Health
Hearing Clinic Launched at Makerere University Hospital
A Hearing Clinic and Temporal Bone Laboratory were launched on 15th August 2023 at the Makerere University Hospital (MakHosp). The clinic and laboratory are operated by the Department of Ear, Nose, Throat (ENT), Head and Neck Surgery, School of Medicine, Makerere University College of Health Sciences (MakCHS). The clinic which is the first to be established in a Public Hospital will manage persons with hearing impairments as well as support research in Uganda.
The Principal Investigator for the project Dr. Christopher Ndoleriire who also heads the Department of ENT at MakCHS thanked the partners who have supported the project since inception. These included Makerere Research and Innovation Fund (MakRIF), Austrian Development Agency, MED-EL, Professor Tom Roland Jr (NYU), Rotary Club of Kololo; and Hear His Voice Uganda.
He said, ‘all age groups can have hearing impairment (HI) however Children with HI face many challenges such as barriers in communication, discrimination, child labour, violence, etc. The challenges of HI do not enable these children to grow to their full potential. Thus their rights to education, health, interaction and play are hindered. This is due to the lack of knowledge and skills on how to screen and manage HI in these children. Therefore, there is a great need to screen, manage and empower children with HI so as to thrive through life.
The cost of not identifying and managing hearing impairment in children at an early age is very high both to the parents and to the government. It`s against this background that a research project linking four main hospitals to asses hearing impairment among children (0-59months) in Uganda was conceived and started.
The clinic which opened in October 2022 provides hearing screening and hearing diagnostic services to the University and community at large. It also conducts and coordinates hearing impairment research in a bid to create a database for hearing loss burden in Uganda. The clinic oversees hearing screening services in other 4 main hospitals namely; Kawempe National Referral Hospital, Masaka Regional Referral Hospital, Mbarara Regional Referral Hospital, Gulu Regional Referral Hospital.
To-date, over 1,000 children have been screened since April 2023 at the collaborating hospitals, 16 have visited Makerere University Hospital; 795 at Kawempe Hospital; 780 Masaka Regional Referral Hospital; 180 at Gulu Regional Referral Hospital; and 240 at Mbarara Regional Referral Hospital. All the patient data at the hospitals is interlinked and stored in a central system at MakHosp for tracking and follow-up of referred cases.
In addition, a temporal bone dissection laboratory has been set up to help train graduate ENT students in surgical management of ear disease and hearing impairment. This facility at MakHosp is open to other ENT professionals to continually improve their skills at a reasonable fee.
Professor Josaphat Byamugisha, Director-MakHosp explained that the clinic was opened in memory of Dr. Irwin Stewart from Canada who spearheaded improvement of hearing health in Africa, particularly Uganda. He recommended that babies` hearing should be checked within the first month of life to treat any defects early.
Professor Byamugisha thanked Makerere University management and the Ministry of Health for the support. He requested government to employ Audiologists, more speech and language therapists. Professor also added, ‘it is good to celebrate our successes; MakHosp is expanding and the addition of the hearing clinic is one of the new developments’. He advised that feedback from members that visit the hospital is welcome to inform future developments.
Alex Muhwezi, the president, Rotary Club-Kololo congratulated Makerere University, MakHosp and MakCHS on the launch of the hearing clinic. He thanked the partners for the contributions made to realise the milestone. He added, ‘I am proud of the contribution by Rotary to launch the facility. The clinic has opportunity to be a regional centre of excellence. Rotary contributed $150,000 towards renovation of the hearing clinic, installation of equipment in the temporal bone laboratory, training of specialists as well as outreach services.
Professor Annettee Nakimuli, Dean – School of Medicine, MakCHS represented the Principal, Professor Damalie Nakanjako and Vice Chancellor, Professor Barnabas Nawangwe. In her remarks, the Dean said ‘the Vice Chancellor and Principal send congratulations to MakHosp and partners on the new development’
Professor Nakimuli noted, ‘many partnerships don’t bear fruit and opening the hearing clinic is an opportunity for all partners here to pat yourselves on the back for the achievement, expressing that as a school we are proud of the ENT department for this milestone’. Teaching, learning, research and community service are a mandate of the university and following celebration of 100years of Makerere University, partnerships are a key feature as we embark on the next 100, she added.
‘For a long time, universities were ivory towers, but we must go to the communities to help solve challenges. Communities don’t only want a healthy life but also achieve their full potential’. The dean also commended the ENT department for getting good friends, noting that Uganda has about 60 specialists in this area and more are needed.
The Director-Public Health at MoH, Dr. Dan Kyabainze, represented the Director General, MoH. He emphasised that government appreciates support from the various partners. He congratulated Makerere University, MakHosp on the developments and pledged government support to the hearing clinic.
