International Health Links (Uganda Partnership)
Sheffield Health and Social Care NHS Trust has established a partnership with mental health services in Uganda and is working with partners in both countries to progress its work.
The Trust is concentrating on work in Gulu in Northern Uganda. This is due to the link that SHSC initially had in Adjumani (established by SHSC Chief Executive Kevan Taylor) in the North West of the country and also due to the need for mental health support following 25 years of terror from the Lords Resistance Army (LRA). It is clear speaking to people in Gulu that the long shadow of the terror of the LRA still has a powerful effect on the community.
SHSC Partners and the work
- The main institutional UK partner for the SHSC work in Uganda is the University Hospital of South Manchester (UHSM), who have had a link with Gulu Regional Referral Hospital (GRRH) for over 10 years. Partnering with UHSM has enabled SHSC to become more effective as sharing resources (accommodation and transport etc) as well as advice and contacts has enabled this Trust to ‘hit the deck running’. Dr. Adrian Sutton, a retired Consultant Psychiatrist is working with UHSM and SHSC on the mental health ward;
- SHSC works in association with the East London Foundation Trust and are grateful to them for their funding of the initial visit to Gulu in 2010;
- The Health Uganda Group (HUG) is the Ugandan Diaspora group in Yorkshire and supports the SHSC work in Gulu;
- SHSC supports the development of a charity – the Sheffield Health International Partnerships (SHIP)- which will enable fundraising to ensure sustainable funding is available for the work of the link;
- The Sheffield Rotary Club has committed itself to supporting mental health work in Northern Uganda and is twinning with Gulu Rotarians to construct a funding package from private sector finance;
- The Gulu Regional Referral Hospital (GRRH) is the main institutional partner in Uganda. It is a 250 bedded hospital and one of 13 in the country with a mental health ward serving the area. The mental health ward is a 40 bedded unit in a state of disrepair, with no water source in the building and no connection to the hospital generator. Thus when the regular electricity outages occur during the night the ward has to rely on battery power for a few hours but can then be in darkness, thereby exacerbating the anxiety of patients on the mental health ward;
- Mental Health Uganda (MHU) is a national body, in some ways like the UK body MIND. It is led nationally from Kampala by Julius Kayiira but run locally by service users. SHSC is working with MHU in Gulu on peer support and livelihood programmes. The livelihood programmes include supporting service users to cultivate land that many people own but may not have the means to produce crops as income generation. This income generation not only generates income but also provides a focus for people’s journey of recovery;
- The Gulu Rotary Club is working with their counterparts in Sheffield to raise funds for the refurbishment of the mental health ward;
- SHSC is in discussion with several groups, including churches and NGOs, to ensure that work is not duplicated and is focused in areas of most need;
- SHSC supports the Heartsounds service user group in Kampala, which is a unique and innovative Internet café providing peer support in the community and in to Butabika Hospital. Butabika is the only dedicated mental health hospital in the country and is on the outskirts of Kampala.
SHSC work in Gulu
Partnership Development Plan
The Sheffield Health and Social Care link in Gulu is currently concentrating on working with the Mental Health Ward in the Hospital and Mental Health Uganda.
The work with the Ward is composed of several elements and has been agreed with the Hospital Management within a Development Plan. The development plan identifies the following priorities:
- Sustainability i.e. ensuring that work undertaken has support from stakeholders, has lasting benefits and is structured to enable long term continuity;
- Ward Physical Environment i.e. the infrastructure of the mental health ward at GRRH is fit for purpose and is at least comparable and if possible improved on the other facilities in the hospital;
- Basic Physical Health Care i.e. ensuring that physical as well as mental health care is of an appropriate standard;
- Training and Staff Development i.e. ensuring that staff at GRRH are supported to deliver high quality support that is appropriate to the situation in Gulu;
- Clinical Care: The Management of Emergency Care i.e. ensuring that acutely unwell patients are managed and supported safely and therapeutically;
- Development of an Occupational Therapy Service i.e. offering patients therapeutic input to enable both an improvement in their functioning whilst on the ward and to provide them with skills and strategies for post discharge recovery.
