August 2021 report: Our youngest ever patient, and other news.
The youngest patient we've ever had in Acheru has now been successfully treated. Kirya Rashid was brought to us on 5th January this year when he was only four days old. He was born in Mukono General Hospital and when they saw his cleft palate they advised Rashid's mother to bring him to Acheru. Our staff were able to reassure her that the child's condition could be treated. He was examined and assessed. His mother was having difficulty feeding him but with Acheru's assistance he started to gain weight, having already lost 0.5kg since birth. Rashid was taken to CoRSU on 7th January to be seen by the plastic surgeon, and to be reviewed by the nutritionist and paediatrician. With nutritional help, and advice for his mother, he did well enough to undergo surgery on 26th March and has made a good recovery.

Kirya Rashid

Rashid after surgery
For many of our orthopaedic patients treatment and rehabilitation can be very lengthy whereas plastic surgery, despite what may appear to be a very serious condition, takes a relatively short time with minimal rehabilitation afterwards. They can thus be much more straightforward for Acheru to deal with, and yet the outcome can be life changing for them, perhaps making the difference between rejection and acceptance.
There continues to be serious disruption to the work caused by Covid, but Acheru continues to have some surgical inpatients. I've just been looking through the most recent reports; in June there were a total of 37 Acheru patient visits to CoRSU for assessment, review, or treatment, six of them from northern Uganda. Most were young, a number under one year old, the oldest 13. Three children were operated on for orthopaedic conditions, and five operations were carried out by the plastic surgeon. Children usually return almost immediately to Acheru for post operative treatment and care but at present, because of the risk of Covid, the emphasis is on getting children home as soon as possible and following up with home visits instead of having too many people staying at Acheru.
Some of you may have heard that the Acheru chairman, Sam Mutumba, and his wife Mary, both contracted Covid. Sam was very ill for a while and was hospitalised, on oxygen, for several weeks. They are now recuperating in the Acheru guesthouse. I continue to look at reports and statistics for Uganda, but without any real idea of the possible outcome of the spread of Covid there. All we can tell, from our own observations, is that it is widespread, that many people are dying, and that hospitals are under immense pressure. For whatever reason, there still seems little evidence of an effective vaccination programme.

Sam and Mary Mutumba recuperating at Acheru
I am unable to give Acheru much guidance on how to deal with this, all I can do is try to support and encourage them. Obviously the balance of the work has changed with far fewer children seen at Acheru. In view of the problems experienced by so many people, it makes sense to step up community work, but this has to be done against a background of severe travel restrictions so it's not as simple as reducing one part of the work while building up another to compensate. I have to leave it to the judgement of the staff to determine how to proceed.
I usually check budget figures and patient numbers every month to give me some idea of the effectiveness of the work, but that doesn't serve much purpose at present with so much changed. All I can do is continue to monitor the situation and hope that some time soon we can start to draw conclusions from what's happening and apply these to our planning - are we waiting for a time when things go back to the way they were, or does what we've learnt lead us to plan some things differently for the future?

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