What Africa Can Teach the World About Scarcity, Tragedy, and Uncertainty During the Pandemic: Part I
This post is written by Robert Kalyesubula, MD, Nephrologist, and Founder of the African Community Center for Social Sustainability (ACCESS)
It is often said that experience is the best teacher. Well, the COVID-19 epidemic presently ravaging the world could be a driver for reverse-learning. It is time that Africa and other resource-limited communities shared their long-learned experiences dealing with scarcity, high mortality rates, and uncertainty with the rest of the world.
ACCESS school of Nursing and Midwifery- Nakaseke invites all legible candidates with Distinctions, Credits, and Passes in English, Physics, Chemistry, Biology, and Mathematics at O’Level to apply for vacancies in Certificate in Nursing and Certificate in Midwifery. Interviews are on-going and application can be downloaded here and deliver it to the school or email it to emails below or obtained the application form from the school.
For more information contact;
ASNM Principal on
ASNM Deputy Principal on
ASNM Administrator on
Tel: +256752950900, 0414667593
Academic Registrar on
Tel: +256775546657 | +256702768184
Founded on the premise that everyone has the right to a healthy life, the African Community Center for Social Sustainability (ACCESS) works with rural communities. Our mission is to work with vulnerable people in resource-limited settings through the provision of medical care, education, and economic empowerment to create long-lasting change that is owned by the entire community.
With continued support from our partners in 2019, we have been able to construct a 500-square-meter health facility that will accommodate ten beds and increase access to quality maternal and newborn care in Nakaseke. This year, we graduated our second and third cohorts of ninety-five nurses and midwives from the ACCESS School of Nursing and Midwifery (ASNM), as well as twenty-one students from our pre-school, which is currently attended by seventy children. We have embarked on the journey to construct a pre-school block that will accommodate about 200 children.
Meanwhile, we continue to support 450 Orphans and Vulnerable Children (OVCs) to attain quality preschool, primary, secondary, and tertiary or university education. In the health sector, we have received 12,618 patient visits at our LifeCare Medical Center. We have implemented a community-based Community Health Worker (CHW) Non-Communicable Disease (NCD) screening program in three sub-counties in Nakaseke District. Through this program, over 4,000 Nakaseke residents were screened for hypertension, diabetes mellitus, and chronic kidney disease while 770 NCD clients were recruited and received patient care in these three clinics. We have also continued providing family planning services. In fact, we distributed 107,767 free family planning services amounting to 42,634 Couple Years of Protection (CYP), a measure that estimates protection from pregnancy provided by contraceptive methods during a one-year period, making us the leading provider of quality family planning services in Nakaseke District.
Furthermore, we have set up numerous income-generating projects, among which include a goat farm and fish farm. These will be used as model farms for the Nakaseke community. We have also maintained our connection with the community through recruiting, training, supervising, and empowering 125 community health workers (CHW) who provide support to all ACCESS community projects. Our work continues to be recognized through both local and international awards.
This report brings to you our achievements and lessons learned in the areas of economic empowerment, medical care, and education in 2019.
ADVERT FOR ACCESS MANAGING DIRECTOR
ACCESS is a community-based organization in Nakaseke, Uganda founded on the belief that everyone has a right to a healthy life. We also believe that empowering community members through health and education creates lasting change that is owned by the entire community. We are engaging local leaders and cultivating new leaders through our programs focused on:
- Support for vulnerable primary school children and their families through income-generating projects, and subsidized school fees
- Educational opportunities in healthcare for young adults at The Health Training Institute
- Agricultural training in our demonstration garden
- Access to clinical and community-based healthcare through our clinic and outreach programs using community health workers
- Community-based research to generate new scientific approaches to health-related challenges.
