I’m hoping to raise £6,500 to equip four health centres in Uganda with alcohol handrub to reduce the spread of infection and help save lives.

我希望可以籌得£6,500，幫助烏干達四間健康中心配備酒精搓手液，減低傳染病擴散的機會，挽救生命。

**向下滾動至中文版本**please scroll down for Traditional Chinese version**

Help Us Save Lives!

Sanitizing our hands keeps our patients safe.

Alcohol hand rub is a convenient and effective routine hand hygiene practice in healthcare settings, especially when soap or a source of clean running water is absent. The pharmacy team in Uganda has the skills and knowledge to produce the handrubs in-house, but they are running out of raw materials.

Your help can save lives, and any amount will help! We have set a goal of £6,500 to secure supplies for six months, but we would be grateful for any support exceeding that amount.

How It All Started - Cambridge Global Health Partnerships In Uganda

I learned about this overseas placement in Uganda from a flyer in December 2023. To be honest, I wasn’t entirely sure what I had signed up for. I had little idea of what kind of impact I could make. Fortunately, I got this opportunity, and experiencing it firsthand has made me a believer.

From February to May 2024, I had the privilege of spending three months in Kampala, Uganda, on a project with Cambridge Global Health Partnerships (CGHP). For those unfamiliar with CGHP, it is a charitable organization dedicated to improving healthcare worldwide. Since its inception in 2007, CGHP has been enhancing healthcare in low- and middle-income countries (LMICs) through health partnerships. CGHP believes that learning should be reciprocal—while we aim to improve health outcomes abroad, the experiences gained by UK healthcare providers through these partnerships can also inspire changes in our local practice. Currently, CGHP has multiple partnerships across the globe, including in Africa and Asia. There are many impressive stories of how lives are impacted by these partnerships, which you can read about here.

I have personally learned a lot from this journey. I feel privileged and fortunate that I can help. Many less fortunate individuals in other parts of the world have kind souls and want to make an impact but are unable to due to their circumstances. This journey has also made me reflect on what matters most in life. Staying healthy is crucial for everyone, and it is not as straightforward as it may seem. Health inequalities still negatively impact many lives—people in low-income countries suffer from high rates of illness, particularly infectious diseases. Because of these experiences, I want to give something back to this amazing country that has helped me grow.

First Impressions of Uganda

Uganda is a landlocked country in East-Central Africa, known for its beautiful landscapes, including rainforests and mountains. It is home to more than 5,000 plant species, 380 mammals, 1,000 birds, 150 reptiles, and 90 amphibians. Uganda also has a sizable population, close to 50 million, with about 5 million people living in Kampala. By 2040, Kampala’s population is expected to soar to 11 million, more than double its current size.

On February 24, 2024, I embarked on my journey to Uganda with two microbiologists, an infectious disease consultant, and two behavioural scientists from the UK.

We first visited a national referral hospital and four primary care health centres, speaking with healthcare workers to understand how we could help. We were impressed by the effort they put into delivering the best service possible given their resources. However, the reality is grim—the facilities are overwhelmed by the volume of patients. For instance, you might find four tiny preterm babies being nursed in one incubator. Resources to manage the enormous patient flow are also inadequate. Supplies of alcohol hand rub and soap are insufficient. Some health centres are routinely supplied with 20 litres of alcohol hand rub every two months, but they only last for a week or two. Sometimes they run out of gloves, and there are times when there is no running water from the tap.

I should also mention that these health centres are not like the typical GP surgeries we imagine—they are more like mini-hospitals serving a large catchment area. Some health centres are situated in the vicinity of the most deprived and densely populated neighbourhoods, which house the population that experiences the most health inequality in the nation. One of our health clinics takes care of 400 outpatients and 30 inpatients a day. These clinics also provide birth delivery services, and some even provide caesarean sections due to the very high fertility rate in Uganda (4.58 births per woman, compared to 1.56 in the UK and 0.77 in Hong Kong).

