seen as an alternative to health centres or hospitals, we wanted to treat the children no one else could deal with. Una and Phyllis confirmed this is still the case, but it also raised a major challenge.
Against a background of increasing costs, it might have been comfortable to defer any thoughts of further growth, as Acheru is already much bigger than we had ever planned, and we are certainly spending much more than we had envisaged. But the report made clear that for many children Acheru is their only hope. If we don’t help them, nobody else will, so can we really ignore their needs? This applies particularly in the north. We had intended work there to be an ‘extra’, perhaps short term to get things kick started in the hope others would take over. This hasn’t happened, and the small Acheru team made a big impression on Una and Phyllis, who saw the potential and confirmed no one else was helping there.
The surgeons’ lists are full, so sadly any new surgical referrals must go on a waiting list, but the report was clear about the potential to develop outpatient and community work. This is what we are now focusing on; Una and Phyllis were impressed by what was being done, but also saw the limitations. Of course there are financial implications in all of this, but every time we have increased the numbers helped, the money has been available. Despite my concerns, we have never had to turn away a child because of lack of funds.
Unfortunately, seeing the rising costs and hearing of the impact of the recession, some of the Acheru staff had feared for their jobs. We have tried to reassure them that there is no threat. We value the work of all of them and want now to develop a three year plan with a guaranteed budget which will give them some degree of security. That budget will be for the ‘core’ work but as we consider the report we will also look very carefully at any additional work or improvements.
We are presently looking at possibilities for a pumped water supply from a borehole to facilitate the work at Acheru, and also what can be done to support community work, and how more help might be given to families of disabled children who may be suffering severe deprivation. The north is also a big concern given the significance of the work there.
We have a lot to think about, and value your continuing support and prayers as we try to make decisions.
Brian Dorman

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