Health
Mak Researchers Partner with Safe Bangle Technologies to Roll out a Real-Time Domestic Violence Reporting Bracelet
By Joseph Odoi
A Consortium of Researchers from Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda together with Safe Bangle Technologies have rolled out a real time domestic violence reporting bracelet.
This roll out was made possible with support from the United States Agency for International Development (USAID) under the PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER) program and the National Academies of Sciences.
Dr. Juliet Kiguli, the Principal Investigator from Makerere University, along with Dr. Roy Mayega, Deputy Chief of Party at RAN, and Dr. Agnes Nyabigambo, the study coordinator, initiated the PEER program to identify entry points for testing SafeBangle Technologies (a social enterprise based at Resilient Africa Network (RAN) with a mission to create a safer and more secure environment for women and children through innovative, affordable, and creative technology solutions to curb GBV in Africa.) wearable safety bracelet in the informal settlements. This decision stemmed from findings of increased intimate partner violence (IPV) and gender-based violence (GBV) in three informal settlements in Kampala, Uganda, following a longitudinal study, geospatial mapping, and interviews. The project, titled ‘The Impact of the COVID-19 Pandemic on Gender-Based Violence among Women and Girls in Informal Settlements in Kampala,’ highlighted the urgent need for affordable and immediate reporting mechanisms for violence.”
‘’While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used incorporated the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time’’ explained Dr. Kiguli.
Innovation details
According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’
“While developing SafeBangle, we tested with the users in both rural and urban contexts. We piloted the innovation around Kampala with support from Digital Human Righs Lab and Naguru Youth Health Network as well as it in five districts of Karamoja region with support from Save the Children and Response Innovation Lab. Right now it has become handy in Kamapala‘s informal settlements. We envision a future where SafeBangle becomes a standard tool in the fight against GBV, ensuring every woman feels safe and secure as it has the potential to transform how we respond to GBV in Africa” added Kabali.
HOW THE SAFEBANGLE TECHNOLOGY WORKS
The SafeBangle is wearable technology similar to a smartwatch that sends an alarm by SMS to people chosen by a woman herself if she feels threatened.
In terms of the acceptability of the SafeBangle innovation as a solution to GBV among at-risk women in informal settlements Of the 72 adolescent girls and women who received the SafeBangle, 22 activated the reporting button, resulting in 19 receiving immediate and appropriate support, including counseling, police intervention, and health services.
All adolescent girls and women who experienced GBV received a phone call from Somero Uganda to discuss the most appropriate intervention, including counseling, police cases being handled by the probation office, referral for health services, and post-exposure prophylaxis. All the GBV survivors received support and are still receiving continuous follow-up.
Researchers conducted a survey among 644 girls and women in Kinawataka (Nakawa Division) and Bwaise (Kawempe Division) to gain insights into awareness and understanding of sexual and gender-based violence among adolescent girls and women in informal settlements. The survey measured socioeconomic factors, mental health symptoms, and exposure to GBV. Focus group interviews were conducted with a separate sample of women over 18 in the settlements to explore responses to GBV.
A tabular representation of the key findings and lessons learned from your study on gender-based violence (GBV)
| Key Findings | Lessons learned |
| Prevalence of GBV. – Overall prevalence: 34.1% of women and girls reported experiencing GBV. – Among adolescents (15-19 years): Over 50% reported experiencing GBV. | – The pandemic highlighted the need for accessible and comprehensive support services for GBV survivors. – Schools emerged as crucial safe spaces for girls, emphasizing their well-being during crises. – Economic independence proved crucial, enabling women to leave abusive environments. – Involving men and boys as allies in GBV prevention efforts is essential. |
| Age-related trends | – GBV prevalence tends to decrease with increasing age. |
| Physical and health consequences. | – Women and girls suffered physical violence, injuries, and deaths, primarily from domestic violence and unsafe abortions due to limited healthcare access. – GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS. |
| Social and economic impact. . | – GBV contributed to family breakups, strained marriages due to financial stress. – Economic hardships forced some women and girls into transactional sex, exposing them to further health risks and exploitation. – Pandemic-related job losses and economic constraints increased financial dependence on abusers, trapping women in violent situations. – School closures and increased household responsibilities limited women’s job opportunities and subjected them to sexual harassment. |
| Psychological effects | – Survivors experienced guilt, shame, anxiety, fear, and suicidal thoughts due to ongoing abuse. |
| Long-term effects | – Post-COVID-19, survivors faced disrupted education, early marriages, pregnancies, social stigma, and persistent mental health issues. |
Reproductive Health Consequences: GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS.
Family Breakdown: The rise in GBV led to family breakups as women fled abusive relationships. Marriages were strained due to increased financial stress.
