Maternal Child Health, HIV, and Realities of Health Access
Uganda, located in the Nile basin of Eastern Africa, has the 20th highest maternal mortality rate and the 15th highest infant mortality rate in the world according to the World Health Organization. The majority of people live on less than $2 per day. It’s estimated that only 30% of women give birth in settings with a trained health professional. Given high incidences of malnutrition, anemia, HIV/AIDS, malaria, and other diseases, many pregnant women are at risk of complicated births that lead to illness or death. Children under five are also at risk of contracting preventable diseases and suffering from acute malnutrition.
Become a part of the community in Kabale, a town located in southwestern Uganda, and learn about their groundbreaking, integrated approach to addressing and improving maternal and child health. Due to insufficient government infrastructure and funding, nonprofit organizations have taken the lead in providing access to healthcare services, especially in remote regions.
In collaboration with CFHI’s local partner you will rotate through the main general clinic, as well as the newly built Maternal and Child Hospital where you will take part in rounds with physicians, nurses, medical officers, lab and ultrasound technicians. At the HIV/AIDS clinic, sit in on counseling sessions, assist health workers with testing and learn how to reduce rates of mother to child transmission. Conduct outreach in a rural village and explore how nutrition and HIV are closely linked. Other opportunities include rotating at a nutrition center that treats and prevents maternal and child malnutrition, visiting traditional birth attendants and healers, and joining a local radio program that provides public health education to the community.
Clinical Rotations & Public Health Placements
CFHI’s partner in Uganda is a health, education, and economic development NGO that was started and grown by local Ugandans - currently operating a Primary Care Clinic, HIV/AIDS Clinic, Nutrition & Rehabilitation Clinic, and Maternal & Child Hospital in Kabale-town.
Primary Care Clinic- Learn from dynamic health teams including nurses, medical officers, X-ray technicians, laboratory technicians, a dental officer, and hygienist. This clinic provides health education, preventative care including vaccinations, disease detection and diagnosis, and referrals for more serious cases. Cost of services is based on a sliding-fee scale, although the majority of patients are low-income and receive treatment free of charge. In southwestern Uganda, the doctor to patient ratio is 1 to 100,000, so you will see first hand how important multidisciplinary teams members are, in getting people access to healthcare and health education. You will witness “task-sharing” where the roles usually carried out by doctors are done by nurses, clinical officers, community health workers, and others.
HIV/AIDS Clinic- Rotate alongside family planning specialists and HIV positive peer educators, who provide medical treatment and social/emotional counseling for HIV positive patients. Clinic staff work in innovative ways to reduce rates of mother to child HIV transmission, and increase awareness and accessibility of HIV/AIDS treatment and family planning options.
Nutrition & Rehabilitation Center- Located across the street from the Primary Care Clinic, the Nutrition & Rehabilitation Center provides inpatient re-feeding and rehabilitation for severely malnourished children five and under. You will learn how the delicate process of bringing up a young child’s level of protein, calories, fats, and other nutrients happens. Engage with teams at the center who also work closely with caretakers to offer education and outreach on the prevention of malnutrition.
Rural Communities (Village groups, schools, churches, etc.)- Collaborate with community groups and partners in rural areas working on programs to improve health and economic livelihood. Programs provide families with livestock, seeds, farming tools, and education on sustainable organic farming methods. Interact with traditional healers, birth attendants, women’s groups, people living with HIV, farmers, and others, in dialogue and development activities.
CFHI is considered a global health ethics leader, therefore, CFHI programs uphold strict standards and comply with all local laws regarding student involvement in health settings. Your experience on the program depends on your previous clinical training and the relationship you build with your supervising preceptor. Above all, YOU are the most important factor in making the CFHI experience as fulfilling as possible by being respectful, inquisitive, and open to the wide variety of learning experiences which you will encounter.
