Children’s Surgical Hospital in Entebbe
EMERGENCY’s latest project and our second pillar of ANME programme.
EMERGENCY’s Children’s Surgical Hospital in Entebbe opened in April 2021 and offers free paediatric surgical care in a country where more than half of the population is under 15 and the infant mortality 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, tripling the number of paediatric surgery beds in the country, and improving the life chances of hundreds of patients every year.
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 as all the auxiliary services such as a canteen and a laundry. It also has a guest house, a free-of-charge accommodation for patients and families coming from afar.
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Training Local Staff
One of the centre’s most important long-term goals is to turn out 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.
Part of the activity at the hospital are training sessions for Ugandan staff, the aim of which is gradually to reduce the number of foreign staff working on the mission and hand over more responsibility to locals.
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.
What is ANME?
In 2007, we took part in a highly innovative cooperative healthcare project. Its aim was to bring excellent healthcare to Africa, and to affirm through action the right of every human being to free, high-quality medical treatment. The Salam Centre for Cardiac Surgery in Khartoum, Sudan, was the first totally free cardiac surgery centre in Africa, providing medical and surgical assistance of a high standard to children and adults with congenital and acquired heart conditions.
The Entebbe Children’s Surgical Centre is the second facility in the ANME network.
EMERGENCY’s Regional Programme means that patients from over 30 countries have been referred to ANME facilities.
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Gino Strada, surgeon and founder of EMERGENCY, and Renzo Piano, one of the most famous architects in the world, set themselves the challenge to combine excellent surgery and excellent architecture. The result of this combination is 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.
When is a hospital a decent hospital? When it’s capable of treating your child. End of story. Anything else is just hot air. If it’s good enough for your child, then it’s good enough for Ugandan, Afghan and Sierra Leonean children too. But if your child is in need and the first thing you think of is how to rescue him or her, then you’re taking advantage of someone. And we’ve never liked that. That’s never been our way of doing things.
Gino Strada at EMERGENCY’S XV national meeting in Genova, 2016
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 was built with excavated earth. Load-bearing walls were made of raw earth using the traditional rammed earth. Rammed earth is a simple and cheap construction method. We planned to maximise its ingenuity by using the same architectural principles used for traditional houses in an innovative way.
The hospital is equipped with 2,500 solar panels, which will provide a portion of the electricity needed by the building, in order to reduce energy usage.
As in other EMERGENCY hospitals, there is a garden, with 350 trees. Green areas are an important part of patient recovery and healing, as recent international medical studies have shown.
Ebola in Uganda: our measures to protect EMERGENCY’s facility, staff, and patients
On 20 September, the Ugandan authorities announced an outbreak of Ebola in Mubende district, about 25 miles from the capital Kampala. On 12 October, the first death in Kampala was confirmed. In order to protect our facility from the virus, and in order not to interrupt treatment of patients, from the very beginning, we have implemented protocols to contain the spread of the virus. Ebola containment measures result from our expertise and skills in treating patients in the midst of epidemics, honed in Sierra Leone during the Ebola outbreak of 2014 and 2015. We have set up an isolation tent outside the Children’s Surgical Hospital, where a specialised team (doctors, nurses, cleaners, hygienists) puts into practice all the proper protocols.
Thanks to this complex, made up of several sectors, we are able to intercept suspicious cases and, if needed, temporarily isolate them in a ‘red zone’, and to then refer to a government facility that can handle their hospitalisation.
Start of clinical activities: April 2021
Patients Average Age: <6
Patients Visited: 12,851
Surgical Interventions: 1,905
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 June 2022)