Children’s Surgical Hospital in Entebbe

Uganda - Entebbe

5

Patients Average Age

2,000

Patients Visited

500

Surgical Interventions

2021

Start of activities

Opened in April 2021, the Children’s Surgical Hospital in Entebbe offers free paediatric surgical care in a country where about half the population is under fifteen and the infant mortality for children under five is 49 for every 1,000 live births. 

The choice we made for the hospital was to create a point of reference in Uganda for paediatric elective 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 will be 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 care50 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 accomodation for patients and families coming from afar.

Healing Architecture

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.

 

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.

Renzo Piano

Sustainability

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 will also be a garden, with 350 trees. Green areas are an important part of patient recovery and healing, as recent international medical studies have shown.

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.

Following the launch of this project, EMERGENCY brought together health ministers from nine African countries in 2008 to discuss how to guarantee their citizens the right to free, high-quality healthcare. The conclusions made at the conference were published in the “Manifesto for a Human Rights Based Medicine”, which states the need for healthcare systems founded on Equality, Quality of treatment and Social Responsibility. It was on the basis of these principles that the African Network of Medical Excellence (ANME) was founded in 2010. The network’s goal is to create a network of Centres of Excellence that will strengthen the continent’s healthcare systems and provide a united response to the region’s health problems.

The Children’s Surgical Centre is the ANME’s second milestone. 

AKSHAL’S STORY

Akshal was one of our first patients arrived at the hospital. His father stopped our systems technician, Livio, on the road, 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.

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