We pride ourselves on our culture of passion and dedication to our work. We accomplish our mission and vision through dedicated involvement from community volunteers and community health workers, the hard work of our staff, local and international partnerships
JOB TITLE: MANAGING DIRECTOR
Position Type: Contract
Report to: ACCESS President
Responsible for supporting ACCESS in setting strategic direction and establish mechanisms for mobilization and optimum usage of resources, to ensure effective implementation of organizational programs
Key Duties and Responsibilities
- Establish reliable Fundraising advocacy initiatives to ensure continuous growth and availability of funds
- Plan for the Organization and establish strong strategies for business growth to ensure continuity
- Establish strategies for managing key Stakeholders and strategic partners for ACCESS so as to build and sustain a good working relationship
- Develop and monitor the implementation of programs to improve the capacity, motivation, performance, and productivity of staff in the organization to enhance the quality of their service delivery
- Provide strategic Leadership and oversee the implementation of organizational programs to ensure continuous improvement in organizational performance and service delivery
Qualifications and Experience:
- A Bachelor’s degree in Medicine, Nursing, Social Work and Administration, Nutrition or Community psychology.
- A master’s degree in Business Administration, Public Administration, Public Health, Education Management, or a related field is added advantage.
- A minimum of 3 years of working experience in an administrative or management positions at a senior management level in a reputable non-profit organization.
- Specialized Training in Leadership
- Specialized training in Corporate Governance
Knowledge, Skills, and Abilities:
- A good track record of winning grants and generating income for running NGO/CBO programs in resource-limited settings is critical
- Experience in building and sustaining diplomatic partnerships and alliances
- Solid administrative knowledge and experience is critical
- Knowledge and experience in strategic planning and budgeting
- Excellent computer knowledge and skills
- Good planning and organizing skill
- Innovativeness, creativity, flexibility and networking capabilities
- Must be a person of unquestionable integrity
- The jobholders should express Strong marketing, public relations, and fundraising acumen with the ability to engage a wide range of stakeholders and cultures
- A high degree of maturity that portrays the good image of ACCESS in all ways
- Strong written and verbal communication skills; a persuasive and passionate communicator with excellent interpersonal and multidisciplinary project skills
- Should have excellent analytical and problem-solving skills
- Should be quick at decision making
- Possess an admirable demeanor that influences behavior in a multi-disciplinary team
- Should be assertive and emotionally intelligent
HOW TO APPLY
Qualified candidates should email their applications, CV, academic transcripts, certificates and recommendation letters at least two, to firstname.lastname@example.org and email@example.com or hand deliver these to our offices in Nakaseke.
For any inquiries please contact us by calling, Tel: +256-041-4667596, +256-782-348560
Deadline: 24th March 2020 at 5:00 pm
Please Note: Only Shortlisted candidates will be contacted
The workshop over drew 50 participants with divers backgrounds and the sessions covered community based screening and management aspects in the field of hypertension, diabetes mellitus and chronic kidney disease.
Find Complete workshop report here
05th July 2019
Inauguration of ACCESS research block
Dr. Charles Holt’s visit at ACCESS was a privilege to us, we were happy to receive him again at ACCESS, he was extremely surprised how ACCESS has impacted the community through the work we are doing. Some of the ACCESS projects that Dr. Charles Holt visited included Dreamgirls project and the Jajja (Elderly) project.
Dr. Charles Holt funded the construction of a research block at ACCESS when he visited, he inaugurated the building. The block will feature some administrative offices, research offices as well as the ACCESS president’s office.
Dr. Charles Holt also visited the ACCESS fishpond, this is one of the ACCESS income-generating activities. It was started to help generate income for ACCESS as well as being a model fishpond in Nakaseke District where community farmers, youths and students can gain fish farming skills.
Mr. Julius came with Dr. Charles Holt, Julius is enthusiastic about agriculture and has been able to transform his community through agriculture. ACCESS being a community organization, we want to work with Mr. Julius to transform Nakaseke through agriculture, we will help all our beneficiaries like the dream girls acquire farming skills, we will utilize the available land to grow crops, rear animals, poultry and beekeeping
The project is a partnership between ACCESS, Grace Age Contractors, and the U.S. based Construction for Change. Construction began at the end of January and is scheduled for completion in September 2019. A project management team from Construction for Change has been working closely on site with Grace Age Contractors and ACCESS management, to help facilitate the construction process.