The southwestern region of Uganda is known as the “Switzerland” of Africa because of its hilly geography, and high number of lakes and rivers. Because of its high altitude, around 2,000 meters (6,600 ft), Kabale is known as one of the coldest locations in Uganda. There are two rainy seasons: April to the end of May, and September to the end of October, though Kabale receives moderate rainfall year round.
Kabale is located in southwestern Uganda, only 20 kilometers from the Rwandan border. Kabale is the capital of the Kabale District. The population is approximately two million people, with the majority of people residing in rural villages, practicing smallholder agriculture and earning less than $2 a day.
Things to Do
Located a mere 4 miles from Kabale-town, Lake Bunyonyi is believed to be the second deepest lake in all of Africa and boasts over 25 islands. Kabale is also a convenient base for the two parks famous for mountain gorilla tracking. Bwindi Impenetrable Forest is home to more than half of the remaining endangered populations of mountain gorillas, as well as approximately 300 species of birds.
An independent tour company, Kigezi Tours, offers guided travel on weekends to many of Uganda’s national treasures, including Queen Elizabeth National Park. Enjoy safari game drives and boat-rides down the Kazinga Channel—this is a once-in-a-lifetime opportunity to see lions, leopards, chimpanzees, elephants, and hippopotami in their natural habitat. Profits from these excursions are put towards our local partner's healthcare programming.
Accommodations & Homestays
Participants stay in apartments, which comfortably house four people per apartment and two people per bedroom. Apartments include a living room, two bedrooms, and two bathrooms. Beds, bedding, mosquito nets, and bathing towels are provided. Accommodation also includes 3 meals a day and filtered/bottled drinking water.
Apartments are located in a safe neighborhood in Kabale, and have 24-hour security. The apartments are located only a five-minute walk from the Primary Care Clinic, HIV/AIDS Clinic, and the Nutrition & Rehabilitation Center. Walking is very safe in Kabale during daylight, but not after dark. Power and running water outages are common in Kabale, so participants should come prepared with flashlights, batteries, and patience for such outages. Water will be provided should there be a shortage.
Eligibility: Who Can Apply?
This is multi-faceted program ideal for a range of students including medical students/residents, allied health students, as well as pre-health undergraduates, anthropology and social work majors. Non-students are also eligible. To confirm you are eligible, please read CFHI's general eligibility requirements.
Language Required: English
While Uganda’s national language is English, it is a multicultural and diverse country with 52 dialects spoken and many cultural groups. The cultural group in Kabale is the Bakiga people, who speak a local language called Rukiga. CFHI partners and volunteers speak English, though in rural villages, the most common language is Rukiga. Participants will have the opportunity to learn basic Rukiga, though they will utilize translators, especially during rural outreach.
Participants should plan to arrive on the designated arrival date (a Saturday) and depart on a Saturday. If you wish to arrive before the program start date or depart after the program end date, you must contact firstname.lastname@example.org to determine if lodging and transport are available on your preferred dates.
Participants should arrive in Kigali, Rwanda on the program start date and will be picked up from the airport by a CFHI representative. Stay overnight in a safe and secure hostel room. On Sunday, participants may visit the Genocide Memorial in Kigali before departing with CFHI local partners to cross the border by vehicle and travel 2-3 hours to reach the program site in Kabale. A welcome orientation will take place the Monday after arrival.
All US citizens should apply for a Ugandan tourist visa in advance. More information will be provided by CFHI after acceptance into the program.
- Guidance from CFHI staff in San Francisco before departure
- Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc.
- Pre-Departure training including historical, geopolitical, cultural, ethical and other need-to-know preparatory info
- Airport pick-up upon arrival and transportation to program site in Kabale with local CFHI representative
- Welcome gathering and orientation with other participants covering safety, transportation, and other logistics
- CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
- Weekly reflection meetings
- Weekly lectures on global health topics related to program
- Placement and coordination of clinical/public health activities
- Preceptor/mentor at clinical/public health sites
- Local Medical Director overseeing your entire clinical/public health experience
- Accommodation and two meals a day
- Local cell phone
- International emergency medical and evacuation insurance
- Transportation to program activities outside Kabale
- Rural outreach program sponsored by your program fee
- CFHI Alumni status- including ongoing global health educational offerings, news about global health educational/leadership opportunities and fellowships
- Post-Return program evaluation
- Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically underserved health systems. Read more.
