As a traveler and a member of the medical community, it’s important to consider the consequences of international involvement in local under-served communities. Personally, I’ve heard and read quite a bit of criticism about “pop up clinics” and church mission trips that arrive at a location for several days, help a small community for a short period of time, and then disappear. This essentially leaves the community more or less the same as before these mission trips arrived without making any sort of improvement in the local system. I’m proud that I chose to do my international rotation with Child Family Health International (CFHI) and Kihefo (Kigezi Healthcare Foundation), two programs that are dedicated to supporting change that is sustainable in nations that need it as well as educating the world about local difficulties. However, I am still skeptical of the longevity of the program without international involvement given its current status.

The rural outreach programs facilitated by Bridge to Health and Kihefo are designed to introduce healthcare into rural communities that previously did not have healthcare access. The outreaches always have follow-up and referrals to Kihefo clinics and local hospitals. This has been an excellent mechanism of changing the quality of health of the entire region of Kabale. The vision is to now create quantitative change and expand this improvement to all of Uganda.

Today, I spoke with Dr. Geoffrey Anguyo, the doctor who created Kihefo and facilitated the partnerships with CFHI and Bridge to Health. Currently, quite a bit of the clinical funding for the HIV, general, and maternal clinics are supplied to USAID (United States Aid for International Development). Kihefo received a grant 5 years ago that is able to sustain the efforts here on $200,000/year, however, renewal of this grant isn’t promised. Kihefo is currently working on making the program self-sustainable by establishing an insurance program and by assisting the economic health of the community via their Rabbit Program. The Rabbit Program gives rabbits to local families who are in need of protein and extra income, allowing these people to consume the rabbits and sell them at the market. The hope is that these extra funds will eventually lead to investment in insurance, allowing healthcare to become available to more individuals throughout Uganda. Yet I am skeptical that the rabbits are going to create enough revenue to sustain these clinics and insurance system. I m confident the Kihefo is making a real impact on the health of this region of Uganda. But I believe that some changes to the financial system still require improvement as the program is largely dependent on international funds.

Over the past several days, I’ve felt privileged to see the differences in prevalent diseases in this area versus home. Yesterday, in referral clinic, we encountered patients with tuberculosis, elephantiasis, and typhoid fever (glad I got my vaccine!). Even after having been here for just one week, its been a fascinating educational experience.

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