The piercing screams of a refugee child ring out as he is being injected by a nurse at a makeshift health facility crowded by other browbeaten and emaciated refugees of all genders and ages who have come for treatment from myriad ailments. These are the sights and sounds that welcome you at a health center run by the Healing Kadi Foundation in Morobi Refugee Camp, Obongi District in North-Western Uganda.
The marvel is that the health facility is not run by the United Nations or one of the high-flying international organizations, but by medics from South Sudan supported by some local staff.
The South Sudanese medical humanitarian outfit, the Healing Kadi Foundation (HKF), was conceptualized by South Sudanese American medical doctor Joseph Dumba in 2007 to provide affordable health care across South Sudan.
“Healing is in English but ‘Kadi’ in the Bari dialect means house. So, it is a healing house. We think of it as a place where people can come to heal whether it is medical or spiritual, we provide it all,” he says.
Dr. Dumba who went to the United States of America as a refugee and studied human medicine there tells Radio Tamazuj that he started the Healing Kadi Foundation to help the people of South Sudan.
“HKF was started in 2009 but the initiative started in 2007 after the Comprehensive Peace Agreement (CPA) was signed when I was able to take a group of doctors, my colleagues, to Kajo Keji,” Dr. Dumba explains. “It transpired that the area was affected by war just like the whole of South Sudan in terms of infrastructure and health needs. So, we needed to do something and my thinking was that we needed to do something more sustainable, so HKF was developed as a model of sustainability.”
He says for sustainability, the community had to contribute a portion for the treatment of each patient.
“So, when the crisis happened in South Sudan and spread to Kajo Keji in 2016 and we had to move with the refugees to the camp in Uganda, that model was not applicable. It does not make sense to charge a refugee when they do not even have food to eat,” Dr. Dumba expounds. “So, in the refugee camp, we are treating the refugees for free. It is 100 percent free, that model we had initially in Kajo Keji was put on hold.”
Funding: A Significant Challenge
The doctor says they face challenges like shortages of medications and other vital supplies but that they make do with the little they have to treat the refugee in the Morobi camp.
“We rely on individuals who make donations, and we have not had any big donors come to our rescue up to this point,” Dumba says. “When we moved the clinic from Kajo Keji to the refugee camp, we were already well known in South Sudan and in particular the Kajo Keji area, so people came from all the other camps to get treatment at our facility.”
According to the doctor, the necessary staff like trained doctors from their health facility in South Sudan who moved to Uganda with the refugees made a big difference.
“The challenge now is that on average we see between 150 to 250 patients a day and that is a lot of patients which requires a lot of resources,” he laments. “Most of the funds we get comes from individuals. We raise funds in the United States and that is what we send to the camp to help. It is not from any big organizations but well-wishers.”
He says HKF has not received any assistance from the UN, donors, or other international organizations despite working in the refugee camp for over four years now.
“So, we lack a lot of resources and we cannot buy vehicles because we are focusing on getting medications for the patients,” Dr. Dumba says. “That is our number one priority so that refugee patients survive, but we have not gotten any help from the big donors or the UN as far as I know as the president of the foundation. Lack of funding is a major challenge.”
“We do not even have an ambulance. We lost one of our staff members due to the lack of an ambulance. She started bleeding and we had no vehicle to rescue her by taking her to a referral hospital and that was the time Uganda had closed down due to Covid-19 and the only vehicles allowed to move were ambulances. By the time we managed to transport her to Adjumani District Hospital, it was too late and she ended up dying.”
On mental health, Dr. Dumba says it is an existential challenge and most of the refugees are traumatized as a result of their experiences.
“That is a big challenge. Most of the refugees are traumatized and have seen and continue to see things that they should not be seeing. We provide a complete service at our facility because we have the medical portion of it, the spiritual part of it and we also have counseling that goes on at the facility,” he says.
About reports of poor nutrition and its impact on the health of the refugees, Dr. Dumba says, “We have been hearing complaints from the refugees regarding insufficient food rations but that is beyond us as medical practitioners.”
He adds that the clinic sees a lot of malnourished children but can do little because of a lack of funding.