The project has also provided an opportunity for local women in Nakaseke to receive basic training in construction skills and hopes to promote women in construction in the community.
Dr. Charles Holt’s visit ended with lunch at ACCESS with all the ACCESS staff.
Grace Herrick, Founder of Grace’s Promise Incorporated
My dad is from California and my mom is Portuguese born in Mozambique. My mom’s stories always piqued my curiosity about the continent of Africa, a curiosity that continued to grow through high school as I frequently attended the WCHN global health evening sessions. In the summer of 2015, I had the opportunity to go to Uganda for two weeks during which I shadowed doctors and nurses, visited an orphanage, and went to ACCESS in Nakaseke where I learned about the activities of this amazing organization and community.
I was particularly moved by the work ACCESS does with children and orphans. During one of our home visits, an elderly woman sang a beautiful and haunting song. I didn’t understand the words, but the emotions I felt were powerful. I felt fully present that day. There existed a feeling of community, a connectedness with one another in the villages we visited that is difficult to describe. In the U.S., we do not often see communities in which everyone treats one another with dignity and respect. I felt that I was witness to something important. I left ACCESS feeling like I had to be a part of that community in a permanent way. I started brainstorming about what I could offer that could have a lasting impact. After speaking with Dr. Robert and Estherloy, President and Founders of ACCESS, we came up with the idea of a preschool program, as that was something the community needed that I could work on remotely. We created a curriculum and opened a preschool program that started during my junior year of high school.
To help illustrate why Nakaseke made such an impression about me, let me tell you about my return to Uganda in July 2018. The morning we drove to visit the school during my next visit in 2018, we stopped at a street shop in Kampala to purchase candy for the children. The shop was small, packed with odd foods and nicknacks and one cashier crammed into the corner because space was so tight. The street was loud and bustling with people and cars, equally packed in, and I was with my sister and her friend. I stepped onto the street with feelings both familiar and strange. Shops and streets in the midst of people hustling about, just like midtown Manhattan. It was in the midst of this familiarity that I felt strange. Here I was with my sister and her friend, three American girls so out of place in a sea of people as to cause them to stop in their tracks to stare at us. How could something seemingly so familiar feel so strange? When I visit Boston or New York City, I feel like a stranger among strangers, and somehow that feels comfortable because no one cares. But in Kampala, I feel like a stranger among friends and neighbors, and it makes me feel alone – like a real stranger – while also feeling envious of a sense of community that doesn’t exist in any city in the US, not even my home Newtown. It is this irony of feeling like a stranger among friends in Uganda but a friend among strangers in the US that is so alienating.
Later, I arrived at ACCESS expecting that we would visit the school program and greet the children with the treats. Instead, they came running to greet us in their bright, electric colored polo shirts chanting “Welcome to ACCESS Preschool.” Their warmth, giggles, and bright eyes filled me with so much love that I burst into tears. We were then greeted by many other people, some familiar like Dr. Robert and Estherloy, and some new. Embracing them felt like coming home. We picked up exactly where we left off when I was 16.
There is something about the way Ugandans greet you that makes you feel immediately welcomed and cared for. They extend both their hands to shake yours, then hold your hand in theirs in a warm embrace while talking to you. They focus their eyes and attention on you as if you are the only person on the planet. It makes you feel safe and connected like the bond is as strong as a family. Never have I been greeted with such strong feelings. It is disarming.
The children continued running around us giggling, tugging on my dress and requesting my attention. Two grabbed my hands, one on either side and walked me with Dr. Robert to a Welcome Brunch. As we went around the large table introducing ourselves, I was struck by the passion and dedication with which community members help the preschool to run. Afterward, we walked to a tent set up with tiny brightly colored chairs where the children put on a show, full of life and infectious laughter. The end performance was a dance similar to the conga line dance where the little ones lined up and danced their way around. Eventually, everyone joined in, including Dr. Robert. It was a moment I wish I could have frozen in time. I spoke with parents about their day-to-day lives, their families, and their friends. They shared the impact the school has had, and the aspirations they have for their children. The stories they shared were intimate and moving with the familiarity of a friend.
