Toth Health Centre

Report
July 2012 to June 2013
Location
Village: Aisa Nankusi

Sub-Counties Served: Namayonyi and Nakaloke

County: Bungokho

District: Mbale

Country: Uganda

Contacts
Dr Samuel Kalibala
skalibala@hotmail.com
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 Brief Background

Nakaloke Development Initiative for Communities (NADECO) is a community based organization that was
started in 2008 in Mbale District in Uganda with the aim of enhancing community development and
social services in rural communities. Between January 2010 and March 2011 NADECO carried out needs
assessment, mapping of partners and training of community health workers (CHW) in two sub-counties
of Nakaloke and Namanyonyi. Both sub-counties together have an estimated population of 60,000
people or about 12,000 families.

In April 2011 NADECO started providing HIV Voluntary Counseling and Testing (VCT) together with Family
Planning (FP) at community venues such as places of worship and schools in the eight parishes of the
two sub-counties. The first such service was provided at Aisa Parish in Namanyonyi sub-county on April
2nd 2011 and 62 clients were served.

When Dr Samuel Kalibala the Director of the project shared this information with Dr Miklos Toth and
his dear wife Elena, Miklos and Elena decided to start the Toth Health Center. We are grateful to Miklos
and Elena for this generous gift to the people of this community.

Elena and Miklos visiting Uganda February 4, 2012

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 General Medical Care

Toth Health Center operates on the first Saturday of the month and provides primary health care
including malaria testing and treatment; HIV testing and counseling combined with provision of Bactrim
to prevent opportunistic infections among people living with HIV; and family planning services.

Figure-1 shows that in the reporting period July 2012 to June 2013 we saw 1,863 patients most of whom
(944 or 51%) were children aged less than 15 years followed by older adults aged above 24 years (732 or
39%), then young adults aged 20 to 24 years (107 or 6%) and youth aged 15 to 19 years (80 or 4%).

Figure-2 shows that the monthly attendance at our clinic averaged to 155 patients. The lowest was 125
patients in November and the highest was 178 in July.
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 Figure 3 shows that in all age groups we received more female patients than males. The total number of
females we saw was 1,284 while the number of males was 579. Among children aged less than 15 years
the difference is less pronouncedwe served 512 females and 432 males.

Most of our patients are women and children:

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 As can be seen above females are the majority of clients seen in our services. This is mainly because
females compared to males are less likely to have money to seek services in the trading centers where
medical services are provided for a fee and where transportation is required to reach. We have also
shown that the majority of clients are young children aged below 15 years. This highlights the fact that
this service is reaching the most vulnerable people in these populations, poor women and their children.

HIV Testing

HIV prevalence remains high in Uganda. The latest Uganda AIDS Indicator Survey of 2011 showed that
the national prevalence of HIV was 7.3%. For this reason, Toth Health Center provides HIV testing. Figure
4 shows that over the 12-month period we tested 101 individuals for HIV. The number tested varied per
month: the highest number was 18 clients in November and the lowest was 4 patients per month in
September and June and the average monthly HIV testing rate was 8 clients.
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 Figure 5 shows that most of the clients tested for HIV were women, 86%.

Figure 6 shows that for most of the months, zero of the clients tested for HIV turned out HIV positive
except for November 11% HIV positive, January 10% and March 13%. Out of the 101 clients tested in all
the 12 months 4 patients or 4% were HIV positive. Per the Uganda AIDS Indicator Survey of 2011 the
prevalence of HIV was 3.7% in the East Central Region where Aisa-Nankusi, the community served by
Toth Health Center, is located. We should note that the people choosing to test for HIV at the clinic
cannot be taken to be a representative sample of the population in the community. Hence very little can
be drawn from the HIV prevalence at the clinic.
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 Malaria Testing

Malaria is a major cause of illness and death in this part of the country and yet it can be diagnosed using
a simple test with a microscope and treated effectively using the new Artemesinin Combination
Therapies (ACT). However, this requires a well-supported health facility that has electricity, well trained
laboratory technicians and a good supply of ACT medicines. We thank God for the gift from Elena and
Miklos Toth which has enabled us to provide this life saving service in a remote underserved area such as
this one.

A lab tech takes a blood sample to test for various conditions including malaria and HIV:
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 Figure 7 shows that in the 12 months of the 2012-2013 reporting period we tested 569 patients for
malaria. In the months of July to November the number tested per month was around 30 but in
December the number rose to 46 and remained at 40 or above up to May and then rose suddenly to
120. The monthly average number tested was 40. While we know that malaria is seasonal, this pattern
does not seem to match the two rainy seasons of February-May and July to October.
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 Figure 8 shows that in the 12-month reporting period the average malaria positivity was 55% with the
lowest positivity rates in October (37%), November (42%) and December (35%). The rest of the months
had high rates ranging from about 50% to as high as 75% in February and 73% in May.

Family Planning Services

Uganda is one of the countries with one of the highest fertility rates of about 7 live births per woman
and this is because of a low contraceptive use. The 2011 Uganda Demographic Health Survey (DHS)
showed that the contraceptive prevalence rate was only 30% meaning that only 30% of married women
aged 15 to 49 years were using modern contraceptives. The same report also showed that the unmet
need for family planning was 34.3% meaning 34.3% of women want to limit their family size or to space
their children but have no access to family planning services. The problem of teenage pregnancy was
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highlighted during the needs assessment survey for Toth Health Center in its catchment area. For this
reason, the project is providing family planning services. Figure 9 shows that in the 12-month reporting
 period we served a total of 139 women with family planning services. The number served per month
differed widely from as low as 3 in March to as high as 28 in October. The average number served per
month was 12.

Conclusion and Word of Thanks

Nakaloke Development Initiative for Communities (NADECO) is very grateful to Dr Miklos Toth and his
dear wife Elena for the assistance they have continued to provide to this project. Indeed, it is befitting
that NADECO decided to name the project Toth Health Center. Miklos and Elena visited the project on
February 4th 2012 and they were received with great pleasure by the community. They were given the
important names from the Bagisu culture of Uganda where the project is located. Miklos was named the
greatest name in the tribe. He was named Masaba which is the name of the father of all Bagisu people
and the same name given to the great mountain (Mount Elgon in Eastern Uganda) on whose foothills the
Bagisu live. Elena was given the name Nakhumisa which is a special name given to girls born during the
season of sowing seeds when the rains are about to come. It means they put a lot of hope in her like
farmers put hope in the seeds they plant.

Elena and Miklos have continued to support the project and they have also funded the provision of
water to the clinic. The water is trapped from rain water and directed in pipes to water taps and sinks
which the health workers use in the clinic. This has greatly improved the quality of care.

Water Tank installed at the back of the clinic to trap rain water:
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 Now the clinic has running water in taps and has sinks.

Laboratory sink:
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 Hand wash basin for clinical staff:

We thank God for all this kindness. Elena and Miklos are special people with a compassion which has
enabled them to take such bold action to improve the well being of others in need.

Thank you very much!!

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