Transactional Sex for Survival: Desperate for basic needs due to job losses and economic hardship, some women and girls resorted to transactional sex, exposing them to further health risks and exploitation.
One study participant stated, “The time of COVID-19 was so terrible for some of us. We in fact got a lot of diseases from it because you would want to get food and didn’t have money. That way you would be forced to get a man who would use you and pay.” – (FGD_Girls_19–24years_Kinawataka).
Economic Effects: COVID-19 restrictions caused job losses and limited economic opportunities, particularly for women in the informal sector. This increased financial dependence on abusers and trapped women in violent situations.
Limited Access to Employment: School closures and increased household chores limited women’s ability to seek employment, perpetuating gender inequality in the workforce. Some faced sexual harassment from potential employers.
Psychological Effects: Survivors of GBV experienced guilt, shame, anxiety, fear, and even suicidal thoughts due to the constant threat and unpredictability of abuse.
Post-COVID Effects: GBV survivors faced long-term consequences, including disrupted education, early marriage, early pregnancy, social stigma, and persistent mental health issues.
Lessons learned
The pandemic highlighted the need for accessible and comprehensive support services for survivors of GBV, the significance of schools as safe spaces for girls, and the need to prioritize their well-being during crises. Economic empowerment emerged as a significant protective factor for women and girls. Those with greater economic independence were better equipped to leave abusive environments and secure their safety and well-being, while dependent ones suffered abuses. Engaging men and boys as allies in the fight against GBV and involving them in prevention efforts can help promote positive behavior change and foster more equitable relationships.
Recommendations
To address GBV against women and girls, the researchers recommend the following moving forward;
- There is need to integrate technology-driven solutions like SafeBangle into national GBV prevention and response strategies. SafeBangle can be a valuable tool for policymakers as cases of violence that would have gone unreported will be brought to light and the would-be victims will be able to get immediate help from trusted relatives and friends.
- Provide economic opportunities and vocational training for women and girls to enhance their financial independence and reduce vulnerability to violence. There is therefore a need to introduce education and training programs that empower women and girls, by providing them with skills, resources, and opportunities to start their own ventures and to participate fully in community affairs.
- Strengthen and enforce existing laws and policies related to GBV, including laws against domestic violence, child marriage, and sexual assault without discrimination be it for law enforcers, leaders, and employers where such cases were suffocated. Ensure that perpetrators are held accountable through swift and fair legal processes that have no room for corruption.
- Establish and promote effective, accessible, and confidential reporting mechanisms for GBV incidents that provide confidence and can be trusted by survivors to enhance reporting of such incidences of GBV. Community Engagement and Involvement: Involve community leaders, religious leaders, and elders in discussions about GBV to promote gender equality, change social norms, and reinforce the message that violence against women and girls is unacceptable.
- Launch extensive public awareness campaigns to challenge harmful gender norms, report cases of GBV, raise awareness about the consequences of GBV, and promote positive behaviors and attitudes towards women and girls.
- Implement comprehensive sexuality education in schools and communities, educating young people about healthy relationships, consent, and reproductive rights to be able to make informed decisions about their own lives and well-being.
- Engage men and boys as allies in the fight against GBV, encouraging them to challenge harmful masculinity norms and behaviors. This will help minimize GBV because mostly they are the perpetrators. Strengthening Support for Survivors: Provide ongoing support and follow-up services for survivors of GBV mostly counselling services to aid their recovery and facilitate their reintegration into society.
- Provide ongoing support and follow-up services for survivors of GBV, mostly counseling services to aid their recovery and facilitate their reintegration into society.
- Provide avenues to seek free or subsidized services by survivors of GBV medical services and legal processes by survivors of GBV to enhance reporting of GBV cases, access to medical care, counseling, legal support, and other essential services.
- Encourage and support more research and innovations like SafeBangle to curb incidents of GBV.
- A comprehensive and inclusive approach is required. The efforts should involve government institutions, civil society organizations, community leaders, and individuals working together to address the root causes and provide support to survivors.
- Involve media in GBV prevention activities and for enhancing campaigns against GBV mostly on radio and TV.
MORE ABOUT THE STUDY
The core project team, included researchers at Makerere University School of Public Health (MakSPH), Medical College of Wisconsin (MCW) led by Prof. Julia Dickson-Gomez, SafeBangle Technologies, and Somero Uganda, a community-focused NGO, began the project by designing their research protocol and taking a CITI Program course on human subjects social/behavioral research. Team members also met with the Ministry of Gender, Labour, and Social Development (MGLSG) in support of the gender-based violence policy process, Ministry of Health and local government. They also established relationships with the Kampala Capital City Authority (KCCA) and Nakawa and Kawempe probation offices to support legal processes for the GBV survivors. SafeBangle Team also received an award from Defenders Protection Initiative.
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