Let me end by talking about Susan, as she perfectly represents what Uganda means to me. By my side throughout most of my days in Uganda, she refers to me as her daughter and herself as my African Mama. I am blessed to have another mother across the world. She plans our days precisely but is there to make it work when I want to go off the schedule. She is tough in the best way possible, even saying no to me, like, “No Grace, you cannot stick your head outside the van in the middle of Kampala with the streets filled like this!” Susan does this purely from her heart, her love of people, and her love of her home. And her home is not just her house, and not just country, but the entire global health-contingent who call upon her when visiting.
I decided to create my own individualized major in global health at UConn. One of the first papers I wrote on the subject was an attempt to understand why the US has undergone a reversal in life expectancy for the first time in its history when compared to other Global North nations. A group of Princeton economists noted that the reversal is largely due to three factors: opiate overdoses, cirrhosis of the liver, and suicide. They coined the term “deaths of despair” to describe this triad. As rich as we are in material goods, we are very poor in the community. Uganda, on the other hand, is rich in this most important commodity that comes freely. And a sense of community is what Uganda has given me.
Non-Communicable Diseases Emerging As A Real Enemy In Uganda? Doctors From Makerere University And Yale University Shed More Light
One of the worst and most devastating outcomes of any treatment is death. Although death is inevitable, a lot can be learned from looking at the causes and trends of diseases in different places around the world.
Though when most people die it is obvious, the causes of death are not often well established. This leaves a big gap in the way health policymakers make decisions for resource allocation in the health sector. Much is known about infectious diseases like malaria, HIV-AIDS, and tuberculosis as the leading killers in sub-Saharan Africa. However, little is known about other causes of death.
Doctors from Yale University, USA, and, Makerere University, Uganda, undertook a four-year study to look at the leading causes of admissions and death in medical wards in Mulago National Referral Hospital, the biggest hospital in Uganda. They recruited a total of 50,624 patients admitted to the medical wards between January 2011 and December 2014. They noted that the majority of patients admitted were quite young, with an average age of 38 years, and were more likely to be females.
On further analysis, they found that up to 72% of the patients had a non-communicable disease (NCD) as the main reason for visiting the hospital. NCDs are diseases that are not directly transmissible but largely arise out of people growing older but more importantly from their lifestyle. It is well established that people who smoke, drink excessive amounts of alcohol, or eat unhealthy foods (low in fruits, vegetables but high in fat), are more likely to suffer from these diseases. The same goes for people who are inactive or do little physical exercise. We have been aware that NCDs present a big problem in limited resource settings like Uganda. Patients often present late for medical care, yet the availability of advanced therapy is limited. This prompted doctors to look into this issue.
In this study, doctors noted that although infectious diseases still played a major part in bringing patients to hospitals, there was a general trend of an increase in admission due to diseases like high blood pressure, kidney disease, stroke, and cancer. Out of the 8,637 (17.1%) who died during hospitalization, the leading causes of death were non-tuberculosis pneumonia (28.8%), tuberculosis (26.8%), stroke (26.8%), and cancer (26.1%). Please note that some patients had more than one disease condition. People diagnosed with HIV-AIDS, those above 50 years of age, and those who were male had an increased risk of dying while in hospital.
Our study demonstrated an increasing trend of NCDs as a major cause of admissions over the 4-year period in the midst of an on-going problem of infectious diseases. Healthcare systems in sub-Saharan Africa need to be prepared for the dual burden of disease in order to avoid catastrophic mortalities.
At the individual level, people should not wait until they fall ill to seek medical advice. We recommend getting appropriate checkups for adults. It is recommended that, whenever possible, people should engage in regular physical exercise, which is required at least 4 times a week. They should consume food low in sugar and unsaturated fats. Take less salt in food and avoid the harmful use of alcohol and smoking. Making such practices routine in one’s life will help us to delay or even reverse the NCD epidemic which is now the leading cause of deaths around the world.
