October 2016 report
The latest figures show that in September, 17 operations were carried out on Acheru patients, 6 of them from northern Uganda. We continue to see a number of referrals from our Minakulu unit in the north despite the development of hospitals and other medical facilities in the region, so a work which we had hoped would be temporary still seems to be very much needed.
The distances involved for people to get to clinics or hospitals mean some never get treatment; for others, follow up appointments aren't kept. For many patients one visit may be enough but for others, their condition may require treatment over a long period and that can prove very difficult. I've been reading the case histories of two previous patients who typify the problem we face. Both suffered osteomyelitis. If initial care following injury or infection was more effective, we shouldn't need to deal with such cases but osteomyelitis continues to be one of the biggest problems we deal with. By the time medical attention is sought the infection may be deeply rooted and cleaning up a wound and applying a dressing simply isn't going to come close to healing them. I have been in a village with Acheru staff and seen for myself the difficulty they face persuading a family to bring a child for treatment. They see what looks like a superficial wound, perhaps treated locally with a dressing, but we know what's going on under the surface, and how serious it's going to become.
Achola Monica, 12 years old, from Otwah sub county in Oyam district, was brought to Minakulu unit with severe pain, unable to walk, with a deformed and discharging right foot. She was diagnosed with chronic osteomyelitis right calcaneus with bone loss. She had had hospital treatment for this a year before but, for whatever reason, the infection hadn't been cleared and she was eventually brought to us. She was referred for corrective osteotomy and sequestrectomy and treated with antibiotics, which can take some time. Now she is walking unaided, is free of pain, and is able to restart her education which had been disrupted.

Achola Monica, before and after
Okello Kenneth is a seven year old boy from Baridwang village, Abok sub county in Oyam district. His problem started over six years ago with swelling of his right arm which became worse with discharge and bone exposure, causing severe pain and inability to use the arm. He was seen at a hospital and various health centres, and also operated on, but the problem kept returning because treatment didn't continue for long enough to properly deal with deep rooted infection. Eventually, after years of suffering, he was brought to Minakulu earlier this year and diagnosed with chronic osteomyelitis. Following sequestrectomy and antibiotic treatment he had follow up care and therapeutic exercises and is now at last free of pain with full use of the arm. His parents are thankful to Acheru and urge them to continue reaching out to people deep in the villages, where children have lost hope due to their physical or mental problems.

Okello Kenneth
In parallel with treatment and rehabilitation, community work continues in the hope that more children can be located, and through education and earlier effective intervention, a lot of suffering can be avoided.

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