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Uganda

Direct Relief's activities in Uganda Reproductive Health Bureau

Location: Kampala, Kaliro, Bugiri, and Sigulu Island, Uganda

Five medical doctors and six clinical officers staff the Uganda Reproductive Health Bureau (URHB), which provides vital services for patients in eastern Uganda. It operates three clinics in Kampala, the capital, and in the rural districts of Kaliro and Bugiri. Its medical outreach also serves patients in Jinja, rural Kamuli, and the remote Sigulu Island on Lake Victoria.

Each center and outreach site offers free voluntary HIV testing and counseling, and support groups for HIV-positive patients (typically people with advanced HIV on waiting lists for antiretroviral drug therapies). They meet regularly to discuss the challenges of living with the virus, attend training sessions on health issues, and learn vocational skills. Some groups even organize musical performances. A community health worker visits each member's home at least twice a month to provide basic healthcare. When a member falls ill, the rest of the group pools its financial resources to pay for transport to the nearest hospital and tests required for ARV therapy. The group also pools its funds to help a member's family cover funeral expenses when necessary.

Among its innovative programs, URHB employs former sex workers as peer-to-peer educators. It trains them in basic reproductive health safety, vocational skills like sewing and basket making, and community organizing. With support from URHB program staff, former sex workers conduct educational campaigns in truck-stop towns on safe sex practices and encourage current commercial sex workers to attend classes to learn new vocations. URHB reports that these programs are very successful.

URHB also provides primary care services for pregnant mothers and children, including deworming campaigns. Its social programs include advocacy for sexually abused children and trainings for teachers on how to spot child abuse victims. The Kampala facility attracts patients from across the city, about half of whom can pay something for their care; it subsidizes the facilities in rural Bulgiri and Kaliro, where fewer than 5 percent of patients can pay anything for their care. On Sigulu Island, one clinic run by the Ministry of Health serves a population of 20,000. URHB handles free voluntary HIV testing and counseling, a vital service on the island, where in a typical day 25 percent of patients test HIV-positive.

Direct Relief has been supporting URHB since 2005 with antibiotics, medical consumables needed for infection control, wound care supplies, analgesics, vitamins, and medical equipment including wheelchairs, clinic beds, exam tables, autoclaves, and instrument trays.