Piloting preventable disease educational workshops in the hospital

One of the major programs we are implementing is health workshops focusing on preventable diseases. This includes five major categories: acute respiratory infections (ARI), malaria, parasites, acute diarrhea disease, and personal hygiene. According to the latest St. Josephs Hospital statistics, the top ten causes of morbidity reported in the OPD (outpatient department) include: malaria, acute respiratory infections (no pneumonia), intestinal worms, acute diarrhea conditions, gastrointestinal conditions, pneumonia, injuries and trauma, malnutrition, HIV/AIDs and skin disease. The chart below indicates the leading causes of death for adults and children in the OPD.

Children <5 years		Adults
Malaria	2,281/39.3%	Malaria	2,551/26.0%
ARI	1,603/27.6%	ARI	1,778/18.1%
Pneumonia	419/7.2%	UTI	878/8.9%
Acute Diarrhea	304/5.2%	Gastro intestinal disorder	685/6.9%
Injuries	113/1.9%	Intestinal worms	425/4.3%

As a result of these figures, we are aiming to implement educational workshops focusing on two major ideas: prevention and treatment. We want to implement these workshops in surrounding communities in St. Joseph’s catchment area to theoretically reduce the cases of preventable diseases (and morbidity). We also want to implement the same educational programs in the schools, thus simultaneously targeting the adults and children in the local area.  We have a graduate student coming down in May that will look at barriers to behavior change and when we return to Spain in June, we will develop programs to move forward in providing programs and infrastructure for the communities to hopefully reduce the prevalence of preventive diseases.

We have done preliminary survey work in various surrounding communities and have identified a few communities that have extremely low knowledge regarding preventable diseases. For example, we surveyed 15 houses in the village of Tumungu and found more than 60% of respondents did not know the cause of malaria (mosquitoes), 73% could not name one way to prevent transmission, 60% of respondents did not think diarrhea was preventable, 40% did not think open defecation poses a health risk, etc.

Together with the senior staff (doctors and nurses) at the hospital, as well as with guidance from local NGOs and the wealth of material available online from the World Health Organization, UNICEF, PATH, USAID, etc. (I have a spreadsheet with all my documents regarding these topics; it contains over 100 files), we have designed programs to educate the communities on preventable diseases. We have procured visual aids from a nonprofit based in Kampala, the Mango Tree, and had additional visual aids created by a local artist.

 Practicing in the outpatient department

Our health education team, Charles (left) and Benson (right). 

We are now beginning our pilot phase of implementing the educational workshops. Our health education team at the hospital has a certain way of teaching and our interactive activities are surely a change of pace from their usual lecturing. We want to involve the participants as much as possible and have various activities to help engage them. One of my favorite activities is one used to help explain the concept of germs and contamination. It’s very difficult to explain to completely uneducated people that microscopic organisms cause diarrhea. Instead, we take a glass of water and offer it to a participant. Then, we take a strand of hair, put it in a pile of feces, and then dip it into the water.  There is no visible difference in the water but the participants will be reluctant to take a drink. Next we explain that a hair is just like a fly’s legs, only a fly has six legs. So when you take a shit behind your house and flies later land on your food…

Charles gives a talk about diarrhea to the new mothers in the hospital. 

In anticipation of our activities in the community, which begin next week, we have been using different departments at the hospital to practice the program. It serves as an excellent venue and patients or patients' family members seem to be especially attentive as many of them have been brought to the hospital because of a preventable disease. We have had so much success with it that we are hoping to integrate it into the department’s programs since the turnover is so high with patients and they are very attentive.