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3. Description of the Benefitting Community
Mbarara District in Uganda is the benefiting community. Mbarara is located in southwestern Uganda. It is 2,900 square miles (approximately the size of Los Angeles County) and contains 2.4 million people. The population is 92% rural and 8% urban. Average per-capita income in Mbarara is $240 per year. Malaria is the number one cause of death in children under five years of age in Uganda, followed by respiratory infection and dysentery. Over 60% of all under-five deaths are due to these three diseases, which are all treatable.
4. Description of benefiting community and needs identified
Until July 2009 there was no dedicated children's hospital in all of Uganda. Mbarara community wanted a hospital focused on children, since children's bodies react differently to illnesses and treatment than adult bodies.
Phase 1 of the hospital (60-bed in-patient facility, outpatient/immunization facility and administrative offices) opened in July 2009. Since then over 12,000 children have been treated at the hospital - over 2,000 in-patients and over 10,000 outpatients.
5. In 2007 a San Diego-based IRS 501(c)(3) non-profit called Holy Innocents Children's Hospital Uganda, Inc. (HICHU) began raising money to build a children's hospital in Mbarara. HICHU partnered with the Catholic Archdiocese of Mbarara, which donated the land and already runs two adult hospitals and 18 clinics in Mbarara.
6. Needs Identified
The specific identified need that can be addressed by Rotary is a drainage system to facilitate malaria abatement at the existing hospital compound site. Holy Innocents Children's Hospital is built on an 8-acre parcel in the Nyamitanga area of Mbarara, Uganda. The ground slopes generally though unevenly downward from the south to the north at an average 1-2% grade. At the higher southern end are hospital staff residential structures, a garage and warehouses. The hospital's in-patient building, outpatient/immunization facility and administrative offices are in the middle of the property. At the lower northern end are ancillary structures, including a mortuary.
Drainage has been a problem since the hospital opened in 2009. Uganda has two rainy seasons, March through May and October through December. During rainstorms standing pools of water appear all over the compound. After the rains cease, standing water remains and becomes a breeding ground for malaria-carrying mosquitoes. The lower northern portion of the property gathers 2" - 3" of standing water during rain storms, which takes a long time to disappear.
7. HICHU also partnered with University of San Diego (USD), which has sponsored six feasibility/ medical/ teaching missions to Mbarara since 2007 involving USD faculty and graduate students onsite in Mbarara. Many other organizations are involved, including Rotary Club of Fallbrook, which sponsored the acquisition of X-Ray equipment for the hospital in 2009. The private, not-for-profit hospital is owned and operated by Mbarara Archdiocese.
• San Diego-based International Relief Teams in working to identify a suitable civil engineer to volunteer his or her services to assist in developing the plat plan (any travel/living expenses for the engineer will be funded outside the Rotary grant).
8. Explanation of how needs are currently being addressed and how proposed activities will further address needs:
Drainage has been partially remedied in the higher southern part of the compound with 18" to 36" open dirt trenches which channel water away from the residential compound and around the hospital. However, the lack of gutters on most structures causes unwanted moisture near the buildings. Moreover, the trenches are open (i.e. not filled with crushed rock) and, since they are made of dirt, they erode and become uneven and result in standing water after rains, again providing a breeding ground for mosquitoes.
The hospital has implemented the use of window screens (not typically used at other local hospitals), bug lights and insecticide-treated nets over each in-patient bed to safeguard children at the hospital. The new drainage system will complete the picture and make Holy Innocents Children's Hospital a model of best practices for malaria abatement/drainage/sanitation.
9. The benefitting community of Mbarara has confirmed that it desires this project. District 9200 has signed the MOU for the project, and several leaders of Holy Innocents Childrens Hospital have confirmed their desire for this project.
10 & 11. The proposed activities will address Rotary Foundation's areas of focus in the following manner:
* Disease Prevention and Treatment: The new drainage system will eliminate standing water which currently serves as a breeding ground for malaria-carrying mosquitoes. It will also serve as a runoff channel for fecal-contaminated ground water which is a further contaminant to the population.
• Water and Sanitation: Removal of standing water will provide a more sanitary environment within the hospital compound and will decrease the incidence of fecal coliform infections.
• Maternal and Child Health: The drainage system will provide a healthier environment for children coming for treatment at the hospital, decreasing malaria infestation of mothers and their children as well as decreasing secondary contaminates during hospitalization.
• Economic and Community Development:
o The drainage project will be completed by workers from the local community, who will benefit economically from the work.
o The hospital has already acquired the reputation as the best medical facility in the area for a child who is ill. The hospital is a source of pride for the entire community; schools bring their children to tour the hospital to see the progress the community has made in treating child illnesses. This drainage project will further enhance the attractiveness of the hospital and give the community a sense of pride, accomplishment and security.
12. To provide a long-term solution to the drainage issue, the following is needed:
• A civil engineer specializing in drainage matters to evaluate the terrain and develop a plat plan
• Grading the compound
• Installation of new drainage, including
o Gutters on all buildings and drainage away from the buildings and into drainage channels
o Concrete culverts where necessary
o French drains filled with crushed stone
o List of any cooperating organization(s) or university(ies) involved
A local Ugandan construction company will be selected to implement the proposed activities. A leading candidate is Block Technical Services Ltd. of Mbarara, which was the general contractor for the hospital construction.
13. Sustainability and Measurability
o Description of intended outcomes and how involved parties will ensure their sustainability.
The intended result of this project is a properly functioning drainage system that efficiently and effectively removes excess water from Holy Innocents Children's Hospital's compound site, thereby enhancing sanitation in the compound and facilitating malaria abatement.
Once in place, the system will be largely self-sufficient, requiring only periodic maintenance. It will be monitored regularly by the hospital grounds keeping/maintenance staff, and inspected annually. Maintenance will be funded by Mbarara Archdiocese.
14 & 15. Estimated start and completion dates
This project will begin as soon as the Rotary funding as available. The plat plan design is expected to be completed one month after project start, and the grading, gutters and drainage system are expected to be completed two months thereafter.
16. Approximate Budget
The budget for this project is $38,000 to $43,000.
17. General Financing
Rotary Fallbrook is providing $6,000. The total amount of requested Global Grant funds, including Rotary Fallbrook's contribution, is $33,000. The remaining $5,000 to $10,000 will be funded by San Diego-based Holy Innocents Children's Hospital Uganda, Inc.
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