The Mobile Pharmacy in Northern Uganda Project

The International Pharmaceutical Students’ Federation has collaborated with Respond ReNU, a non-governmental organisation based in northern Uganda, to establish and develop a project that would aim to improve the quality and effectiveness of health services supervision in northern Uganda. Roohil Yusuf explains

The International Pharmaceutical Students’ Federation (IPSF) is the main advocate for pharmacy students worldwide. Its aims are to promote improved public health through the provision of education, information, networking and a range of publication and professional activities. 

Following the success of the Neema Village Concept Project, which was an IPSF humanitarian project held in Tanzania in 1993, sufficient work has been put into developing another humanitarian project. After some research into the field, a need for the provision of basic healthcare in internally displaced person (IDP) camps in northern Uganda was identified. 

The lives of nearly two million Ugandan citizens have been devastated by a 23-year long civil war between the Ugandan government and the Lords Resistance Army. Around 25,000 children were recruited and forced to become children of war and thousands of people were killed or injured. 

In 1996, the government made a decision to move 1.8 million citizens out of the Pader district and into IDP camps. Today, around one million Ugandans still populate these camps and, although these camps were built with the best intention, they lack infrastructure, education systems and healthcare. They are overcrowded and poverty and disease are widespread.

Furthermore, moving citizens away from their homeland has resulted in a lack of crops being planted and land being fertilised, and abandonment of water systems, education and health services. The people of Pader want to go home and, although work is under way to allow this to happen, it may take until the end of this year for this to become a reality.  

An example of one of these camps is Amoko Lagwai, which is home to 1,229 inhabitants. The majority of people are unable to read or write and the nearest health centre is 18km away, which is close to a four-hour walk. The inhabitants of these camps commonly suffer from diseases such as malaria, typhoid, oral-genital candidiasis, dysentery, fungal infections, worms, schistosomiasis, HIV/AIDS and tuberculosis. A symptom of a number of the aforementioned diseases is diarrhoea. 

Diarrhoea causes 1.9 million deaths in children under five every year.1 In addition, unsanitary environments, such as those in IDP camps, increase the rates of pathogens that cause diarrhoea and facilitate their ability to multiply more easily. 

Treatment is simple. The World Health Organization has reported that oral rehydration salts decrease the effects and duration of diarrhoea1 and is the gold standard for the treatment of this condition. In Gulu, northern Uganda, $1 covers enough treatment for 100 people with diarrhoea.

On identifying a need for the provision of basic healthcare in these camps, the IPSF has agreed to collaborate with Respond ReNU, a non-governmental organisation based in northern Uganda to establish and develop a project that would remedy this. 

The main aim of the Mobile Pharmacy in Northern Uganda Project (MPNUP) is to improve the quality and effectiveness of the health services supervision in northern Uganda by increasing access to basic medical care to people living in medical camps in Pajule. 

The objectives of the project are to increase accessibility of health services by improving and supporting public health, medical care and home-based services, and to improve awareness on hygiene and infectious diseases. In addition, the project will ensure that it advocates for the healthcare of vulnerable individuals such as orphans, mothers and the disabled.  

The project was implemented at the beginning of January 2010 and will be running until the end of December this year. Since implementation, it has been growing from strength to strength. Student volunteers from all over the world are responsible for working with doctors to dispense medicines such as antidiarrhoeals, antibiotics, antifungals and basic pain relief. In addition, they work with the local health clinic and are developing an efficient dispensary system. 

Public health campaigns are a topic that the IPSF knows well as a result of its work on annual world health days. In Uganda, campaigns such as those on hygiene and sanitation are crucial to improving the inhabitants’ environment and preventing potentially fatal diseases. 

Volunteers work with a physician and translator to provide healthcare following an assessment of the villagers requiring healthcare by a physician and a field operations manager. The mobile clinic is unique. It is usually set up under a tree or in an abandoned hut. The medicines are stored in accommodation occupied by volunteers and are transported to the camps on a truck. Work is carried out in 10 camps on a rotational basis and the MPNUP team visits camps three times a week. 

The role of pharmacy students in the clinics is to check the medicines prescribed by the doctor, and the MPNUP co-ordinator records the patient specific information. The pharmacy students, together with the translator, explain dosage and administration instructions to patients and answer any questions that they may have. Work in the health centre will involve organising the dispensary, helping to organise stock and ensuring that all medicines are in date. In future, students will be working in clinics.

At present, the MPNUP team is able to treat approximately 100 people out of the 2,500 per camp. The provision of healthcare, although limited, has a huge impact on the population and, combined with health education, really can help people to help themselves. However, as the project is continuing to expand further, financial support is needed to ensure that the care provided is adequate. 

The IPSF is calling for donations from anyone in order to allow this project to continue to benefit the people. Donations can be made on www.ipsf.org by clicking the MPNUP banner.

Further information can be obtained from Roohil Yusuf, IPSF contact person (UK) and humanitarian co-ordinator (e-mail humanitarian@ipsf.org).

Reference

1. World Health Organization, Unicef. Diarrhoea: why children are still dying and what can be done. 2009. Available at http://www.who.int/child_adolescent_health/documents/9789241598415/en/index.html (accessed 14 May 2010).

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Citation
Tomorrow's Pharmacist, TP, 2010;()::DOI:10.1211/PJ.2021.1.82859