Peace but no prosperity

But there are certain inadequacies, especially in health care.

Field officers expressed fear over continuing services when the government takes over the facilities, as it has not been living up to its obligations.

It is a classic example of teething problems encountered in transitional phases.

Donor organisations swap substitute doctors for government workers.

“We provide only those drugs that the government has not got, or build and rehabilitate neglected health centres. We work with government nurses, whom we train in health and management skills,” said Thilo Guettler, a water and habitat delegate of the ICRC.

Jovana Ajok, the officer in charge of Lugore Health Centre II, in Palaro sub-county, said there were four government workers in the facility serving an area with about 6,200 people.

She runs the centre on a target-chart system introduced by the ICRC, where targets are determined by the population in relation to government targets — such as first time outpatients, antenatal cases, immunisation and those with ailments like malaria and HIV.

“With this chart, I can tell how many people to expect at the clinic. For instance, 5 per cent of the population of women in an area is usually pregnant. From that, I can tell how many maternity visits to expect each month. I work with village health volunteers and we usually meet the target,” said Ajok.

ICRC has built three two-bedroomed houses at the health centre for the staff, the kind of houses going for Ush200,000 ($100) per month in Gulu town.

The health centre is well stocked. But Ajok is worried about what could happen if the clinic is handed over to the government.

She recalls a case where the government delivered coartem, an anti-malaria drug, two years after the requisition was made.

I found out that Care International, another development partner, had built this health centre as a three-roomed block, and later handed it over to the government.

When delivery of services deteriorated, the ICRC came in.

It restocked the centre with medicine and built an additional block for wards, staff quarters, an incinerator and a refrigerator, to store vaccines. It also fenced off the centre.

My next stop is Labworomor Health Centre III, in the same sub-county.