Five Year
Report
2021-2025
January 1, 2021 – December 31, 2025
During
this first year of full-time operation, Pius Health Clinic succeeded beyond our
expectations! With PHC up and running, we have fulfilled Immy Rose’s late
father, Lawrence M. Kiondo’s, request that a health clinic be established on
his rural property in eastern Uganda in order to provide not-for-profit health
services to villagers.
During 2021, 699 patients were seen: 385 Females, 314
Males. A total of 781 illnesses were treated. There were 628 Outpatients and 71
Inpatients. Four births took place.
In November 2021, construction began on a new medical wing
at PHC. The Atlanta Wing would have two wards (male and female), a maternity
room, a minor surgery room, a medical storeroom, and a kitchen. (See an image
of the wing floorplan and other images of PHC buildings, grounds, and staff at
the end of this report.)
During the 2021 First Quarter of operation, we hired a
clinical officer (nurse practitioner), a nurse/midwife, and a laboratory
technician/nursing assistant. A night watchman, janitor, and gardener were also
employed. Free child vaccinations began and continue to the present.
During the first quarter of the year, a refurbished desktop
computer, printer, and computer desk were locally purchased. Also, medical and
administrative reporting procedures were established for the clinic.
The first child was born at PHC in Quarter 2! Also, during
the second quarter, professionally embroidered smocks and nurse’s uniforms were
locally made and provided to the professional and support staff. Staff were
also provided with photo ID badges. A Government of Uganda clinic license was
procured, and the clinical officer’s license was renewed.
During the Third Quarter the first COVID patients were
treated at PHC. Uganda Ministry of Health protocols and recommended procedures
were followed. Statistics on COVID patients treated were captured under the
category of “Other Illness.”
Capital improvements during Quarter 3 included the placing
of culverts connecting the PHC campus to the road. Prior to this, entrance into
the clinic grounds by car was impossible in the rainy season. Most patients
walk to the clinic. Additional medical equipment was also purchased in Q3 –
blood pressure testing machines, IV drip stands, and beds. In July we held our
first Zoom meeting with PHC professional staff.
Also, during Quarter 3, PHC began receiving and disbursing
free nutritional supplements and over-the-counter medical supplies provided by
a local Uganda NGO, Bamaayi Community Development Initiative (BACODI).
During Quarter 4, construction of a new PHC wing, the Atlanta Wing, was fully underway. It is hoped the new wing will be open by Easter 2022.
2022
During
2022, Pius Health Clinic’s second full year of operation, 978 patients were
seen, an increase of 38% over 2021! Including occasional weekend emergency
patients, this equaled an average of four patients seen per day. During the
year 595 females and 383 males were treated.
A total of 1,029 illnesses were treated in 2021. There were
872 outpatients and 106 inpatients. The ratio of females to males and
outpatients to inpatients remained approximately the same, females being the
majority. Seventeen births took place at the clinic, compared to four in 2021.
During the year PHC grew in terms of its buildings and
grounds improvements. Construction began on the Atlanta Wing in November
2021 and was completed in March 2022. As we always do at the clinic, building
materials are procured locally to reduce cost and support the local economy.
All paid labor is from the village where PHC is located.
Capital improvements during 2022 also included laying a
concrete paver courtyard connecting the main reception building, Atlanta Wing,
the lab, and the new laundry bay. Paver sidewalks were also installed
connecting the main reception building, the new wing, and the latrines. Pavers
reduce the amount of mud and dirt tracked into clinic buildings.
After an unusually heavy downpour and the partial flooding
of the PHC campus, a brick stormwater barrier wall was erected on the eastern
border of the campus. A second large rainwater catchment tank was purchased and
installed next to Atlanta Wing. Ceramic tiling was completed inside the Atlanta
Wing, the lab, the main reception building, and the latrines. Privacy screens
were made locally and placed in the women’s and men’s ward. Cabinets, some with
locks, were locally made and placed in the medical storeroom, the surgery, the
maternity room, and the lab.
In terms of staffing, we hired a clinic administrator, Robert Musungu. Robert lives near the clinic and came highly recommended by an eminent local community leader. Admin Robert is in charge of the petty cash account and payments received and made. Patients only pay for medicines, bandages, etc. at cost. The petty cash is audited and certified at the close of each day by the nurses and Robert. The Admin is also engaged in purchasing medicines, equipment, and supplies, and overseeing the maintenance of the buildings, equipment, and grounds. Medicines are purchased from the petty cash fund on a replenishment basis. Since coming onboard Robert has completed an inventory of all PHC medicines, medical supplies, office and medical equipment, and furniture. Robert reports directly to Executive Director Immy Rose.