Meet the Local Team
Dr. Geoffrey Anguyo- CFHI Kabale Medical Director: The role of CFHI Medical Director is to arrange clinical and public health placements, supervises participant experiences at these sites, provide weekly lectures, and assist in medical issues experienced by participants. The CFHI Medical Director is the expert on socioeconomic determinants of health in the region and healthcare delivery strategies in low-resource settings.
Dr. Anguyo is the Founder/Executive Director of CFHI’s local partner, a Ugandan non-profit organization that prides itself on the creation of an “Activated Community." Dr. Anguyo has been practicing medicine for over twenty years in Uganda, working in government hospitals, private clinics, and through non-profit healthcare delivery. His specialty is HIV/AIDS. Dr. Anguyo grew up in Northern Uganda. As a child, his family was displaced by political violence, fleeing to Congo DRC. These early experiences were formative, and today Dr. Anguyo remains committed to developing practical solutions to improving healthcare and livelihood in Uganda. Dr. Anguyo is currently working on his Doctorate in Public Health at Bath University in the United Kingdom.
The role of the CFHI Local Coordinator is to organize housing, transportation, orientation and weekly meetings. The CFHI Local Coordinator is a great resource for any questions related to navigating the program locale, cultural norms, and tips on planning weekend travel.
KIHEFO’s Local Coordinator is Caroline Kyampeire. She is a native of Kabale District and has worked with the Kigezi HealthCare Foundation since 2008. Caroline is a social worker with a BA in Social Work and Social Administration and has professional experiences in community mobilization, civic engagement/empowerment, advocacy, and policy analysis.
In addition, she has a special interest in working with marginalized groups including widows, the elderly and orphans in helping them realize their capacities towards improving their livelihoods.
Caroline is a result oriented team player who enjoys multitasking–she has implemented several projects in health, Agriculture, and civic empowerment.
What Alumni Say
"This was my first global health trip and it was definitely a life-changing experience. I built many new relationships that will be life-long connections. The Kihefo staff was like a second family to me. We had breakfast, lunch, and dinner together, and played soccer and/or card games in the evenings. Before attending this program I was aware of how social determinants affect underserved populations from the classes I had taken and articles that I have read, but to actually be part of the experience is very eye-opening. I have bigger dreams and goals to achieve since being in Kabale and also have a different perspective in life on what is important and what is a luxury" Read more on Eva Kisakye's review
--Eva Kisakye, Public Health/ Pharmacy student (PharmD) at Belmont University (Alumna, October 2017)
"This is the way to experience global health! I was forced to put my own assumptions aside and learn to think about health from a different perspective. I left Uganda with a new sense of purpose and a renewed passion for global healthcare." Read more of Courtney's review.
-- Courtney James, Senior Resident (Alumna, November 2015)
"Our group consisted of a variety of students from diverse backgrounds. For those of us who were medical students, time in clinic was a priceless experience. For those with public health backgrounds, there were many chances for involvement through projects conducted at the request of KIHEFO. For example, a few of us were able to complete a literature review of cervical cancer while another student is currently evaluating the success of the rabbit project that provides rabbits as a source of income and protein for malnourished children and economically disadvantaged families..." Read more on Selemawit's blog.
-- Selemawit Ghebrendrias, MS-1 (Alumna, June 2015)
"HIV/AIDS and Maternal/Child Health are two of the biggest global health challenges of our time. The experience of traveling to a place different in so many respects than all you've come to know is so incredibly enriching and paves the way for significant personal and professional transformation..." Read more on Lyndsey's blog.
-- Lyndsey Brahm, Prospective MSc International Health (Alumna, November 2013)