Toth Health Centre Report

July 2016 to June 2017

Location Contacts
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Village: Aisa Nankusi Dr Samuel Kalibala

Sub-Counties Served: Namayonyi and Nakaloke
County: Bungokho skalibala@hotmail.com
District: Mbale
Country: Uganda
 Brief Background

Nakaloke Development Initiative for Communities (NADECO) is a community based organization that was
started in 2008 in Mbale District in Uganda with the aim of enhancing community development and
social services in rural communities. Between January 2010 and March 2011 NADECO carried out needs
assessment, mapping of partners and training of community health workers (CHW) in two sub-counties
of Nakaloke and Namanyonyi. Both sub-counties together have an estimated population of 60,000
people or about 12,000 families.

In April 2011 NADECO started providing HIV Voluntary Counseling and Testing (VCT) together with Family
Planning (FP) at community venues such as places of worship and schools in the eight parishes of the
two sub-counties. The first such service was provided at Aisa Parish in Namanyonyi sub-county on April
2nd 2011 and 62 clients were served.

When Dr Samuel Kalibala the Director of the project shared this information with Dr Miklos Toth and
his dear wife Elena, Miklos and Elena decided to start the Toth Health Center. We are grateful to Miklos
and Elena for this generous gift to the people of this community. Toth Health Center started seeing
patients on 2nd July 2011the first Saturday of that monthand has continued to see patients every
first Saturday of every month. Figure A shows that in the first year of operation (July 2011 to June 2012)
we treated an average of about 147 patients per month; in the second year of operation (July 2012 to
June 2013) we treated an average of 155 patients per month; in the third year of operation (July 2013 to
June 2014 we treated an average of 161 patients per month; in the fourth year of operation (July 2014 to
June 2015) we treated an average of 150 patients per month; in the fifth year of operation (July 2015 to
June 2016) we treated an average of 163 patients; and in this reporting period, the sixth year of
operation (July 2016 to June 2017) we treated an average of 151 patients per month. Therefore, the
number we treat each month on average lies between 147 and 163.
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 Figure B shows that in the first year of operation (2011-12) we saw a total of 1,764 patients; in the
second year of operation (2012-13) we saw 1,863 bringing the cumulative total to 3,627; in the third year
of operation (2013-14) we saw 1,937 patients bringing the cumulative total to 5,564; in the fourth year
of operation (2014-15) we saw 1,794 bringing the cumulative total of patients treated to 7,358; in the
fifth year of operation (2015-16) we saw 1,960 bringing the cumulative total to 9,318; and in this
reporting period, the sixth year of operation (2016-17) we saw 1,808 patients bringing the cumulative
total of patients treated to date using this gift to11,126 . On average, every year we have been treating
1,854 patients. We thank God and the Toths for this gift.

Elena and Miklos visiting Uganda February 4, 2012

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 General Medical Care

Toth Health Center operates on the first Saturday of the month and provides primary health care
including malaria testing and treatment; HIV testing and counseling combined with provision of Bactrim
to prevent opportunistic infections and referral for anti-retroviral (ARV) treatment for people living with
HIV; and family planning services.
Figure-1 shows that in the 12-month reporting period between July 2016 and June 2017 we saw a total
of 1,808 patients comprising mostly children aged less than 15 years, 969 (54%) followed by older adults
aged more than 24 years, 671 (37%) then young adults aged 20 to 24 years, 118 (6%) and least youth
aged 15 to 19 years, 50 (3%).

In figure 2 we show that, for this reporting period, on average we saw 151 patients per month. We saw
the highest number in December (179) and the lowest in March (117).
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Figure 3 shows that in all age groups we saw more females (1,269) than males (539): among children
aged less than 15 years we saw 553 females compared to 416 males; among the youth aged 15 to 19
 years we saw 41 females compared to 9 males; among the young adults aged 20 to 24 years we saw 97
females compared to 21 males; and among the older adults aged more than 24 years we saw 578
females compared to 93 males.