Please find more details here
Your invited to support our partner Grace’s Promise by attending a fundraiser to benefit underprivileged preschool children living in rural Nakaseke District in Uganda.
The Miss ACCESS Scholarship Pageant was produced and hosted by Lanial Madden a Masters of Public Health student at Touro University California for the nursing and midwifery students at ACCESS school of Nursing and Midwifery (ASNM) in Nakaseke, Uganda.
These young women are currently students pursuing careers as healthcare professionals. They have been working extremely hard and studying for the Uganda Nurses and Midwives Examinations Board ( UNMEB) exams. Upon completion of their programs they will obtain Certificates in Nursing and/or Certificates in Midwifery.
The purpose of the scholarship pageant was two-fold:
1) to provide financial assistance to aspiring nurses and midwives in the region, and
2) to build up confidence, affirm self-worth, and empower young women.
The Evening of the Miss ACCESS Scholarship Pageant took place on Friday, July 27th, 2018 at 5pm on the campus of ASNM, in Nakaseke, Uganda. Scholarships were awarded at the conclusion of the event and the winners were announced.
Here are some of the photos from the evening of the event
Theresa Ermer is a German medical student from FAU. This May she spent a month at ACCESS in Nakaseke, Uganda as part of her clinical electives.
“ACCESS in Uganda does not only provide health care but promotes community development through a broad spectrum of projects.
Drs. James, Richard and Alex guided me and three American students through this very diverse rotation. At Nakaseke District Hospital, we saw patients in the ART (antiretroviral therapy) and NCD (non-communicable diseases) clinic, and assisted with deliveries on the labor ward and in the operating theater. On the wards we encountered and discussed many conditions that are much less common in Germany, such as malaria, HIV, cryptococcal meningitis, hepatitis, sickle cell disease and malnutrition. During a training on viral hemorrhagic fevers such as Ebola, I even got to try on an Ebola protection suit.
Dr. James is the heart and soul of the Lifecare clinic at ACCESS. Through his extreme kindness and dedication towards his patients he really has become a role model for me. Through ACCESS we also got in contact with the village communities: we visited families whose children receive guidance and school materials through the OVC (orphans and vulnerable children) program, participated in a family planning outreach, helped to teach children in the preschool, and got to know the “Dream girls” – a group of HIV-negative girls in the villages who act as multiplicators in their communities. It was wonderful that we had had some lessons in the local language Luganda – even just saying a few words in my rudimentary Luganda really helped me connect with the people so much easier.
One of the most interesting parts of my time in Nakaseke, was being involved with teaching and training patients and community health workers in the context of a research project on NCDs funded by Else Kroener-Fresenius Stiftung. It was eye-opening to be faced with the concepts of disease inhabitants of rural Uganda have developed and it was sometimes challenging for me to find comprehensible answers to their questions. After this global health rotation in Uganda, I really understand the importance of epidemiological research on NCDs in developing countries as a basis to design treatment concepts adapted to the needs of the population.
I cannot thank the program and the people at ACCESS enough for all their kindness and dedication to the communities they serve and also to us visiting students. My time in Uganda did not only make a professional, but also a very personal impression on me. Weebale nnyo! – Thank you so much for teaching me and for opening up your hearts to let me be a part of the ACCESS family!”
ACCESS UGANDA is a community based organisation though often working with government facilities. The management came to realize the needs of the people of Nakaseke District and amongst the list was the need for medical treatment including drug supply. BARCELO FOUNDATION, an organization based in Spain, decided to give a hand and facilitated us with sponsoring a Community Based Pharmacy which provides access to drugs that are otherwise difficult to stock to the community.
The Pharmacy officially opened in October 2015 and it has so far been running for more than ten months. Every month, we receive and treat over one hundred clients on the outpatient basis who receive the services the pharmacy provides. The drugs are provided at very low cost to enable the community access to the most needed medicines which would have otherwise not been available within the community.
The pharmacy is under the close supervision of the general clinic, though it can or seems like an entity on its own. It offers both whole and retail sale of drugs, health education to the community members as well as the clients that visit the clinic. In conjunction with the family planning clinic it has an outreach program. In the outreach package, the Pharmacy helps in the facilitating health education about contraceptive options.