The HKF founder believes that South Sudanese refugees are very resilient and strong and thinks that if they had land to cultivate, most of them would have already grown food for themselves.
“I keep telling them to keep praying for peace and hope they can return to their homes,” Dr. Dumba says. “We will continue providing medical care as much as we can even though we are almost running out of funding and I do not know how long we are going to maintain the clinic open.”
HFK Beneficiaries
A 74-year-old refugee, Jennifer Nyoka, fled from the war in Lainya, Central Equatoria State four years ago and is currently resident in Dongo Block 4 in the Morobi Refugee camp. She says the HKF clinic was a Godsend because it is where the refugees get free treatment.
“I am a refugee residing in Dongo, Block 4 and I get treatment at the HKF clinic and they have been nice to us and help us with medicines,” a cheery Nyoka says. “Now, like us grandmothers, this is the only clinic which has helped us because the referral hospitals are very far in Moyo or Adjumani districts.”
Steven Tut Biel, who fled from fighting in the Yei area in 2017, says he had a big wound on his leg which doctors at the refugee reception center initially thought was cancerous but was treated by Dr. Jackson at the HKF health center.
“When I ran from South Sudan into Uganda, I had a very big wound on my leg which was stinking and I even thought my leg would be cut off. Dr. Jackson of the HKF clinic worked on me for months and I completely healed,” Tut says.
He thanks the HKF clinic for providing free health care to the refugees and avers that many refugees would have died without the health facility.
Another refugee at the Morobi camp, Maju Oliver, says he thinks he would be dead by now had it not been for the health care and medication provided by the HKF health facility.
“HKF clinic has helped me and other people here a lot with medication and emergency health care,” Maju explains. “I am a beneficiary because I suffer from hypertension (high blood pressure) and get my medicine from the clinic here. In the past, I used to face challenges in accessing my medicines because the other hospitals are very far away from my camp. So when HKF came here, I started getting my medicine from them here.”
He says his blood pressure has now normalized and that he does not have many health complications like in the past.
About going back to South Sudan, Maju says, “I am not yet ready to go back to South Sudan because I am not yet sure if there is peace there.”
A youthful refugee, Sokiri Simon, says the youth have benefited from the health facility because it provides them with bandages and other free medication when they are involved in sporting activities.
“I stay in Block 6 here in the camp. The HKF health center helps us with medical drugs at no cost. When we the youth go for sports activities, especially to play football, they also supply us with bandages, liniment, and pain killers,” Sokiri explains. “They also treat the youth who get injured during sports activities. This is how we youth have benefited from the HKF clinic. The only problem is that at times they run out of medicines.”
HFK Staff
The medical clinical officer who is currently in charge of the HKF clinic in Morobi Refugee Camp, Jansuk Robert, echoes the challenges mentioned by his boss, Dr. Dumba.
“We face a few challenges here like inadequate medical drugs and equipment supplies in the way that we have a lot of patients, these days between 150 and 160 in a day, and the drugs we are given to last a month run out before that time. This is the major challenge,” Jansuk says. “The other challenge is that of transportation. We do not have a vehicle or ambulance to handle emergency referrals and to transport critical patients to the health center or referral hospital.”
He says when faced with emergencies, they resuscitate the patient and or give first aid and advise them to go to the nearest health center.
“It is so traumatizing and worrying that we do not know what will happen to the patient along the way because their condition may worsen,” Jansuk explains. “We are a health center 2 so we do not admit patients but see out-patients. We just stabilize and refer patients in critical conditions or with complications. For pregnant women, here we provide antenatal care only but they go and deliver at the health center 3.”
He says the facility lacks proper infrastructure and that this exposes both the patients and the health workers to risks.
Jansuk says, “Malaria leads among the prevalent diseases here followed by watery diarrhea and skin diseases among children. The adults mostly suffer from gastritis (stomach ulcers) and urinary tract infections.”
He adds: “Poor nutrition among the refugees also manifests as malnutrition. Inadequate food affects their health. Most of the refugees are also psychologically stressed.”