2023
and Beyond
Our
minor surgery/treatment room within the new Atlanta Wing did not open in 2022
as we had hoped. A surgery bed/table, surgery equipment and supplies, and an
additional cabinet were needed. Minor surgeries continued to be done in a
corner of the clinical officer’s consultation office in the main reception
building. At year’s end, our clinical officer, Dr. David Soita, began
researching the cost of locally purchasing or making the surgery bed/table, and
other surgery room needs. When we open the surgery room in 2023. Dr. Soita will
conduct minor surgeries and treatments there.
After the Atlanta Wing, no new buildings or other capital expansion are anticipated. PHC, in 2022, became a clean, high quality six-bed, not-for-profit health facility meeting local health care needs.
2023
During
2023, Pius Health Clinic’s third year of operation, 875 patients were seen, a
decrease of about 10% from the 978 patients seen in 2022. During the year 499
females and 376 males were treated. The number of males increased by
approximately 11% in comparison to females. A total of 932 illnesses were
treated. There were 743 outpatients and 132 inpatients. Nine births took place
at the clinic, compared to 17 in 2022.
Without a scientific survey of the patients who visited the
clinic, it was not possible to know precisely why total patient numbers
declined, why the ratio of men to women patients increased, or why the number
of births declined.
Anecdotally, head nurse/midwife Jalia Namutosi reported
that many patients, despite PHC’s minimal charges, cannot afford to pay their
bills in full and resort to “clinic shopping.” That is, they run up a bill at
one clinic then go to another clinic and do the same. This is understandable in
a subsistence family economic sense. Money income for subsistence families in
the area averages less than $500 per year. Money is earned primarily through
hiring out one’s labor and the small-scale selling of farm produce and staples.
Some families supplement their income by setting up small roadside shops to
sell a variety items and internet/phone airtime. Money is needed for children’s
school fees, school uniforms and supplies, farming equipment and supplies,
small shop supplies, clothing, medicines, entertainment (including local brew),
etc. Anywhere savings in the family budget may be found, families take them.
We were not overly concerned with the 10% drop in the total
number of patients treated at PHC during 2023. The clinic is operating within
its capacity just as we intended it to. The increase in proportion of men
patients at PHC is probably a reflection of the leadership of women who have
found the clinic to their liking.
In May 2023, Immy Rose visited the clinic to confer with
the staff, observe medical and administrative operations, and inspect campus
buildings and grounds. She brought with her portable medical instruments and
handed them over to the clinic.
During the third quarter of 2023 we completed the construction of a storage building at the back left corner of the clinic grounds. This building stores building and grounds maintenance equipment and supplies, patio furniture, and other bulky non-medical items. Admin Robert supervised the construction of the storage unit. His effective supervision reduced the need for Immy Rose’s detailed oversight from across the continent and ocean.
2024
During
Pius Health Clinic’s fourth full year of operation, 2024, 591 patients were
treated. This decreased from 875 in 2023 and 978 in 2022. During 2024, 358
females and 233 males were seen. A total of 634 illnesses and injuries were
treated. Other care/treatment included baby deliveries. Four births took place
at the clinic during the year, compared to nine in 2023 and 17 in 2022. During
2024, 472 outpatients and 119 in-patients were treated.
The decline in patient numbers and baby deliveries has
become a trend. “Clinic shopping” continues to influence lower patient numbers
and fewer deliveries at PHC. Patients clinic shop to avoid paying for even the
most minimal medical service charges. Another factor influencing decreasing
patient numbers and births at PHC has been the ongoing proliferation of
government and other small private clinics such as PHC in the Eastern Region.
After four full years of operation, we are concerned about
the continuing drop in the total number of patients treated at PHC. From an
all-time high of 978 in 2022, PHC treated 591 patients in 2024. Immy Rose and I
planned to visit Uganda during the year to confer with PHC staff, observe
medical and administrative operations, and inspect campus buildings and
grounds. Reasons for the decline in patient and birth numbers and what might be
done to increase them were also to be discussed with staff. Regrettably, for
reasons beyond our control, our visit had to be postponed.
There was a bit of shocking news at the clinic. At year’s
end our Dr. David Soita at the clinic was assaulted and robbed at night at
his home, about 3-4 miles from the clinic. The assailant inflicted a
severe wound on the doctor's head. He subsequently spent time as a patient at a
hospital near Mbale City. We were in touch with his wife, and all is being done
to help him and his family. Dr. Soita made a full recovery and returned to
work.
On a positive note, nurse/midwife Jalia gave birth to her own baby girl in late December 2024, and both continue to do well.
2025
During
the First Quarter of 2025, 128 patients were treated at Pius Health Clinic.
Patients included 78 Females and 50 Males. There were 108 outpatients and
twenty inpatients seen during the quarter. Illnesses and injuries treated
totaled 130. There was one infant delivered during the quarter.