Our community members can now get their required amount of drugs at affordable costs. Previously a patient or the attendant would travel to Kampala to acquire drugs prescribed, but now Barcelo Community Pharmacy is availing almost all drugs in all their kinds to the community members.
The Health Education talks sponsored by the Pharmacy are creating an impact to those that attend. These talks are general and are directed towards changing behaviour to improve the standards of living and health, education, social welfare and finance are the basic priorities. We would like to start on home visiting embarked with home care nursing to fully embrace ACCESS COMMUNITY COMPONENT, and this will need all our different programs, such as: support for orphans and vulnerable children, family planning outreach, and our Jaaja (elders) Project to sponsor and support this program.
On behalf of the Government of Uganda, community of Nakaseke, ACCESS-UGANDA, and on my own behalf, I take the honour to thank particularly FUNDACION BARCELO and Partners for ACCESS, and ACCESS-UGANDA under Dr Robert Kalyesubula, for the great enthusiastic work, love, care, mercy and grace they have for the community of Nakaseke, and Uganda as whole. I have no better heartfelt words to express how grateful we are but only to say thank, thank you so much. Amelia Fornes, Supervisor of African Region under FUNDACION BARCELO project FARMASOL, muchas gracias, te amos muchisimo, thank you again.
In-charge of Barcelo Pharmacy ,
Life Care Clinic
Through their involvement in the community, Gabriel and Aida realized a lack of support for the elders living in Nakaseke. Many elderly people (jaja in Luganda) were living in poverty, social isolation and suffering from untreated health conditions. They found elders who were sleeping on the floor, some who had been neglected by their families, others who were widowed, and disabled. They recognized that many of the issue facing the jajas could be solved by interaction and support from one another.
Gabriel and Aida sprang into action to organize a gathering of Jajas at ACCESS. They used the ACCESS bus to collect individuals from all over Nakaseke, and brought them to ACCESS to share a meal, receive medical consultation and examination, and identify needs that ACCESS could address in their home settings.
The jaja were overjoyed to spend time with one another and be heard by those at ACCESS.
Today, Aida and Gabriel continue to work with the jaja through home visits, and support for basic needs (food, clothing, bedding, etc.) They are looking for more ways to support the jaja, and plan to bring them together at ACCESS again in the future to foster relationships and wellbeing among Nakaseke’s most vulnerable seniors.
In May, 2012, ACCESS invited the Nakaseke Community to come and support the new nursing school. People came in big numbers! 150-200 people came and celebrated with us, and showed their support by raising $2,000!
The day was filled with students, patients and staff sharing stories of ACCESS impact on their own lives and on the Nakseke Community.
Students, staff, volunteers, and neighbors brought gifts to contribute to the auction.
We were honored with the attendance of local government leaders, and visiting leaders from Kampala.
The students worked so hard to put on this event. Thanks to SAWA World for the video summary of the event.
Click here to view the video: ACCESS Fundraiser in Nakaseke Raises $2000
Rural communities in Uganda are lacking access to health care due to a shortage of doctors and nurses.
Young men and women living in rural communities lack access to higher education.
ACCESS is building a Comprehensive Nursing School in Nakaseke, Uganda to help provide education and job opportunities in the rural healthcare system. This 3-year program will build a secure future for young people living in a rural area and provide crucial access to healthcare for the entire community.
Through the generous support of our partners and donors we have built a brand new classroom block, shipped a boxcar of medical and educational material, established our library and skills lab, and secured our compound with a perimeter fence. We are on our way to opening the doors of The Health Training Institute!
But we need your help. 95% of every dollar you give will go directly towards upgrading our existing community nurses’ aide program into a 3-year Accredited Nursing School.
Our nurses will make approximately $200/month. This money will send their siblings to school, provide for their families, and bring healthcare to the community. Even a small donation has the potential to transform the community!
In November, our team in Boston raised $16,000! That means we are well on our way to building the 3-year nursing program by March, 2013.
But we need your help!