Children’s Surgical Hospital in Entebbe
Free Surgery for Children in a State-Of-The–Art Facility
In 2021, EMERGENCY opened the Children’s Surgical Hospital in Entebbe to provide free paediatric surgical care in a country where more than half of the population is under 15 and the mortality rate for children under five is 43 for every 1,000 live births.
The hospital is a point of reference in Uganda for elective paediatric surgery, with operations planned in advance and organised through waiting lists in order to systematically tackle deep-set problems in Uganda and nearby countries. The hospital’s three operating theatres are used for surgery every day and improving the life chances of hundreds of patients every year. The opening of the Children’s Surgical Centre led to a tripling of the number of paediatric surgery beds in the country.
Elective surgery mainly deals with birth defects, urological and gynaecological problems, abnormalities in the gastrointestinal tract, illnesses of the bile duct and cheiloschisis (or cleft lip, which affects one child in 800) and other pathologies of more general surgical relevance.
The facility boasts 100,000 square feet (9,700 m2) of floor space, 72 beds – six for intensive care and 16 for sub-intensive care – 50 beds in the ward, one observation and stabilisation ward, six outpatient clinics, a diagnostic centre, a laboratory for analysis, a blood bank, a pharmacy, as well auxiliary services such as a canteen and a laundry. It also has a guest house: free-of-charge accommodation for patients and families coming from afar.
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Training Local Staff
One of our most important long-term goals is to help produce a generation of trained, qualified young Ugandan doctors and nurses, who will in turn help build local skills and leave a long-term mark on the country’s healthcare.
Activities at the hospital include training sessions for Ugandan staff, which aim to gradually reduce the number of foreign staff working on the mission and hand over more responsibility to local colleagues.
At the moment there are about 350 people on the local staff, almost 200 of whom are doctors, nurses and other medical workers. Ugandans comprise 80% of the medical staff and 95% of the non-medical staff.
The African Network of Medical Excellence
The Children’s Surgical Hospital in Entebbe is the second facility in the African Network of Medical Excellence (ANME). ANME is an initiative between EMERGENCY and more than a dozen African health authorities to develop an integrated network of high-quality, free medical centres across the continent.
The Children’s Surgical Hospital provides – completely free of charge – elective paediatric surgical care according to the most advanced international standards and making use of the latest innovations, while simultaneously working to promote the autonomy of the Ugandan national healthcare system. Additionally, the facility’s Regional Programme will create critical connections between different health systems to integrate the network and encourage collaborations.
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The Regional Programme
Through the Regional Programme – and in collaboration with numerous local authorities – EMERGENCY’s medical team will begin to conduct regular screening missions to identify patients from a vast area who require transfer to Entebbe for urgent paediatric surgery, and guarantee the necessary follow-up care for patients who have already been operated on.
The Regional Programme will also coordinate between medical centres and health systems, bringing young medics to the hospital for specialist training periods. These collaborations will strengthen and increase the long-term sustainability of the local, national and regional health systems.
Our project began when Gino Strada, surgeon and founder of EMERGENCY, met Renzo Piano, one of the most famous architects in the world. Their challenge was to combine excellent surgery and excellent architecture, two disciplines that, on the surface, do not have much in common. The result of this combination was healing architecture.
The concept of healing architecture is very simple. Beauty is not just an aesthetic choice, it is part of treatment. It can have a physical and mental effect on patients and so play a part in healthcare. One of the guiding principles of the project was the idea of a hospital that was not just functional and efficient from a medical point of view, but also “scandalously beautiful.” It would respect the dignity of the patients and their surroundings.
Every detail of the hospital was built with children in mind. The walls are covered in pictures, colour is everywhere, large windows fill the rooms with light and the garden offers a place to play. All these things were designed to convey peace and safety, to make our young patients feel at home. They reflect something that to us is essential: putting patients, their needs, their personalities, their fears and their rights, at the centre of everything.
What most struck me that day was something Gino said: “I want a scandalously beautiful hospital.” Those two words together were the perfect plan, not to mention a promise: we would bring the best of our skills, all the facilities, technologies and resources needed. As Gino says, it is a duty to share the best results we have achieved, be it in medicine, surgery or architecture.
The Children’s Surgical Hospital is a project of medical, health, economic and environmental sustainability.
The facility’s load-bearing walls are made of rammed earth, a simple and cheap construction method. By applying the architectural principles used in traditional house building, we maximised the facility’s ingenuity and environmental efficiency.
The hospital is also equipped with 2,500 solar panels, which provide part of the electricity needed by the building, reducing energy costs.
And, as in our other EMERGENCY hospitals, there is a garden, with 350 trees. Beautiful green spaces are an important part of patient recovery and healing.
Start of clinical activities: April 2021
Patients Average Age: <6
Patients Visited: 14,470
Surgical Interventions: 2,125
Activities: Paediatric surgery, paediatric first aid.
Facilities: 3 operating theatres, 1 sterilisation room, intensive care, sub-intensive care, admissions ward, 1 emergency ward, 6 clinics, radiology, laboratory and blood bank, CAT, pharmacy, administration, auxiliary services, guest house, welcome and medical education area, outdoor play area.
Bed spaces: 72
Bed spaces (guest house): 36
International staff members: 6
Local staff members working on construction: 60+
Solar panels: 2,500
Area occupied by the centre: 9,000m²
(Data correct as of December 2022)
Akshal was one of the first patients to arrive at our hospital. His father stopped our systems technician, Livio, on the street, after spotting the EMERGENCY logo on his T-shirt. He asked him if what they were saying was true, that the new hospital was treating children free of charge. His four-year-old son was losing the use of his left hand due to a burn that had turned into a scar, and he could not find the money for the operation. Livio, with his customary frankness, told him that his job was to fix the pipes. He did not know if we would be able to do something about Akshal’s hand, but they could certainly come to the hospital and have it looked at. Akshal’s operation went well. The day after he was already scampering up and down the corridors between the wards, with his mother and the nurses hot on his heels.