Most of our patients are women and children:

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 As can be seen above females are the majority of clients seen in our services. This is mainly because
females compared to males are less likely to have money to seek services in the trading centers where
medical services are provided for a fee and where transportation is required to reach. We have also
shown that the majority of clients are young children aged below 15 years. This highlights the fact that
this service is reaching the most vulnerable people in these populations, poor women and their children.

HIV Testing

HIV prevalence remains high in Uganda. The latest Uganda AIDS Indicator Survey of 2011 showed that
the national prevalence of HIV was 7.3%. For this reason, Toth Health Center provides HIV testing.
In figure 4 we show that during this reporting period on average we tested 8 clients for HIV. We tested
the highest number in December (14 clients) and the lowest number in September (two clients).

Figure 5 shows that we conducted more HIV testing among female clients, 69 (76%) than male clients,
22(24%).
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 Figure 6 shows that for most months all the clients tested HIV negative except for September where one
out of the two clients (50%) we tested turned out HIV positive and in June when one out of the eight
clients we tested turned out HIV positive. Therefore, the HIV prevalence among all the clients we tested
over the twelve months was 2 out of 91 (2%).

Malaria Testing

Malaria is a major cause of illness and death in this part of the country and yet it can be diagnosed using
a simple test with a microscope and treated effectively using the new Artemesinin Combination
Therapies (ACT). However, this requires a well-supported health facility that has electricity, well trained
laboratory technicians and a good supply of ACT medicines. We thank God for the gift from Elena and
Miklos Toth which has enabled us to provide this life saving service in a remote underserved area such as
this one. Figure 7 shows that in the 12-month reporting period we tested 351 for malaria giving an
average of 29 patients per month with the highest number tested in June (40 patients) and the lowest
number in May (21 patients).
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 In figure 8 we show that for this reporting period 23% of the patients tested malaria positive with the
higher percentages in the months of February (30%), April (29% and August (29%); and the lowest
percentages in the months of June (13%) and December (13%).

Family Planning Services

Uganda is a country with one of the highest fertility rates of about 7 live births per woman and this is
because of low contraceptive use. The 2011 Uganda Demographic Health Survey (DHS) showed that the
contraceptive prevalence rate was only 30% meaning that only 30% of married women aged 15 to 49
years were using modern contraceptives. The same report also showed that the unmet need for family
planning was 34.3% meaning 34.3% of women want to limit their family size or to space their children
but have no access to family planning services. The problem of teenage pregnancy was highlighted
during the needs assessment survey for Toth Health Center in its catchment area. For this reason, the
project is providing family planning services.
Figure 9 shows that in this reporting period we provided family planning services to a total of 136
women giving an average of 11 women per month.

Conclusion and Word of Thanks

Nakaloke Development Initiative for Communities (NADECO) is very grateful to Dr Miklos Toth and his
dear wife Elena for the assistance they have continued to provide to this project. Indeed, it is befitting
that NADECO decided to name the project Toth Health Center. Miklos and Elena visited the project on
February 4th 2012 and they were received with great pleasure by the community. They were given the
important names from the Bagisu culture of Uganda where the project is located. Miklos was named the
greatest name in the tribe. He was named Masaba which is the name of the father of all Bagisu people
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and the same name given to the great mountain (Mount Elgon in Eastern Uganda) on whose foothills the
 Bagisu live. Elena was given the name Nakhumisa which is a special name given to girls born during the
season of sowing seeds when the rains are about to come. It means they put a lot of hope in her like
farmers put hope in the seeds they plant.

Elena and Miklos have continued to support the project and they have also funded the provision of
water to the clinic. The water is trapped from rain water and directed in pipes to water taps and sinks
which the health workers use in the clinic. This has greatly improved the quality of care.

Water Tank installed at the back of the clinic to trap rain water:

Now the clinic has running water in taps and has sinks.

Laboratory sink:
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 Hand wash basin for clinical staff:
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 We thank God for all this kindness. Elena and Miklos are special people with a compassion which has
enabled them to take such bold action to improve the well being of others in need.

Thank you very much!!

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