Bulamu Healthcare’s 2019 Annual Report Letter
Friends and Supporters:
In these difficult times, our first hope is that everyone reading this is staying safe and in good health. The situation today in Uganda is like many other countries, with everyone working from home. Because of the scarcity of ICU beds and ventilators in the country, Uganda’s leaders took strong steps in late February before the first COVID-19 case was even reported there, shutting down their international airport and issuing a strict stay-at-home order for all but essential medical and food supply workers. As a result, cases remain low and are increasing only slowly. Bulamu’s team moved quickly to donate protective equipment to health workers in Sheema District, our partners in the HCE program, including PPE that many other districts lack.
Despite the global pandemic, this is the appropriate time to share with you our 2019 Annual Report: Healthcare Delivery Innovation in Africa, which features 10 patient stories and 14 tables of facts about Bulamu’s work. The tremendous progress we have made over the first four years of our history is summarized in this table:
Most importantly, we want to share the impact Bulamu has made in the lives of people who have often gone months or years without access to quality healthcare.
A Few Highlights from 2019
We revised our mission statement this year—To treat the sick and strengthen health systems serving Africans most in need—to emphasize that we are both directly providing medical services to the rural poor and orchestrating systemic change at government health facilities through our innovative Health Center Excellence (HCE) program. Some highlights:
- Bulamu’s 5 Supercamps treated 61,588 patients in 2019 at a cost of $6.03 per patient, including surgeries. These patients received a total of 140,836 services, for an average of 2.3 services per patient. This breadth of services is one of the unique features of our camps.
- Between our Supercamps (1284) and Angel Program (149), we performed or sponsored 1,433 surgeries this year, dramatically changing and sometimes saving lives on an incredibly cost-effective basis.
- After receiving our training, Village Health Team (VHT) workers in the five districts followed up with 17,327 medical camp patients in their homes, of whom 22% needed referral to their local public health facilities.
- We installed the HCE Program at 26 government hospitals and clinics treating more than 200,000 patients per year for an initial cost of $.85 per patient touched and a projected cost of $.30 per patient in subsequent years. This technology-based management system provides officials with a weekly dashboard of 51 Key Performance Indicators and measures clinician productivity for the first time.
- With the diagnostic equipment we have provided in Sheema, health workers at 26 facilities are now able to take vital signs as part of their standard of care, but compliance remains a work in progress. In a recent survey of 5,206 outpatients treated post-HCE launch, the number given blood pressure tests had increased from 3% to 39%. More importantly, 23% of those tested had Stage 1, Stage 2, or Crisis level hypertension, a diagnosis that would have gone undiscovered previously. We expect to extend the HCE program to at least one additional district in 2020.
People in the U.S. often ask about the quality of healthcare being provided at our medical camps, which are staffed entirely by Ugandan doctors and nurses. One visiting American doctor, Andrew Griffin MD, who recently joined our board of directors, made this observation: “The clinicians I encountered were impressively competent and compassionate. All of them were from Uganda, and it’s a tribute to their medical system’s training that they seemed on a par with physicians I have encountered in the States and elsewhere.”
A Strong Start in 2020, Until…
We started 2020 strong at the February Supercamp in Budaka District, where we treated a record 17,206 patients at a cost of $5.10 per patient. The “True Value” of those services is $29.90 when converted to fair market value prices in Uganda, or 5.9 times our out-of-pocket cost. If the same services were being provided in the U.S., the cost might be 100 times greater. We build this leverage into our model by partnering with local district governments and an ecosystem of 15-20 other agencies and NGOs in a free exchange of services. They come because of the efficiency of treating so many patients at one time and place. We are confident this momentum will continue as soon as the country opens up again.
Bulamu’s longer-term strategy is to build on our partnerships with Uganda’s local government districts and the Ministry of Health in order to strengthen their existing health system. With 3200 government hospitals and clinics treating 45 million people in an area the size of Oregon, Uganda does not need more bricks-and-mortar facilities. Instead, they need better clinical practices and patient records, more diagnostic devices and computers, improved management systems, and a culture of caring—all key elements in the Bulamu HCE Program.
We increased our Board of Directors to 10 members and our Advisory Council to 18 members in 2019. Of these 28 highly educated and experienced professionals, 18 are medical doctors or have public health or nursing degrees; 6 are Ugandans and another 12 have lived or worked extensively in East Africa. Also noteworthy, our 2019 financial statements are audited by PKF International, a global firm with an office in Uganda, where our operations all take place.
We thank our donors in the U.S. and program partners in Uganda for their support of our efforts to improve the lives of so many Ugandans in need. At this challenging time the health of the world’s population depends on the frontline medical workers who utilize their skills and demonstrate their courage in daily acts of service, among whom our dedicated Ugandan team will do their part.
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