July 2017 report
I receive monthly statistics from Acheru which give a useful indication of the balance of the work and any trends we may need to take into consideration as we plan ahead. The figures for June are typical with 60 inpatients treated (30 male, 30 female) and 170 outpatients (88 male, 82 female) with smaller numbers also seen at Minakulu in the north.
The most common conditions among the inpatients were osteomyelitis, club foot, various leg deformities, burns contractures, and ulcers. Among outpatients the most common conditions were burns contractures, cerebral palsy, club foot, and fractures. The figures show Acheru continuing to operate to capacity, which encourages us to maintain our support for the work.
Most of the Acheru inpatients require surgery. Acheru is equipped and staffed to deal with post operative treatment and rehabilitation but operations are not carried out there. Suggestions have been made from time to time for additional services to be provided at Acheru such as a small operating theatre for minor surgery, an X ray machine, or provision for blood tests but the costs of buildings, equipment, and staffing, make this unrealistic when we consider the relatively small number of children. Such facilities can only be justified for almost continual use, not the occasional use they would get at Acheru. The emphasis at Acheru is on rehabilitation, staffed and equipped for assessment, post operative nursing care, physiotherapy, and community work. Other work is dealt with through our partner CoRSU (Comprehensive Rehabilitation Services Uganda) where children are referred for surgery. For most operations children are only there for a day or two before being brought back to Acheru. CoRSU has a big modern well equipped hospital and skilled orthopaedic and plastic surgeons, and our partnership with them enables us to deal with a wide range of disabilities and injuries. Operations are carried out at no cost to Acheru and we pay for X rays, medication and other services, so the relationship with CoRSU means a lot to us. We don't have a doctor at Acheru so use the services of the local hospital in Mukono if a child requires attention. In turn we can sometimes do something to help the hospital.
Acheru is located at Kabembe to the East of Kampala, positioned to serve the catchment area agreed with CoRSU, who also have other partners. It's a compromise, as we deal with a wide area including parts of Northern Uganda, but we also need to be close to CoRSU as there's a lot of travel to and from the hospital, taking children for surgery, X rays, reviews etc. The distance isn't great, but that doesn't make the journey easy. CoRSU is at the other side of Kampala from us, at Kisubi on the road to Entebbe airport. The Acheru ambulance, a Toyota minibus, makes the journey several times each week. It's around 40 miles each way but to say they face heavy traffic doesn't begin to convey the problems of getting there as roads through Kampala can be choked with traffic at any time of the day so it's an uncomfortable and sometimes dangerous journey, and sitting in Kampala traffic means a serious problem with fumes and dust. Maybe in the future the balance of the work will change. Any reduction in surgical work could enable development of outpatient and community work, but we monitor the statistics and for now what's done reflects the needs of the children brought to us.
I'm presently editing more of our case histories which I want to add to the website, hopefully within the next few months. These show the quality of the outcomes, and are evidence not just of the effectiveness of Acheru but the skills we can access through our partnership with CoRSU.
Brian Dorman

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