As in other parts of sub-Saharan Africa, the medical situation in Uganda is very bad. Life expectancy is under 50 years, one in five women dies in or because of labour and one in eleven children does not reach five years. In the Mukono district alone, thousands of people a year die of infectious diseases that are easy to treat, such as diarrhea, malaria and pneumonia. Children die of dehydration caused by diarrhea, even though plenty of clean water is usually available. This type of loss of life occurs only because of a combination of lack of knowledge and inaccessible medical care. Since only 40% of all people live within 5 km of a nurse or doctor or other form of healthcare, reaching medical care is both expensive and difficult. In Mukono, there is one doctor for every 19000 inhabitants. As a result, people seek medical attention only when it is too late. Most people entering a hospital in Uganda can no longer be treated. Even in Uganda, (almost) everyone can borrow some money to travel to a hospital, but people only do so when they are absolutely certain that it is necessary. It is therefore important that people can find out whether it is necessary closer to their homes. Simple treatment and diagnosis in the villages would make a huge difference.

This projects will develop primary medical care in Mukono that meets the local conditions and requirements, exactly where it is needed. MediStructures consist of two parts. During the first part, we give basic medical trainings to women from different villages in the district. One woman per village is trained to recognize the most common diseases, and is taught how to treat some simple medical problems. The women learn how diseases such as malaria, HIV, diarrhea and tuberculosis can be prevented, but also how a wound can be kept sterile or when water is safe to drink. The courses are given by local medical staff, assisted by medical students from Europe and under the responsibility of the head of medical staff of the district. The women learn the basics of which disease is serious and which symptoms are harmless, and become a source of medical knowledge on return to their villages.
The second phase of the project starts half a year after each training. We then conclude which women provided most effective medical care, and where that care was most needed. Some participants may for instance live not far from an existing clinic, so that their village already had better access to medical care. In other places, were the need was critical, we construct small clinics, or 'health centers'. Both a nurse and a midwife will work in these health centers, which will also offer some laboratory diagnostics, a clean labour ward, an immunization programme and treatment for a large variety of prevalent diseases. The medical trainings are given such that we can allocate a health centre for each 7500 inhabitants of the district. With this strategy, medical care becomes available for everyone. An important aspect of the project is that all costs after the construction are covered by the government (Ministery of Health). These costs include salaries, medication and any tools needed in the clinic. With this guarantee, the project will not fall apart the moment the construction is finished. Instead, MediStructures realized a sustainable network of healthcare in the region. Although the long-term costs are covered, SYPO will stay involved in the project to invest in the cooperation of the clinics and future trainings for the nurses.