Toth Health Centre Report

July 2015 to June 2016

Location Contacts
Village: Aisa Nankusi Dr Samuel Kalibala
Sub-Counties Served: Namayonyi and Nakaloke
County: Bungokho skalibala@hotmail.com
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District: Mbale
Country: Uganda
 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. Toth Health Center started seeing
patients on 2nd July 2011the first Saturday of that monthand has continued to see patients every first
Saturday of every month. Figure A shows that in the first year of operation (July 2011 to June 2012) we
treated an average of about 147 patients per month; in the second year of operation (July 2012 to June
2013) we treated an average of 155 patients per month; in the third year of operation (July 2013 to June
2014 we treated an average of 161 patients per month; in the fourth year of operation (July 2014 to June
2015) we treated an average of 150 patients per month; and in this reporting period, the fifth year of
operation (July 2015 to June 2016) we treated an average of 163 patients.

Figure B shows that in the first year of operation (2011-12) we saw a total of 1,764 patients; in the
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second year of operation (2012-13) we saw 1,863 bringing the cumulative total to 3,627; in the third year
of operation (2013-14) we saw 1,937 patients bringing the cumulative total to 5,564 patients treated; in
 the fourth year of operation (2014-15) we saw 1,794 patients bringing the cumulative total of patients
treated to 7,358; and in this reporting period, the fifth year of operation (2015-16) we saw 1,960
patients bringing the cumulative total of patients treated using this gift to date to 9,318. On average,
every year we have been treating 1,864 patients. We thank God and the Toths for this gift.

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 and referral for anti-retroviral (ARV) treatment for people living with
HIV; and family planning services. Figure 1 shows that in the 12-month period of July 2015 to June 2016
Toth Health Center treated 1,960 patients mostly children aged less than 15 years, 1,053(54%) followed
by adults aged over 24 years 734 (37%), then young adults aged 20 to 24 years,108 (6%) and youth aged
15 to 19 years, 65(3%).
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 Figure 2 shows that on average we saw 163 patients per month; we treated the highest number in the
month of February (210) and the lowest numbers in April (116) and October (117).

Figure 3 shows that we treat mainly female patients (1383) compared to males (577). And this is true
across all age groups: among children aged less than 15 years we saw 582 females compared to 471
males; among youth aged 15 to 19 years we saw 58 females compared to 7 males; among the young
adults aged 20 to 24 years we saw 102 females compared to 6 males; and among older adults aged over
24 years we saw 641 females compared to 93 males.
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 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 in this 12-month reporting period we tested 82 clients for HIV with an average of 7 clients
tested per month. We tested the lowest number in May (4 clients) and the highest number in July (13
patients) while in the month of April we tested no patient.

Figure 5 shows that we mainly tested female clients, 67 (82%) compared to males, 15(18%).
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 In figure 6 we show that of the 82 clients we tested 4% tested HIV positive. For most of the months all
the clients tested HIV negative except for August where 18% tested positive and May where 17% of the
clients tested positive.

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.

Microscopy in the cornerstone of malaria testing in our clinic:

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 Figure 7 shows that in this 12-month reporting period we tested 417 patients for malaria giving an
average of 35 per month. We tested our highest numbers in May (55 patients) and July (47 patients); and
our lowest numbers in March (16 patients) and April (24 patients).

In figure 8 we show that overall, we detected malaria in 21% of the patients we tested. Our highest
detection rate was 35% in October and the lowest was 13% in April and May.

Family Planning Services

Uganda is a country with one of the highest fertility rates of about 7 live births per woman and this is
because of 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
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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 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 we provided family planning services to an average of 11 women per month. We
served the highest number in March (17 clients) and the lowest number in December (6 clients).

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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