Silent but Serving

“Whenever you pray, do not be like the hypocrites… standing in synagogues and on street corners so that people can see them….But whenever you pray, go into your room, close the door, and pray to your Father in secret. And your Father, who sees in secret, will reward you.” (Mathew 6:5-6)

The wisdom embedded in these words is probably the engine of the silent but life-saving Bishop Masereka Medical Centre (BMMC), located in the heart of Kasese Municipality, Kasese district, western Uganda.

The Medical Centre is part of the Bishop Masereka Christian Foundation (BMCF), named after its founder, the retired South Rwenzori Diocesan Bishop, Zebedee Kahangwa Masereka.

Enclosed in a brown parameter brick wall that is partially built with mud and cement, the clinic is a referral for hundreds of clients from far and near.

Equipped with an anesthesia machine, the theatre at the clinic carries out various types of surgical operations including abdominal opening, caesarean birth, tumor management like hernia and even liver operations.

Also contained here is the oxygen moderator, a life-sustaining gadget during operations.

Headed by Dr Daniel Sambili for the last three years now, the centre also is equipped with a biochemistry analyser used to carry out various tests including, blood, kidney, liver, bone marrow, and prostate functions.

The Clinic equipment includes a Huma-Clot to carry out coagulation studies.

Another piece of equipment here is the Elyser machine used in hormone analysis and carrying out fertility tests. “It also tells what type of HIV one has,” says Abraham Muhindo Bwalhuma, the Lab technologist.

This equipment is programmed to carry out four tests – thyroid, fertility, cytomegalovirus, a condition associated with fevers and detecting the extent of prostate-specific antigens.

At BMMC you also find a hematology analyser , (blood analyzer), which uses less than a drop of blood.“It analyses the blood according to the values of different ages and sex.”

It is also used to examine both white and red blood cells, it takes about one and a half minutes to analyze the blood sample.

The Centre is also equipped with an electro-cardiogram to check the heart, oxygen concentrators, a baby incubator and breath stabilizers.

Also found in the centre is an HB telescope and the HB meter, a sickness index that enables the medical workers to do a sickness analysis to quickly handle emergency cases.

Common infections managed at the centre include diarrhea, fevers and HIV-related complications.

A diagnostic image room, comprising of an X-ray and an ultra sound scan are what make the centre tick.

Andrew Kateregga, the X-ray guru, says here broken bones or those poorly fixed can be restored to normal at only 10,000 Uganda shillings a scan.

Holder of a Makerere University bachelor’s degree, specializing in radiography, with two years experience, Andrew says X-ray rates are suited to the socio-economic status of the centre’s clients.

HIV and AIDS management at BMMC

Started in 2001 as part of BMCF, by Bishop Zebedee Masereka and some committed Christians and members of the local community, the medical centre was established in response to the scourge of HIV/AIDS that was devastating many families, and still continues to wreck havoc on people’s lives and the economy of the community.

“We provide common and routine tests daily for diseases like malaria, typhoid, brucellosis (meat and milk-related problems), urinalyses, stool and HIV testing,” Bwalhuma says.

According to Bwalhuma, a client usually receives the results within 30 minutes.

“We handle about 25 cases daily,” he adds, noting however that some patients are often not patient enough to wait. Often we are forced to speed up the processes especially because some clients are always very anxious to have immediate HIV results.”

Determined to prevent HIV/AIDS, the centre provides HIV prevention education in the community, in churches, and in schools for older students.

Records from sentinel sites in Kasese district estimate the current HIV prevalence at 11.2 percent.

This high HIV prevalence accounts for the presence of thousands of orphaned children and many widows/widowers in the district. This unfortunate situation of HIV/AIDS was largely worsened in 1996-2000 by the rebel conflict in the area.

The conflict caused displacements of large sections of the population in certain parts of the district.

According to the BMCF founder, retired Bishop Masereka, the centre runs two main programmes – child sponsorship, health and medical work.

Begun in 2002 with 50 children, the child-sponsorship program has given hope and a future to more than 500 children.

“About 40 of these children are living with HIV, so our challenge is how to (increase) anti-retroviral (ARV) treatment,” he says.

But the retired but not tired bishop, adds, “About 45 of the children and youth we care for are at various universities in the country.”

