Dr. Robert Speaks About Delivering Care in Nakaseke

African Community Center for Social Sustainability (ACCESS), formerly known as Nakaseke Community Development Initiative (NACODI), is a registered non-profit community- based organization located in the Nakaseke region of Uganda.  ACCESS has a medical clinic, Nakaseke Lifecare Center, situated in a rural area on part of a 17-acre piece of land.  It was founded in 2002 by a group of three medical workers who wanted to support the orphans and people living with HIV-AIDS (PLWAS) in Luwero, Uganda.  At the time of its inception, there was no center to provide medical services for patients with HIV who had to be referred to Kampala or Kiwoko Hospital, which are 60 and 18 km away respectively.

In addition to treating HIV-AIDS, the center was opened to the public for general medical care in 2004.  The clinic offers voluntary counseling and testing, which is a major entry point in the care and management of HIV-AIDS, and has a small laboratory to carry out simple diagnostic tests for common diseases like malaria.

The medical center has the capacity to admit six patients at a time, but sometimes can become overwhelmed by extremely sick patients who then become ‘floor cases’.   As well, many patients cannot access the clinic due to the long distances they must travel, lack of transport, and being too ill to leave their homes.  Through a grant from Action Medeor, we have been able to train community volunteers who conduct community outreach and home visits to patients in 85 villages.  These volunteers also help with the school outreach programs, in which students are taught the prevention of common illnesses, including sexually transmitted diseases and HIV-AIDS.  Some of the trained community volunteers are youth from schools who act as peer educators within the schools.

The center currently has four staff and two volunteers.  Its director, Dr. Robert Kalyesubula, a medical doctor with special training in the field of HIV-AIDS and Nephrology, heads the center and clinic.  A full-time clinical officer and a manager oversee the daily activities.  The center also has two nurses and one nursing assistant who is a volunteer from the community.  These nurses work directly with the doctor and the clinical officer in providing counseling and treatment to patients.  They also participate in community outreach and provide home visits to bed ridden patients, whenever transport is available.  The center also has a laboratory assistant, who is in charge of our small laboratory.  In addition we have two support staff, one of whom is a volunteer.  These triple as cleaners, guards and farm managers.  An advisory board is led by a local leader, Rev Father Kyeyune, the head of the Kiziba Catholic Diocese.  Other board members include a Physician from Mulago Hospital and a social worker, who is also a director of African Children’s choir in Uganda, an organisation which looks after orphans.