Funding and Work in Gulu
SHSC is using several funding streams to finance its partnership work with Gulu:
- SHSC has successfully applied to the British Medical Association on behalf of GRRH for a Book Grant. This grant of £1700 worth of books will enable GRRH to establish a Medical Library;
- SHSC successfully applied for a Start Up Grant for New Links from the Tropical Health Education Trust (THET). THET is the managing agent for funding from the Department for International Development (DfID) for NHS Trusts involved with international health links. This enabled an SHSC team to visit Gulu in June-July 2012 for a scoping visit and to establish agreement on a Development Plan. This visit was led by Liz Lightbown, Chief Operating Officer for the Trust and also included Greg Harrison (Planning & Performance Manager and Sheffield Gulu Partnership Coordinator, who visited Adjumani in 2006 and Gulu in 2010); Kim Parker (Senior Nurse and Sheffield-Gulu Clinical Lead, who visited Gulu in 2010); Noelle Riggott (Adult Mental Health Lead for Occupational Therapy); Kate Mullally (Discharge Coordinator on Burbage Ward) and Kim Wakefield (Deputy Manager, Rowan Ward);
- Three Gulu staff from the Mental Health Ward visited Sheffield for 7 weeks in July-September 2012 as part of the Commonwealth Fellowship programme. The Ward Manager, a Principal Psychiatric Clinical Officer, and another Psychiatric Clinical Officer (PCO) who is also a qualified Occupational Therapist, observed practice in mental health services both in SHSC and service user groups. As part of this visit our Gulu colleagues identified projects which they have undertaken to pursue on the ward. PCO’s are a classification of staff that do not have a direct comparison in the UK but are placed between Senior Nurses and Doctors and can assess, diagnose, prescribe and discharge. The PCO role addresses the significant shortage of Psychiatrists in Uganda.
The fee that SHSC received for hosting our Gulu colleagues was used to supplement the Start Up Grant from THET to enable SHSC staff to visit Gulu.
SHSC applied for 5 Gulu Mental Health Ward staff to visit Sheffield for 8 weeks as part of the Commonwealth Fellowship programme in 2013. Further visits are being arranged for 2014.
A key element of the visits is shared learning for all partners.
Kim Parker, Senior Nurse and the Clinical lead for the Sheffield-Gulu Mental Health Partnership, visited Gulu in October 2012, financed by an under-spend on the above grants. Kim’s visit was to follow up on agreements made in the June-July visit; debrief the Commonwealth Fellows (CF) who visited Sheffield in 2012 and brief those who are nominated to visit in 2013; liaise with the Gulu Rotary Club about joint working with the Sheffield club; buy and distribute bicycles to local villages with money donated by the SHSC Board of Directors (US$1000); review the project plans of the CF visitors –which included:
- A feeding programme for patients, who currently only get a bowl of porridge provided by an NGO, once a day unless they are accompanied by an attendant, or carer;
- A handover system for Ward staff to ensure clear information informs the clinical decision making process and improves quality and consistency of care;
- The establishment of an Occupational Therapy service on the mental health ward.
SHSC has applied for 2 Medium Grants from THET, one to establish RESPECT training throughout GRRH (RESPECT is the management of violence and aggression training course used in SHSC), the other to develop an Occupational Therapy service in the mental health ward.
For further details about any of this work please contact either:
Greg Harrison (Greg is the Sheffield-Gulu Partnership Coordinator), or
Kim Parker (Kim is the Clinical Lead for the Partnership).
Ujamaa Newsletter Edition 6
Ujamaa Newsletter Edition 5
Ujamaa Newsletter Edition 4
Ujamaa Newsletter Edition 3
Ujamaa Newsletter Edition 2
Ujamaa Newsletter Edition 1