onsdag 4 december 2013

Delegation trip to Zambia and Uganda, November 25-29 - part II

Next stop Uganda

Wednesday evening November 27
Upon arrival in Kampala, we reunited with the delegation for a late dinner with briefings from the Embassy on the situation in Uganda and the programme for the remaining two days of the delegation trip. In Kampala, two more companies, Solarwave and Cavidi joined the group and were introduced. The programme in Kampala was as packed as the one in Zambia, with the extra challenge of Kampala traffic.

Thursday November 28
Many Ugandan politicians have themselves lived, or have relatives who lived, in Sweden during the fighting in the 70’s. One example is the Minister of Trade, Industry and Cooperatives, H.E. Amelia Kyambadde, who lived in Gothenburg for 5 years. She welcomed us to her Ministry on Thursday morning, in Swedish. She gave us an informative and efficient snapshot of Uganda of today, and what the areas with investment potential are.

[caption id="attachment_12667" align="aligncenter" width="540"]Delegation and Minister for Trade Delegation and Minister for Trade[/caption]

The morning’s second meeting was with the Ministry of Health, where the Minister Honourable Dr. Ruhakana Rugunda welcomed us. We first had presentations and and as the two ministers had bilateral discussions, the rest of the group participated in breakout sessions focussing on clinical services, communicable disease, quality assurance and community health. The quality of the group discussions varied, but serveral of the companies formulated action points together with the ministry officials, and got valuable contact information to the persons responsible for their areas of interest.

[caption id="attachment_12668" align="aligncenter" width="540"]Meeting at MoH Meeting at MoH[/caption]

The afternoon was dedicated to a Swedish-Uganda Health Care Conference, similar to the one held in Zambia. The Minister for Health participated and opened the Conference, after a welcome and introductory remarks from the Ambassador Urban Andersson and Göran Hägglund. Our key note speaker in Uganda was professor Stefan Peterson, whi spoke about the epidemic of NCDs and the challenges it poses for the health system. The health system must be better equipped to map and monitor the NCD epidemic, to prevent and manage those diseases.

[caption id="attachment_12669" align="aligncenter" width="540"]Attentive audience Attentive audience[/caption]

Dr. J. Orem from Uganda Cancer Institute updated us on the situation on infection-related cancers in Southern Africa and Uganda in particular. Many bacterial and viral infections of the population is one important explanation to the high incidence of certain cancers in the region, e.g. cervical cancers related to hiv infection or Burkitts lymphoma, related to a certain herpes virus. There was interaction between the audience and the speakers through time for questions and answers after each session.

Communicable diseases is a focus area for Uganda Health Marketing Group (UHMG). Their managing director, Ms. Emily Katarikawe, spoke to us about how they work to fulfil their vision of improving the quality of life of all Ugandans by providing essential, superior, and affordable health care solutions through innovative social marketing, strengthening of private sector health service delivery through their network of franchise clinics and increased access to drugs and supplies and by forging partnerships. Sarah Wamala mentioned among other things the high fertility rate in Uganda; at 6.1% it’s the second highest in the world after Niger – compared to 1.9% in Sweden.

[caption id="attachment_12670" align="aligncenter" width="168"]Emily Katarikawe, UHMG Emily Katarikawe, UHMG[/caption]

Media was also present during the conference, and the companies were interviewed by newspapers, Maria was interviewed for national television and I participated, together with Paul Voigt from Cavidi, in a one-hour direct radio broadcast show about the delegation and various other health-related topics.

[caption id="attachment_12672" align="aligncenter" width="540"]Paul Voigt and Anna Riby on air Paul Voigt and Anna Riby on air[/caption]

The conference was ended by a reception, allowing possibilities for the companies to mingle and present themselves in more detail to the participants. There were appr. 130 of them in total, quite a good number. After the conference the official delegation headed home, while the rest of us stayed on for a Friday filled with interesting meetings.

Friday November 29
Our final day in Uganda and of the delegation started with a visit to the private hospital, International Hospital Kampala, where we also heard interesting information about the other companies in the IMG group. We toured the 110-bed hospital as well, and got e.g. a peek into the well-equipped 12-bed ICU. We had a nice chat over coffee/tea, with the IMG representatives, which resulted in quite a lot of mutual interest and contacts to follow up on.

[caption id="attachment_12677" align="aligncenter" width="540"]ICU International Hospital Kampala ICU International Hospital Kampala[/caption]

The contrast between the modern and well-equipped and well-staffed IHK to Mulago Hospital was quite stark. Mulago has officially 1500 bed (but often cares for the double) and is the national referral hospital. In reality they cater for patients needing primary, secondary and tertiary care. We met with the hospital director and many of the heads of directorates and consultants.

[caption id="attachment_12678" align="aligncenter" width="540"]Mulago Hospital main entrance Mulago Hospital main entrance[/caption]

The group again divided into four groups; one visiting Uganda Cancer Institute, one to Infectious Disease Institute and 2 touring some departments at Mulago itself. Some of us also got a special, unofficial tour by a visiting Swedish doctor and got some inside information from her. The hospital had been cleaned before the ministerial meeting, according to her, but still it could not disguise the overcrowding, with women in the maternity ward sleeping on the floor, and relatives filling the corridors. The hospital was built in 1962, when Uganda’s population was approximately 7 millions and it has not been expanded since, even though the population now reached 37 million. Other challenges include dysfunctional referral system, inadequate budget for special supplies and staff-related issues, such as shortage of superspecialist doctors, constricted staff structure and low salaries.

At Uganda Cancer Institute we met with the director Dr. Orem Jackson who told us about the ambitious plans for cancer care in Uganda. Similarly to Mulagalo Hospital, Uganda Cancer Institute has now not grown since 1967. but the Ugandan Governmnet is currently putting up a modern cancer clinic that will turn into a national center of excellence. In the near future Uganda will also establish regional- and community cancer centers.

After lunch we were off to Nakasero Hospital, which started its operation less than 5 years ago. According to its CEO, Mr Abed Malik, the hospital has already established itself as a leading hospital in Uganda. The number of outpatients almost doubled during the first 5 months of the year, so there is cause to believe him. They are expanding their services, the latest addition being a dialysis unit. Based upon our visits to IHK and Nakassero it is clear that the private hospitals in Kampala are constantly expanding and that there is great interest for our Swedish health care companies.

[caption id="attachment_12679" align="aligncenter" width="540"]The Nakasero Hospital pharmacy The Nakasero Hospital pharmacy[/caption]

Swecare in cooperation with the Ugandan  company The Medical Concierge Group, organized a eHealth networking session with the purpose of sharing experiences in the area, improving new and existing solutions and making new contacts. Both Swedish and Ugandan companies held presentations, followed by a lively panel discussion. There is clearly a strong belief that eHealth/mHealth can support health care workers and patients in Uganda, in areas such as electronic health records, data collection, health information and education.

[caption id="attachment_12680" align="aligncenter" width="540"]Helena Samsioe presenting at e-health workshop Helena Samsioe from Helseplan presenting at the eHealth workshop[/caption]

In conclusion, the trip to Uganda and Zambia was very succesful and we have experienced a growing health care sector with a lot of interest for our Swedish solutions. Dont hesitate to contact Swecare if you are interested in these markets and would like to be participate in future activities.

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