Also offered at the centre , is career guidance, grief management and counseling for orphans,

Some of the students’ demands, Bishop Masereka says, include hostel charges, tuition and personal upkeep.

“Each year, we raise over ugx 90m/= ( US $45) from donations in fees for these children,” he says, adding, ‘we are sleepless to ensure our support is sustained.”

“We think that in the next 15-20 years, we shall have produced many university graduates,” says the usually self-reserved but warm-hearted and hard-working and optimistic retired prelate.

Already, the centre is sponsoring one of its staff in medicine and engineering at several at the University of Medicine and Technology. Rev. Peter Muhindo attends the Medical School in Tanzania

Other BMCF students are training as clinical officers, Nurses, Teachers and Technicians.

“We have attached most of our beneficiary children to our sponsors under some kind of bonding, for skills training, to save them from dropping off along the way,” Masereka said.

Regional reach: Determined to be a regional hub, the centre also has extended a benevolent hand to other children who hail from outside Kasese district.

“Most of the students we help are from Kasese, but also close to 100 come from Bushenyi and Kabarole,” explains Masereka, adding that they come to the Foundation because their relatives have worked or died in Kasese.

“We support the children from the age of 5 years until around 25, when they can stand on their own,” he says.

Health and medical services: Started first as an HIV and HIV prevention project, the unit eventually translated into a clinic that initially used to treat at least 10 outpatients, the centre now handles about 40 outpatients daily and 17 admissions weekly.

The centre periodically is boosted by visiting professors of obstetrics and gynecology.

Dr. Sambili is assisted by two well-trained staff persons: Abraham Bwalhuma, a Lab Technologist, Andrew Katerega, a radiographer. They are both University graduates.

Though very well equipped, the maternity area, the operating theatre and the lab are too small for the ever-increasing number of clients, who daily throng the facility from within and outside Kasese district.

“We also carry out outreaches for immunization, health education and radio mobilization,” Masereka explains, stressing, “Our focus is education and health.”

With its vision of providing “a healthy and self-sustaining regional facility,” the centre also focuses on maternal and child health.

Community benefit: “I used to sometimes deliver babies at home because the services in other health facilities were priced too high for me,” Agnes Masika, mother of six, says of the centre.

With about eight nurses, two clinical officers, a midwife, a Medical Officer and a radiographer, the centre is able to silently serve the fast-growing Kasese municipality.

The centre handles about 10 deliveries every week. The monthly attendance at the clinic ranges from 450 to 650 people, children and adults, according to records at this nine-year-old facility.

Linkages with government: In addition to getting consultations from government, the centre also often receives some technical and logistical support supervision from Kilembe Mines Hospital, located some seven miles away.

Bishop Masereka conceives idea: Masereka says he conceived the idea of the foundation four years prior to his retirement and later started the Foundation as a family project. It has become a community project.

During his tenure as first bishop of South Rwenzori (1984-2003), Masereka used every foreign trip opportunity to make friends.

“Whenever I went abroad on evangelical mission and during my sabbatical leave, I used to make friends,” he said. “As clergy, we must learn to utilize our God-given talents to continue living positively after retirement. Friends are a great source of inspiration for my ministry.

Challenges: Several challenges hamper the centre’s full operations; one of them being insufficient rented space.

“Rent is such a big challenge. We pay Ugx Sh2,400,000=( US $1200) per monthly,” he says.

To address this, Bishop Masereka says the foundation has acquired land for its permanent home. Construction work on the administration facility and the maternity facility has already started.

Inadequate rented space, low manpower and electricity fluctuations remain among the major bottlenecks that prevent the clinic from attaining its full potential.

“Paying good salaries to our staff is another challenge we face,” Masereka says.

Next steps: According to Masereka, a new home for the centre is in the offing on the western fringes of Kasese Municipality.

Displaying an artistic plan of the new complex, he says it will comprise an administration block, a two-floor outpatients department (OPD) wing, a main ward, a maternity block and a laboratory, all valued at about USD$1,000,000, (one million dollars)

“We shall build it in phases, starting with an OPD and maternity facility before embarking on the main ward and theatre,” he says.

NOTE: During October and November 2010 Masereka and the Rev. Ezra Mukonzo Yongeza toured areas of the United States to spread the word about the amazing work being done in Kasese, Uganda, to educate orphan children and improve the health of the community.