The number of patients seen at the clinic
increased from Q4 2024 to Q1 2025, from 111 to 128, respectively. However, from
151 in Q1 2024 to 128 in Q1 2025, there was a marked reduction in the number of
patients seen at the clinic. As noted in previous reports, this decline is the
result of a combination of factors. First, despite the minimal charges at PHC
to cover the cost of medicines, patients’ budgets are stretched to a point that
subsistence farming rural families continue to engage in “clinic shopping.”
Another possible factor could be that the health services provided at PHC have
lowered the number of local patients with chronic and recurring illnesses.
Another factor, also mentioned in previous reporting, has
been the late 2023 upgrade of a formerly run-down government health clinic 7km
away from PHC that now offers completely free, government subsidized, health
care. However, in terms of cleanliness, efficiency, and immediacy of
professional health care services, including around-the-clock availability for
infant delivery and pre- and postnatal care, PHC remains unequalled within a
20km radius of its location. Nevertheless, we are considering lowering all
patient fees for medicines and medical supplies (bandages, etc.) to zero at PHC
thus making it a free clinic. Dr. Soita felt that doing so might overwhelm PHC
with patients. Such a change will remain under consideration.
During the Second Quarter of 2025, April 1 – June 30, 2025,
124 patients were treated at Pius Health Clinic. Patients included 75 Females
and 49 Males. There were 100 outpatients and 24 inpatients seen during the
quarter. Illnesses and injuries treated totaled 128. There were four infants
delivered during the quarter, one of which was a stillbirth.
During the Third Quarter of 2025, July 1 – September 30,
2025, 159 patients were treated at Pius Health Clinic. Patients included 90
Females and 69 Males. There were 137 outpatients and twenty-two inpatients seen
during the quarter. Illnesses and injuries treated totaled 171. There were
three infant deliveries during the quarter. Sadly, one was an abortion.
During the Fourth Quarter of 2025, October 1 – December 31,
2025, 142 patients were treated at Pius Health Clinic. Patients included 80
Females and 62 Males. There were 114 outpatients and twenty-eight inpatients
seen during the quarter. Illnesses and injuries treated totaled 155. There were
no deliveries during the quarter. There was one abortion, in December.
At the end of December, Nurse/Midwife Jalia Namutosi
resigned. Jalia has been with PHC for all of its first five years of operation
and has contributed much to the clinic’s success. We thank her and wish her all
the best as she pursues opportunities more suited to her career goals.
To replace Jalia, Immy Rose has recruited and hired a second clinical officer who will enter on duty in January 2026. She also hired a full-time lab technician.
SUMMARY
During
its first five years of full-time, not-for-profit operation, Pius Health Clinic
established itself as high quality health care facility with a sustained
reputation for cleanliness, professionalism, and superb medical treatment. Over
this period, PHC staff have treated nearly 4,000 illnesses and injuries of
nearly 3,700 patients. By 2024 and 2025 the number of patients seen was between
about 550 and 600 per month. In a twenty-day work month, with a little added
for emergency care over weekends, a median of 575 patients works out to be an
average of three patients per day.
With
the early 2026 hiring of a second clinical officer and full-time lab
technician, whose patients at their former places of employment have begun
following them to Pius, we expect the average number of patients to rise
slightly. Given the constraints of six beds and four members of the medical
staff – two clinical officers, a nurse/midwife, and a lab technician – we
estimate PHC can now adequately treat an average of 5-6 patients per day.
The professional staff of PHC began with a clinical officer
a nurse-midwife, and a laboratory technician/nursing assistant. PHC Executive
Director Immy Rose Namutosi Lassiter recruited and hired all initial and
subsequent staff members, with recruitment help from her brother, Dr. Peter
Kiondo. Today PHC employs two clinical officers, a nurse-midwife, a lab
technician, and an administrative officer. Initial support staff consisted of a
gardener, cleaner, and security guard, and remains at the same level.
Improvements have been made over these first five years of
operation in terms of infrastructure, administrative and financial
accountability, and property management procedures. All medicines, medical
supplies, equipment, furniture, and buildings have been procured/constructed
locally. This has resulted in significant savings in terms of avoiding
transportation and import fees for such purchases. For example, patient beds, a
maternity birthing bed, minor surgery table, ward privacy partitions, draperies,
and intravenous drip stands were all made in the vicinity of or near PHC.
Locally procured equipment and furnishings have included: a lab centrifuge,
refrigerator, lockable medicine cabinets, bed sheets, draperies, a medical
trolley, and small solar panels for emergency use during frequent power
outages. Some medical equipment – a microscope, blood pressure tester,
otoscope/ophthalmoscope – were donated/purchased in the US and personally
transported to Uganda by Immy Rose.
Thank you to all the PHC staff for your hard work and
dedication to Pius Health Clinic as an affordable top-quality health facility.
May the coming years be equally successful for you and PHC!
