Staff inLower Mulago Antenatal Clinic

Mission
To provide specialised quality health care to women with Urogynaecology disorders, enhance training and conduct research

Vision
To become a leading centre of excellence in quality specialised health care delivery to women with Urogynaecology disorders/ birth trauma inAfrica.

Objectives
1. To provide consultation on comprehensive management of female patients with birth trauma, urinary incontinence and uterovaginal prolapse including associated complications.

2.To provide medical and /or surgical treatment of incontinence associated with or not to conditions of the female genital tract and rectum.

3.To provide Urogynaecology in an institutional setting where all effective forms of therapy are available. This includes comprehensive management of urinary incontinence including screening, diagnosis, therapeutic procedures, follow-up and rehabilitation, advice on prevention, teaching and research.

The unit also has ward and theatre nurses/midwives, who have had specialised training in care and counselling of Urogynaecology patients. Also on a rotational basis the resident doctors/medical and nursing students participate in the daily activities including outpatients’ linic, operation room, post operation care and community activities.

Location
1) The unit has a 14 bed ward (carved out of mulago ward 11) that has bed occupancy of about 200% (floor cases as they are prepared for surgery). There are

2) operation tables in a theatre currently shared between VSC and Urogynaecology. The Division now has an annual theatre output of more than 300 patients per year, most of them being obstetrics fistula, and stress incontinence and uterovaginal prolapse.

3) The friday Urogynaecology clinic is run weekly on 5^th floor (above casualty in GOPD) and over 400 patients are seen annually including outreaches.

4)  To use obstetric fistula as a catalyst to advocate for mprovement in maternal/perinatal care and hence reduce on the current figures of maternal and perinatal mortality. This will involve outreaches into villages, communities and rural heath units.

Staff
The division is currently headed by Dr Barageine Justus and has three other specialist senior staffs i.e. Dr Susan Obore, Dr Alia Godfrey and Dr Mwanje Haruna. All the specialists are Obstetricians and Gynaecologists. These have in addition undergone specialised training in genital fistula repair and management of complications.

Ward 11
Collaboration/Funding of Activities

The treatment is free to patients and the unit mainly depends on the supplies and other inputs from MOH/Mulago hospital. Facilitation in terms of equipment, supplies not in the hospital stock and outreaches is mainly from AMREF, UNFPA and Previously Engender Health. The training of personnel was also done by the above partners.

Challenges
As a growing unit, it has number of challenges e.g. lacking enough skilled man power, inadequate space, inadequate specialised equipment (diagnostics, surgical and rehabilitation). The work load is much which is a result of poor maternity services in the country. There is no full time lecturer among the staff. However the unit looks forward to a better future with the plan of Mulago III.