In January 2017, FourSum Uganda convened with the residents of Sikuda Sub County through focus group discussions and community theatre performances to discuss the social injustices identified in their community. This sub- county is located in Busia district along the border between Uganda and Kenya; it covers a total of four parishes, Tiira, Buchicha, Skoda, and Ajuket.
These sessions were geared at conveying social issues that were theatrically performed to demonstrate the daily struggles of ordinary citizens. The responses from the community theatre performances were emotional and they opened up the conversation on existing barriers to access health care services. Through this open dialogue, we identified an approach which was to focus on interventions that can produce results in the short or medium terms, and can be implemented at local level, either by health sector solely, or in collaboration with other departments.
There were disheartening health challenges.
Okurut Florence from Adidali village, Sikuda parish, said “….in the entire sub county,there is only [one] sikuda health Centre II, 7km from our village and the nearest health Centre is 5 km located away in a different sub county, Busitema, behind that hill’,she pointed. She expressed concern that it is very difficult for a person in need of emergency responsiveness or who fell sick at night, to get medical attention in time.Transport cost are wild since means of transport available are Boda-Boba at Ushs 10,000 (to and fro), so the majority walk all that long while Carrying the patient”,
“It is particularly evident in Sikuda health Centre II, despite the fact that that is only one health worker he also reports late to work and closes early, making it almost impossible to deal with emergencies”, noted Omonding, a resident of sikuda parish.
He also observed that the health facility receives 50-80 patients per week, but they are not effectively handled and some are excluded from services.Consequently, many are told to return the following day
.“Majority of the drugs are not available in health facilities, promoting the health worker to refer a lot of patients to private clinics, pharmacies to buy such drugs – an indicator of deplorable health services delivery that has left local communities frustrated”, says Omoding.
“Although some access the medicine, patients with Tuberculosis, running stomach, headache,and malaria are all given Coartem and Paracetamol”, he illustrated. The other major concern is that this lone Health Centre II lacks a maternity section. Pregnant mothers opt to be delivered by traditional birth attendants an extremely risky choice; and those with money take their wives as far as Iganga in Uganda or Amogoro hospital in Kenya”
Omonding added that the trained Village Health team have abused their mandate by setting out to sow segregation amongst the people most especially during the national elections period-marginalizing opposition affiliated individuals and /or groupings.
In conclusion, in improving access good health care, FourSum Uganda managed to carry out focus group discussions with local members on issues affecting them regarding social
Injustices and top community leaders to find out the mitigation for the identified social injustices within the community; among which we made enactments of these social injustices in health,Education, accountability, development, social security, and roads and safety to create awareness so that residents of Sikuda Sub County can be able to practice, a strong social position for democratic environment.