“I pray for the Bulamu team every night before going to bed so that they will continue to provide services to many other patients like me.” – Francis, referred and treated for complex leg fracture he suffered from since 2011, through Bulamu’s Angel program.
Francis after recovery!
Bulamu provides and improves access to surgical care for low-income patients in multiple ways – through our Surgery Intensive program, through the Angel Program, and through our CST and Essential Surgical Supplies programs. Thanks to our ongoing partnership with the Association of Surgeons of Uganda, we are able to organize care that is provided locally for the rural poor, while also ensuring this care is supervised by some of the leading surgeons from their country.
Since 2016, Bulamu’s surgery program has treated more than 9,700 total patients directly at no charge. This includes more than 4,300 surgery patients treated and supported in 2021. In 5 years, Bulamu’s teams have performed or arranged essential surgeries for thousands of patients, including for hernia repairs, goiter removal, C-sections, cataracts, and many other procedures. Of the different services Bulamu provides, our surgery programs often have the greatest impact on patients’ lives. While primary care is generally free within Uganda’s MOH system, patients are often expected to pay for surgeries that most families cannot afford.
Surgery Intensive Programs
In addition to treating thousands of patients directly, Bulamu’s Clinical Support Teams identify and register patients who may need surgical care. Each CST program in a district is then followed by a 5-day Surgery Intensive (SI), where a 40-person Bulamu surgical team comprising surgeons, clinicians, and support staff bring the necessary supplies and treat 200-350 surgery patients at a Health Center IV (district community hospital). Patients who need care are screened and undergo lab tests in advance, while patients who cannot be safely treated within this approach are referred for care at other hospitals. In 2021, Bulamu and ASOU conducted 8 Surgery Intensive programs, treating more than 2,500 patients directly.
In 2022, 8 Surgery Intensive programs are scheduled once again, each in partnership with the Association of Surgeons of Uganda who provide the supervising attending surgeon for each SI program, as well as supporting other patients’ care and referrals when needed.
For patients who need more specialized care, Bulamu refers them to the best available partner hospitals in Uganda for their conditions and covers their transportation and surgery expenses through the Angel program. We regularly transfer patients in need to four leading hospitals in Uganda that offer specialist care: CURE Hospital in Mbale (Pediatric Neurosurgery), CoRSU Hospital in Entebbe (Orthopedics, Burns, Plastic Reconstruction), EMERGENCY Pediatric Hospital in Entebbe, and Mulago Hospital in Kampala (cancer and other acute illnesses). Our partnership relationships allow patients to be pre-admitted, while Bulamu supports the expenses of patients we refer as needed in order for the patients and their families to access this care.
Surgical Care Provided by Clinical Support Teams and Essential Surgical Supplies
In 2021, Bulamu’s CST doctors performed 502 surgeries, of which about 90% were C-sections. Finally, through Bulamu’s new Essential Surgical Supplies (ESS) program, we provided surgical supplies to partner health centers that performed more than 1,800 surgeries, which in many cases were only possible because we had given them uninterrupted access to supplies.
Bulamu’s focus on Maternal and Child Health and continuing to expand surgical access for the poor through multiple interventions will remain at the heart of our work this year and beyond. Through a combination of clearing bottlenecks (such as the ESS program’s ensuring C-section supplies are always in stock) and using timely data to find best practices and ways to improve (which the HCE program supports), as well as by partnering with global surgery leaders and publishing on the work that we do together, we are confident that there are substantial ways to improve surgical access for the poor. As with everything that we do, the key lies in effective partnerships and continuous improvement.