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Healthy People. Better World.

Direct Relief works inUganda to expand access to healthcare by equipping doctors and nurses with lifesaving medical resources.

By Compelling Story

July 25^th, 2023

Direct Relief is a humanitarian and disaster relief organization that works internationally to expand access to medicines and healthcare in areas of most need. Direct Relief is one of the largest providers of humanitarian medical assistance in the world and provides support to ministries of health, healthcare providers, and local organizations in 98 countries, including Uganda.

Direct Relief has partnered with the Ugandan Ministry of Health in the Diflucan Partnership Program to provide more than $919 million of Fluconazole in the last 20 years. With long-term partnerships with other local organizations Direct Relief is providing sustainable access to insulin for children living with type 1 diabetes, cancer treatments, rare disease therapeutics, midwife kits, fistula repair modules as well as supporting Uganda during emergency responses.

Kisenyi Health Center IV

Robert Ayebale, a clinical officer at the HIV clinic expressed their sincere gratitude to Direct Relief for making Diflucan available to those patients suffering from cryptococcal meningitis. This is a co-infection that can occur in advanced HIV disease and very lethal. Having continued access to Diflucan has been critical to prevent mortality in these patients. Although fluconazole is usually available in the market, it is very expensive and prevents many patients from having access to it. The number of patients needing treatment continues to increase as testing for cryptococcal meningitis increases within their health center. The HIV clinic saw 14,000 clients last quarter.

The number of patients needing treatment continues to rise as testing for cryptococcal meningitis increases within Kisenyi Health Center.

China Uganda Friendship Hospital

This hospital was one of the recipients of Diflucan through the Uganda Ministry of Health. China Uganda Friendship Hospital (CURH) is one of the busiest hospitals in Uganda and offers general services such as ob-gyn, pediatrics, surgery, and HIV treatment. The hospital has 100 inpatient beds but averages almost 400 inpatient and 300+ outpatients per day. Recently, the government recognized a need for concentrated trauma services in the country and CURH will soon undergo a transition to become the first specialized national trauma center.

Senior Administrative Assistant, Okodi Sheila explained that the budget for medicines is not enough and since they do not turn away any patients, they experience frequent stock-outs. As recently as two months ago, they were stocked out of many of the critical medications needed within a hospital setting. Many of their patients are low-income and almost all services and medications are provided free of charge.

Diflucan, is still very much needed for both HIV patients and non-HIV patients and there are major concerns about how to proceed once the donation runs out.

Uganda Cancer Institute

Professor William Bazeyo, Board Chair of Uganda Cancer Institute expressed their joy in working with Direct Relief and the impact it has had on countless lives. In a presentation on the Uganda Cancer Institute (UCI), Dr. Nixon explained its comprehensive approach to offering services that include medical oncology, gyn-oncology, surgical oncology, pediatric oncology, palliative care, research and training, laboratory, radiation therapy, and cancer prevention.

There are 34,000 new cases of cancer each year but UCI only treats 20% of them (and only 10% of children). Their goal is to increase that to 85% which is why they have plans to expand their central location from 130 beds to 365 beds and develop four regional centers around the country (two are already operational). They also see 450 patients per day through the outpatient clinic. As an East Africa Centre of Excellence, they receive patients from Uganda, Sudan, South Sudan, Eritrea, Somalia, Burundi, DRC and Congo.

The demand for oncology medications at the Uganda Cancer Institute far outweighs the allocated budgets by the Ugandan government and Direct Relief has now become the largest supporter. The recent donations of Abiraterone, Carfilzomib, Erlotinib, and Balversa have been extremely impactful. Additional needs included consumables (reagents, surgical supplies, specialized tests, colostomy bags, prosthetics) and continued education to train staff on using advanced diagnostics.

Uganda Nurses and Midwife Union

Direct Relief has partnered with Uganda Nurses and Midwife Union (UNMU) since 2020 to deliver Midwife Kits and PPE. They expressed their sincere gratitude for the partnership and continual support. The midwife kits have saved countless mothers from dying due to lack of supplies and medicine.

We visited two hospitals, Mukono Hospital and Kawolo hospital, where the midwife kits were distributed. Everyone was very excited by the work of Direct Relief and we had the opportunity to talk with the midwives and even opened up a midwife kit to explain each of the materials that were included. Sincere gratitude and appreciation was shown by the midwives and hospital leadership for the work done by Direct Relief in protecting mothers and children and allowing for safe deliveries.

Tororo General Hospital

Tororo is a 6 hour drive, Northeast from Kampala. Tororo General Hospital, is a recipient of the Diflucan Partnership Program. Medical Superintendent, Dr. Ochar Thomas explained the HIV/AIDS response in Africa and how the Diflucan Partnership Program reduced fungal infections across the country.

Capacity building was a focus in the early years, and Tororo trained nurses to recognize sign/symptoms of cryptococcal meningitis so that treatment could start early. With increased access to treatment and interventions as the one previously described, rates of cryptococcal meningitis and esophageal candidiasis continue to decrease.

Dr. Ochar shared that commodities not bought by the government have steady supply in-county (HIV, TB, malaria, etc.) but those bought by the government (antibiotics, diabetes and hypertension medications, gloves, etc.) are not steady and tend to run low/out before the delivery from national medical stores every 2 months. In particular, rates of diabetes, hypertension and sickle cell disease continue to increase.

Additional needs include information systems that allow for data collection and analysis and surgical sutures. The hospital has over 100 maternity cases that require surgical sutures each month and this takes up a large portion of the budget because of high cost.

Wanale Health Center

In the foothills of Mt Elgon is Wanale Health Center, another recipient of the Diflucan Partnership Program. The health center sees around 80 patients per day (mostly outpatient) and offers services such as general clinic, family planning, labor and delivery, young child clinic (vaccines) and HIV clinic.

At the HIV clinic, Diflucan, which has been reserved for patients living with HIV suffering from cryptococcal meningitis and esophageal candidiasis.

It was quite impressive to travel into this remote mountain town and see the reach of the Diflucan Program. The program has sent over $990 million of Diflucan to Uganda since its inception and it was very rewarding to see its impact within the communities.

Experiencing the other aspects of this busy clinic was very interesting. This included prenatal exams, immunizations and we even heard the birth of a baby. It was incredible to see the resiliency of the staff because the clinic was overloaded but still provided remarkable care to the community. It was truly inspiring and a highlight for all of us to witness.

CoRSU Rehabilitation Hospital

CoRSU is a non-governmental hospital in Kisubi, South of Kampala. CoRSU’s goal is to mitigate the debilitating effects of disabling physical conditions, by ensuring accessibility and availability of quality, preventative, curative, rehabilitative services for people with disability in Uganda and neighboring countries.

CoRSU provides subsidized treatments (surgery and rehabilitation) for vulnerable patients and this is carried out through social assessment tools. The fistula clinic was established to enable women access obstetric fistula treatment. Direct Relief supports this surgery program with Fistula Repair Modules.

These are a standardized pack of high-quality medicines and surgical supplies necessary for fistula repair surgery and post-operative care. The comprehensive module was created in close consultation with leading surgical experts and is endorsed by the International Federation of Gynecology and Obstetrics (FIGO). Each module contains enough product to repair approximately 50 obstetric fistulas.