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KHC Breast Screening outreach day

In May, KHC welcomed the Poole Africa Link Breast Screening team, led by Dr Judy Mella, to offer a breast screening day to the local community.

Dr Judy is a breast surgeon based in the UK. Her work in Africa began in 2010, on an early visit to South Sudan where she was surprised by the amount of breast cancers presenting very late in young women, and felt very strongly that breast cancer in Africa was a neglected issue. Her work with Poole Africa Link focuses on training local health workers in breast assessment and gaining funding for the necessary provision of ultrasound machines and breast clinic operations.

Over time the doctors, midwives and nurses from Poole Africa have met our team in Uganda on trips. We have been fortunate enough to host them at Kristina Health Centre and learn from their extensive experience. We are thrilled we could collaborate with Dr Judy and reach so many women.

Below is an account of the breast screening outreach day written by Dr Judy.

This beautiful clinic (and it is beautiful in so many ways) is a reasonable distance from Lira. It took just under 2 hours for our team to reach the clinic, mainly due to slow road conditions. Travelling with me is an image of a young and determined Julius Achon, running this road to get from his village to a Lira athletics meet many years ago… and how he did go on to run for his country in the Olympics. His story is extraordinary. When he lost his mother Kristina during the horrific LRA civil war due to lack of health care for her bullet wound, he pledged to build a clinic for his village, and this is it. The instant I walked in, I thought about how health care in Uganda could and should be.

Our team consisted of Ocwa Phyllis, a radiographer in Lira University Hospital; Sr Philomena, educator, spokesperson, and palliative care specialist, she organises, accompanies, and nurtures the patients’ travel to Kampala. The trained midwife breast nurses – Sr Fiona (Amach HC IV); Sr Stella (Aboke HC IV); Sr Doryn (Lira referral hospital); Sr Harriet, (Ogur HC IV), myself, a breast surgeon; Ongora Cosmas, team co-ordinator; Gloria, team assistant and Dr Sarah, fellow Poole Africa Link team leader and also breast surgeon.

Our new trainees: Two from the Kristina clinic –Daniel, Senior Clinical Officer at KHC; Harold the newly recruited radiographer; and two others –  Sr Ambrose, (Dokolo HC IV )& Sr Lucky (Alebtong HC IV).

Our welcome was magnificent, and certainly so much more than we are familiar with! Daniel and the Kristina clinic team had erected tents along three sides of the lawn to accommodate the waiting women – some of whom had arrived the previous night and slept under the awnings. There was a PA system for announcements, to call in patients, and, for the majority of the day, this cheered us on with lovely music. After our introductions Sr Philomena revved up the crowd with inspirational teaching, punctuated by ululations from her audience.

The team had accommodated us in the male ward with beautifully labelled and laid out cubicles, and so much space!

We set up three clinical teams to consult each woman, taking a history, examining them, and then offering ultrasound +/- any needle tests or referral as required. Overall, we saw 64 women and 3 men. 14 had no breast symptoms, 32 had unilateral breast pain, 7 had bilateral breast pain and 8 had lumps. The remainder had a mixture of symptoms ranging from fungal infections to nipple discharges. There were no lumps that needed a biopsy and no breast cancers. Phyllis and Harold saw a few non-breast patients as well.  the vast majority of these were fine, some had benign conditions for which we could not offer much help – such as a man with neurofibromatosis affecting his nipple, and others who required some advice, mainly for breast pain.

The clinic provided a wonderful teaching opportunity. Our four new team members had attended a one-day course at Lira University the previous week where we had covered the theory of breast disease, explained a few practical procedures with lectures and models, run a session on ultrasound theory and practical usage of machines, and explained the process of setting up the breast network.

However, the main learning happens on real patients, and Daniel and Harold were very involved in taking histories, examining and ultra-sounding women – really learning what “normal” is. It is only through this solid base of experience of “normal” that diseases can be appreciated and diagnosed. They impressed us with their quick assimilation of knowledge.

We had a late lunch at 3.30 of rice beans and meat, under the shady mango tree on the grounds. By this time no more women were presenting, and we were able to see the last group by 5 pm.

We made the long journey home to Lira, tired but in good spirits. We were delighted to have had this opportunity to engage with the Otuke community and sensitise them to breast awareness. We are happy to have linked Harold, the KHC radiographer with Phyllis, the radiographer from Lira University Hospital. The Lira breast team will link up with any women with breast lumps and facilitate them if they need to get to Kampala for treatment. Thank you Kristina Health Centre for your partnership.

Partnerships like this are so important to the operation of a health clinic in a remote area of northern Uganda where KHC is located. It opens the doors to offering the community additional health care services without the need to invest in additional equipment, staff or resources.

The ongoing support of our generous Love Mercy community facilitates the daily operations at KHC. Just $50 can provide medical supplies so the team is prepared when patients are in need.

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