Health
Makerere University Research shows challenges facing Forcibly Displaced Persons (FDPs) with Chronic Disease in Northern Uganda
By Agnes Namaganda
Preliminary findings from a study by Child Health and Development Centre (CHDC) -Makerere University have revealed several challenges faced by Forcibly Displaced Persons (FDPs) with chronic diseases like diabetes, hypertension and cardiovascular diseases. This study is specifically looking at FDPs in northern Uganda. Accessing food, water, medicine, clothing, toilet facilities, privacy and support is a challenge for healthy FDPs but for those with chronic diseases, these provisions may mean the difference between life and death.
According to Drs, Ritah Nakanjako and Esther Nanfuka Kalule, who are post-doc fellows at Makerere University, FDPs with chronic diseases are unable to access facilities with medicines. Speaking at the February monthly colloquium of CHDC, Dr. Nanfuka said, “Medicines and medical forms are sometimes forgotten by these patients yet some do not know the names of their medicines. For others, these medicines get finished along the way due to the abrupt movements.” These disturbances in the continuity of care affects their health and wellbeing.
As an example, she referred to the constant need to monitor blood pressure or blood sugar for these FDPs. “Even when facilities are available, you may not have the money to refill medicines or you may not remember the name of the medicine.” She added that the stress and trauma of this kind of situation usually exacerbates these conditions.
Speaking about the rationale for doing this research, Dr. Nakanjako said that non-communicable diseases (NCDs) are largely unrecognized and inadequately addressed in humanitarian settings, something which the Red Cross calls ‘a neglected crisis’. Yet, studies conducted among refugees and asylum seekers across the world report a high burden of NCDs. Uganda hosts over 1.5m refugees, the highest proportion in sub-Saharan Africa with the majority comeing from South Sydan.
“The objective of this study is to examine the experiences of FDPs- which will contribute to knowledge on innovative ways of chronic disease care. This will also contribute to the management of NCDs in humanitarian, low resource settings,” Dr. Nakanjako explained.
This 5-year study that started in 2022 will run till 2026 and is funded by the Novo Nordisk Foundation under the Mobility-Global Medicine and Research Fund. It is a collaboration between three institutions; Makerere University, the University of Copenhagen, Denmark and the Sudan Centre for Strategic and Policy Studies in South Sudan. This research is taking place in Nyumanzi Reception Center in Adjumani district; Nyumanzi Refugee Settlement also in Adjumani district; IDP Settlements in South Sudan; and the Bidi Bidi Refugee Settlement in Yumbe District.
Other challenges revealed by the FDPs with chronic diseases include the fear of drinking recommended amounts of water before or during travel to manage urine and to avoid stop-overs for security reasons.
After arrival at Nyumanzi Reception Centre in Uganda, these FDPs with chronic diseases do not receive any special care. It is only those with communicable diseases like TB. Cholera or Covid19 that get special care. Other challenges include; “a limited range of drugs, maintenance of cold chains for insulin, rationed water, lack of drinking water, lack of sanitary facilities and the congestion.
The Democratic Republic of Congo (DRC) and Uganda recently reported an outbreak of Ebola Virus Disease (EVD), which is a serious and often deadly disease caused by a person being infected by the Ebola virus.
The virus spreads through direct contact with body fluids such as blood, saliva, faeces, vomit, urine, sweat or genital fluids from a person who is infected with EVD.
The symptoms of EVD usually develop after 8 – 10 days from contact with an infected person and may include fatigue, high fever, headache, sore throat, muscle and joint pains, vomiting and diarrhea and in severe cases, bleeding.
What should we do as the Makerere University community?
The Chief, Makerere Health Services, Prof. J.K. Byamugisha advises as follows:
- Avoid unnecessary contact such as shaking hands, hugging etc.
- Place alcohol disinfectants or hand washing equipment at all entry points within the University and ensure everyone is using them.
- Students should sit in single-person chairs while in class, avoiding contact with their neighbours.
- Do not sit too close to one another especially in frequently crowded places such as classrooms, library or any other waiting area.
- While at the University Hospital, wash hands a the gate, use alcohol disinfectant at the reception.
- All patients should have a maximum of one caretaker – others can check on them by calling.
- Avoid bringing luggage to the University Hospital.
- Target to do as instructed by the health worker.
- For further information and guidance on Ebola, please call Dr. Charles Basigara on Tel: 0702 966652 and Sr. Eunice Namubiru on Tel: 0779 950978 (Contact persons for the University Health Services)
Additionally, always look out for and ensure full compliance with Ministry of Health (MoH) Infection Prevention and Control measures such as the one below.
Please find attached detailed communications from Prof. Byamugisha and
the Permanent Secretary Ministry of Health.
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