As you can imagine, conducting invasive surgery like caesarean sections under these limiting conditions is far from ideal and makes the surgery riskier than it should be. In sub-Saharan Africa, 1 in 100 women who undergo a caesarean section will die. For context, the risk of death is 100 times higher than for women in the UK.

Antimicrobial Resistance Affects You, Me, and Generations Beyond

Suboptimal infection prevention and control (IPC) has led to another problem—the widespread inappropriate use of antibiotics. We observed that antimicrobials are often prescribed because clinicians are not confident about the hygiene in the health facilities. Broad-spectrum antibiotics are used for extended periods of time after surgery in hope of preventing infections that may or may not occur. This “just-in-case” approach is way too common.

Misuse of antibiotics has led to serious problems. Data collected in a local hospital suggest that antimicrobial resistance is highly prevalent. This means that many antibiotics that are supposed to be effective for certain infections are now unlikely to work. Known as acquired bacterial resistance, the overuse of antibiotics is a major driving factor for this outcome. We are not expecting many new antibiotic discoveries soon, and even if new antibiotics are developed, access to them in developing countries is often poor; it may take years, if not decades, for new antibiotics to become readily available at an affordable cost.

The impact of antimicrobial resistance is long-lasting and can affect all of us and our future generations. By 2050, it is predicted that antimicrobial resistance will cause 10 million deaths per year globally and push 28 million more people into extreme poverty due to increased healthcare costs, prolonged hospital stays, and time off work.

Our Plan Needs Your Help

To combat these challenges, we have conducted a baseline assessment to better understand the situation and provided workshops to improve the healthcare workers’ understanding of IPC principles and theories. However, we also acknowledge the dire need for IPC materials in these health centres.

IPC can only be effective if there is sufficient tangible support to translate theory into practice. Hand hygiene is one of the most effective ways to prevent the spread of infection. Our plan, therefore, is to raise funds to provide the materials they need for better infection prevention. The team in Uganda has the skills and experience to manufacture alcohol handrub locally at a much lower price than commercially available preparations, based on World Health Organization (WHO) guidelines. However, they will need support to purchase the raw materials.

To manufacture 20 litres of WHO-recommended handrub, it will cost around 270,000-300,000 Ugandan Shillings (approximately £60 or HKD$600). The cost of raw materials fluctuates depending on demand. During COVID-19, prices were higher, but they have now stabilized, although future fluctuations are hard to predict.

We estimate that all four health centres will consume 18 x 20L of alcohol hand rub monthly. We have set a goal of £6,500 to secure supplies for six months, but we would be grateful for any support exceeding that amount. We will make every penny count and ensure that the money you donate leads to positive outcomes.

Your generosity goes beyond a gift; it ignites hope and drives our mission forward.

Thank YOU!

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

酒精搓手液是一種非常方便而且有效的常用醫療用品。在缺乏梘液或潔淨水源的情況下，其價值尤其重要。

在烏干達(Uganda)的藥劑部同儕擁有生產酒精搓手液的技能和知識，但原材料即將用盡。任何捐助都有所幫助！我們的目標是籌集6,500英鎊，以確保六個月的供應，亦感激超過這個數額的支持！

海外服務的機會

2023年12月，我從一張傳單上得知這個機會。坦白說，一開始我並不完全清楚自己可以帶來什麼改變。幸運的是，我得到了這個機會去嘗試以及體驗。

從2024年2月到5月，我有幸參與Cambridge Global Health Partnerships (CGHP)在烏干達首都 康培拉(Kampala)的一個項目。自2007年成立以來，CGHP旨在提高中低收入國家的醫療水平。CGHP同時相信通過雙向學習，義工參與者能夠將經驗提升英國的醫療服務。目前，CGHP在全球多個地區，包括非洲和亞洲，擁有多個夥伴關係。按此可以閱讀更多。

健康并非偶然。維持健康需要大量資源。在發展中國家，保持健康在並不像看起來那麼簡單，健康不平等特別是傳染病仍然對許多人的生活造成負面影響。這些經歷令我想回饋這個令我成長的地方。

