November 2018 report - Extracts from the latest CBR report, with news from Northern Uganda
To help control costs, the number of Acheru staff based there has been reduced to two following a review by the Acheru management. This shouldn't significantly affect the scope of the work there as our unit is beside a government health centre, there is access to other medical services, and a good level of cooperation. Regular visits are made to the area by a team from Acheru to run rural clinics. The number of surgical referrals from the north hasn't varied much and usually around half of the Acheru inpatients will be from the north. The indications are that the work conducted by the staff based there, and the visiting teams, is continuing to reach many children who need help.
There remains a significant problem with follow up. Relatives of a child may see a big improvement following Acheru treatment and think that the work is finished. They therefore don't keep subsequent appointments. Other factors mitigating against effective ongoing treatment are the distances involved and the pressure placed on families to revert to 'traditional' medicine or witchcraft. From our Minakulu base the Acheru work covers thousands of square kilometres in the north, where transport and communications are poor. As well as running rural clinics, we depend on good working relationships with other organisations working in the community to bring problems to our notice.
The following are a few examples of the difficulties encountered with children needing follow up treatment:
Andrew Okechi, 11 years old, was treated for club feet. A concerned community member originally led the Acheru team to the family. After initial treatment contact was lost, but more recently they were again located and the boy's mother said that their disappearance was due to their 'social and financial' circumstances. Her husband was sick and she could not leave their one year old twins as there was no one to help them. Now that contact has been re-established we hope there will be the opportunity for his treatment to be completed. For many of our club foot patients surgery is not required, and the necessary manipulation and casting can be done on an outpatient basis at Minakulu or at rural clinics, meaning the child doesn't need to be brought to Kabembe.

Andrew Okechi
Kisakye Innocent, 3 years old, also has club feet. He is cared for by his grandmother, his father is unknown, his mother is mentally retarded. He was initially treated, then wasn't brought back. The Acheru team followed up and was told by the grandmother that after some of the treatment the boy seemed fine so they decided not to continue. As time passed they realised that the problem was recurring and thought what had been done was not working so they resorted to traditional herbs. Counselling was arranged and the grandmother is being encouraged to bring him back to complete treatment.
Typical of community outreach was a visit to Kitwe primary school, the aim being to identify new patients and teach young ones about disability and how to help people. Many children are not aware of how to deal with their own or other's disability, it's a serious stigma and this was discussed in an effort to convince them that all are equally loved by God and they should reciprocate by loving one another. A number of new patients were seen who can now hopefully be treated and Acheru information was left with teachers for sharing with parents.

Kitwe primary school
Nyalwa Magdaline, 15 years old. Another patient with club feet, she has now had several months of treatment and a home visit was made to see how she was progressing. Before treatment she couldn't walk because of the pain. Now she can walk, ride a bicycle, and carry out housework without difficulty. Because of her problems she had stopped going to school, but now intends learning tailoring. Her treatment has significantly changed her life and prospects.

Nyalwa Magdaline

Nyalwa Magdaline, on right, after treatment
Kawudha Sumaya is 11 years old. She was brought to Acheru unable to walk or stand because of severe bowing of her legs. Several surgeries have been carried out and she has now been able to go back to school. Her treatment continues and it is really encouraging to see her walking, happy, and free from pain. Her parents were advised to follow the treatment plan and keep appointment dates.

Kawudha Sumaya
Mwangu Jovan is 5 years old. His initial treatment for club feet went well but then he wasn't brought back for his appointments. The CBR team visited his home and found that he was not doing well, his parents are being encouraged to bring him back to finish his treatment. Without this he will be unable to walk and his future prospects will be bleak. Too often, parents see an improvement and think no further intervention is needed.
For so many cases like these all that's needed to change the child's life is relatively straightforward and low cost outpatient treatment, and it's frustrating to see children miss out on the opportunity.

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