Safe House

The Robert H. Cooley Pediatric Clinic
Community Health Center of Papoli, Phase I – COMPLETE 

The Robert H. Cooley Pediatric Clinic (RHCPC), one of the units within Papoli Community Health Centre opened its doors to the public on the 5th May 2010 and became fully operational on 6th May 2010.

At its Day Care centre where children living with HIV & AIDS receive nutrition rehabilitation, there are a number of activities (services) that benefit our clients. These services include but are not limited to:

• Medical check ups and treatment against opportunistic infections like; cough, diarrhea, pneumonia, asthma, allergies, boils, rash etc.
• Child counseling, a professional services that provides psyschosocio support to our clients. This service is very crucial for some of our clients come when they are quite traumatized.
• In door activities like singing, playing with dolls, pianos and many others;
• To speed up their psycho-motor development our clients are also subjected to a number of out door games especially foot ball, net ball and simple athletics;
• We also have climbers, swings and merry-go round games for our clients;
• We daily special moments for bible teaching, devotion and teaching morals. A number of hymns are taught to the clients;
• We further help our clients with personal hygiene. We bathe and train them to cut their finger nails, brush teeth;
• Story telling is another activity which makes life very interesting for our clients and any body who gets to interact with them;
• Because some of our clients come from very economically devastated home environments, we have always had to address their need for clothing and beddings;
• Daily nutrition and health talks with the care givers of our clients, so that while at home, there is continuity of services / care that is provided at the facility. This followed by home visits by our Health Workers and Community Development Facilitators.
• We offer weekly immunization within against the killer diseases namely; whooping cough, diphtheria, measles, polio, tuberculosis &tetanus.
• Voluntary Counseling and Testing (VCT) that we conduct at the Facility once a month for both kids and adults, we receive over 200 clients, but able to test 100-120 only.
• For proper nutrition rehabilitation our clients take three meals a day within the facility as scheduled:

ENROLLMENT

We started with 20 clients on the 6th of May 2010, and the number has steadily increased to 172. This is a result of protracted awareness campaign within the community by our Health Workers and Community Development Facilitators.
The level of awareness has also gone high because of the Voluntary Counseling and Testing (VCT) that we conduct at the Facility once a month. This VCT is conducted once in a month because of the high costs it bears, we need $ 200:oo (UGX 400,000=) to transport the testing kits and cater for the technical staff from without Papoli. We carry out the VCT in partnership with ART clinic in Tororo General Hospital.

CHANGES IN OUR CLIENTS

Within the three months we have operated the safe house quite a number of changes can be seen in our clients.

a) General appearance
Most of our clients were enrolled when they had lost body weight but through the technical nutrition support, they have tremendously increased in weight. Examples:

b) Skin colour
Some were admitted with abnormal pale skin colour. But as of now all our clients have regained their skin colour and texture.

c) General Appetite
Whereas some had excessive appetite, others had very low appetite but today they are all balancing to normal appetite.

d) Socialization

At the beginning most of them found it difficult to socialize but the Day care unit is now full of only social beings. The worst of these was Abilolo Stephen who could hardly say a word but today he is seen almost as the football captain and a choir leader of the group. Akoth Peres who could hardly stand on her own is now seen standing and walking on her own around the play room.

e) Moral
Since they cradle from different moral back grounds, it has not been easy at the beginning but because of our continued moral training there is great change in their morals.

f) General body cleanliness
Our clients can now be seen as children who are generally clean. We bathe, smear them and wash clothes for them. Treaming of hair is also part of our Primary Health Care activities with them at the Facility.

g) Responsibility
Our clients can now take responsibility of their environment i.e in the play room, they have learnt to be responsible for their toys and other play materials.

h) Community involvement and participation
Papoli Community health centre is living true to it’s name that is the driving spirit. Community participation at all stages of work is encouraged and realized; just as the acquisition of land, making bricks, collecting building sand etc had community members doing it, so is the operationalization of the safe house. The parents and care givers of the kids assist at the facility in feeding, bathing and taking care of the kids, cooking, food preparation, heaping sweet potatoes and planting greens that will be used for feeding the sick kids. The community members have continued to support in areas like; cleaning compound, planting grass and tress, building feeding shade, making bricks in preparation for OPD construction.

i) Training of parents and care givers
The safe house staff give lessons to parents and care givers, in areas like personal hygiene, cooking, vegetable growing, washing etc. The shade under construction will also serve as a class room for this type of lessons.

HOME BASED CARE (COMMUNITY OUTREACH)

Basing on the constant Health and Nutrition talks we carry out within our cliental community and looking at the rate of improvement shown by our Day care children, we are placing the very improved children under Home Based Care programme on Tuesdays and Thursdays.

Mondays, Wednesdays and Fridays is our clinic days when we attend to all our clients at the clinic.
While under Home Based Care, our Health workers do monitoring and guiding the care givers on how to look after the children. This is meant for kids who are being weaned off the facility, however those who are still weak and those newly recruited continue with day care and clinic services throughout the week.

This program is still being developed, lessons on current trails will inform how we move forward and work. It is seen as a way of decongesting the safe house facility and also minimizing cross infections and operating costs of the facility.

Other innovations: Due to great demand by the community for OPD services, the village council okayed for trails targeting emergencies on weak mothers and girl children, they pay for all their treatment.

CHALLENGES

Amidst progress, we are faced with a number of challenges in the provision of the Pediatric services to our clients

• Our clients have to walk long distances to access our services. This is aggravated by rainy seasons when they have to walk under rain
• We do not have a shade for feeding our clients (we are currently constructing a grass thatched temporary one that will also serve as classroom for care givers)
• An ever increasing demand for Out Patient Department (OPD); this has forced us to kick start one that takes care of emergencies
• Lack of electricity in the Facility makes it difficult to carry out some activities, we have to keep vaccines far off
• Some of our health workers yet have to walk on foot to access our clients’ homes during home visits

OTHER DEVELOPMENTS

• Negotiations are in advanced stages to start Family planning service provision at the clinic in partnership with Planned Parenthood.
• Our health workers pay monthly visits to neighboring primary schools apart for one of Papoli to give health education lessons and distribute sanitary pads to bigger girls.