Uganda experienced decades of political, economic, and social collapse beginning in the late 1960s. The Uganda-Tanzania conflict in 1979 plunged the country into years of terrible civil strife. With his rise to power in 1986, the current President of the Republic, Yoweri K. Museveni, gradually restored peace, the rule of law, and economic recovery to most of the country, with the exception of the north, where the Acholi people live.
St. Mary's Lacor Hospital is located in northern Uganda, a region where a violent rebellion ended only in 2006. At the end of the conflict, more than 95% of the population in the north had been living in camps for internally displaced persons for years, lacking basic necessities.
Today, the Acholi region remains one of the poorest in the world. According to the Uganda Bureau of Statistics (2019-2020), 80% of households cannot afford sufficient and healthy food; 56% of the population lives below the poverty line, 78% live in thatched huts, and 84% have dirt floors. See Multidimensional Child Poverty in Uganda.
The COVID-19 pandemic has exacerbated poverty (a 30% increase in rural areas) and led to an increase in school dropouts, especially among girls. Added to this are major gaps in essential infrastructure (running water, sewage, electricity). With the exception of two or three national roads, the roads are dirt tracks and many become difficult or even impassable during the rainy season. The resulting travel difficulties can make illness or childbirth dramatically riskier.
As highlighted in a recent report by the World Health Organization (WHO), the incidence of catastrophic health expenses is extremely high in low-income countries. This indicator informs Sustainable Development Goal (SDG) 3.8.2, to be achieved by 2030. It represents the proportion of families who spend 10 to 25 % of their annual household income on healthcare — it should be noted that the poverty line in Uganda is 3.00 USD per day (2021—purchasing power parity). In Uganda, 40% of current health expenses is incurred by poor families, mainly for the purchase of medicines and hospital care.
This is where St. Mary's Lacor Hospital makes a difference. Its main effort is to subsidise the cost of care so that people in the region can seek treatment knowing that they will have to contribute the equivalent of a few chickens or a few bags of beans, but without having to choose between selling their home and land or foregoing care so as not to ruin their family.
The generosity of donors enables the hospital to subsidise 75% of its patients' healthcare costs and to provide medical care that does not lead to destitution or exacerbate existing poverty. The hospital therefore plays an essential role in the region, not only in the areas of health, of medical staff training and of development, but also in combating poverty by providing affordable access to healthcare and being an employer of choice.
What is the hospital
A sophisticated organisation with over 600 employees that continues the mission of its pioneers, Dr Lucille Teasdale and Dr Piero Corti. Professional men and women make up the medical and nursing staff. Many work in collaboration with the local university and national government to train new professionals. The hospital staff are very familiar with the common health problems in the region, whether due to environmental or social factors.
The hospital lacks resources, especially financial ones. It operates in a poor region of a poor country. It prevents its clients from being ruined by the cost of healthcare.
What the hospital is not
The Hospital is not a hut in the savanah, nor a place where a healthcare system can be set up with three-year projects, regardless of the sustainability of the measures implemented, focusing sometimes on one disease, sometimes on another. We cannot have a healthcare system based solely on what donors want to fund. Everything must be consistent and adequately funded.
The hospital is not an organisation lacking in experience, analytical and management skills. Its leaders are not ill-intentioned, poorly trained and ready to accept any form of aid, regardless of its relevance to local problems.