在地的醫療情況

烏干達是一個位於東中非的內陸國家，以其美麗的景觀，包括雨林和山脈而聞名。這裡擁有超過5,000種植物，380種哺乳動物，1,000種鳥類，150種爬行動物和90種兩棲動物。烏干達還擁有接近5000萬人口，其中約500萬人居住在康培拉。到2040年，康培拉的人口預計將飆升至1100萬，是目前的兩倍多。

2024年2月24日，我與兩名微生物學家、一名傳染病顧問醫生和兩名行為科學家一起踏上了前往烏干達的旅程。我們首先參觀了一間醫院和四間基層醫療中心。在有限的資源下他們對病人的付出我從心底敬佩。然而，現實是殘酷的---設施被大量的患者壓得喘不過氣來。例如，你可能會發現四個早產嬰兒被護理在一個保溫箱中。資源供應如酒精洗手液和肥皂嚴重不足。有些醫療中心每兩個月只獲得20升酒精洗手液，這僅能維持一兩個星期。手套會耗盡，設施有時亦未能提供乾淨水源。

另外我應該要提到，這些醫療中心並不是我們一般認知中的診所。它們更像是一間小型醫院，服務生活於貧民窟的基層市民。有些中心每天照顧400名門診病人和30名住院患者。這些診所還提供順產分娩服務，甚至剖腹產手術。這個與烏干達高企的出生率不無關係(平均每名婦女生育4.58個孩子，對比英國的1.56和香港的0.77）

可以想象，在這些有限的條件下進行像剖宮產這樣的侵入性手術並不理想，令手術風險比平常高。在撒哈拉以南非洲，每100名接受剖宮產手術的婦女中就有1人會術後死亡。作為對比，英國婦女的死亡風險低100倍。

抗生素抗藥性影響你和我

不完善的感染預防和控制導致了另一個問題---廣泛抗生素的不當使用。由於醫療人員對醫療設施的衛生缺乏信心，處方抗生素被用作為一種預防疾病的方法。我們觀察到，在手術後廣譜抗生素處方過長。

濫用抗生素製造了一個嚴重而且影響深遠的問題。從當地收集的數據顯示，抗生素耐藥性非常普遍。這意味著許多理應有效的抗生素對病菌起不了作用。在缺乏抗生素的科研發展以及發展中國家資源有限的情況下，新抗生素可能需要多年，甚至數十年才能以可以在發展中國家普及使用。

抗生素耐藥性不但會影響我們所有人，亦會影響我們的下一代。到2050年，聯合國組織預計抗菌素耐藥性每年將造成1,000萬人死亡，並因增加的醫療成本、延長的住院時間和工作損失的關係，將另外2,800萬人推入極端貧困。

我們需要你的協助

為更清楚了解當地情況，我們進行了基線評估，亦組織了工作坊去加深醫護人員對感染預防和控制理論的理解。然而，我們意識到，除了理論，這些醫療中心亦急需物資。

手部衛生是防止感染傳播的最有效方法之一。因此，我們的計劃是籌集資金，提供他們需要的材料，按照世界衛生組織指南以制作酒精搓手液。在烏干達的藥劑部同儕擁有經驗以及技術，能以遠低於商業價格制作搓手液。

製造20公升的酒精搓手液成本約為270,000-300,000烏干達先令（約60英鎊或600港幣）。原材料價格因需求而波動，儘管未來的波動難以預測，但現在已經穩定下來。

根據我們的估算，項目下的四個健康中心每月將消耗18 x 20升酒精洗手液。我們設立了6,500英鎊的目標，以確保六個月的供應，亦感激超過這個數額的任何支持！我們會善用每一分錢，確保您捐贈的錢能帶來積極的結果。

您的慷慨不僅僅是一份禮物，它亦點燃了希望，推動我們向前。

多謝你的細心閱讀，萬分感激！