Cardiff-Ssese Islands Project
Type of Project
Address community needs and produce sustainable, measurable outcomes
Do any of these committee members have potential conflicts of interest?
Tell us a little about your project. What are the main objectives of the project, and who will benefit from it?
Schistosomiasis is a chronic parasitic disease of man and other mammals caused by infection of Trematodes of the genus Schistosoma. The types in Uganda are Schistosomamansoni which is prevalent in most of the country including Lake Victoria and Schistosomahaematobium which is limited to a few districts in central northern Uganda. The disease is transmitted from man to man through larvae shed by infected snails that live in fresh water bodies. Man is infected while in contact with the infested water while fishing, swimming, playing etc.. The larvae penetrate man through unbroken skin and migrate through blood vessels to the liver, where they mature. For Schistosomamansoni, adults live in intestinal blood vessels where each female worm produces over 300 to 3000 eggs per day. Some of the eggs are excreted in stool and, once reach they reach fresh water, they hatch into larvae that infects snails to begin the cycle again. The remaining eggs are trapped in the body especially the liver causing liver fibrosis and cancer.
For the Rotary supported project, other than providing and equipping an upgraded health centre, it will also support schistosomiasis and soil transmitted helminth (STH) control by improving health centre based management of the diseases and as part of outreach services, support schistosomiasis& STH mass treatment to increase treatment coverage which is persistently very low.
Schistosomiasis problem in Uganda.
Schistosomiasismansoniwas first detected in Uganda in 1909 but thorough investigations occurred between 1950 and 2007. All studies showed the disease to be a serious problem and wide spread particularly along large water bodies including Lake Victoria. One of the studies described the infection to be very intense, more so than any other area ever studied. Hospital records over a 30 year
period between 1951 and 1980 showed this condition to be the first cause of hospital death and the second cause of hospital admissions in adults in north western Uganda. Control of the disease was initiated in 2003 when Schistosomiasis Control Initiative (SCI) of Imperial College, London, UK provided the required funds. The interventions hinged on annual mass treatment (MDA) with praziquantel and Health Education and these have been implemented since then to date. By 2006, the prevalence and intensity of infection in majority of the foci in the country had been drastically reduced and transmission interruption seemed potentially possible in majority of affected areas. Problem of schistosomiasis control in Lake Victoria islands
However, in Lake Victoria Islands, the story was different. Due to high transport costs on water, operations in the islands were expensive and poorly implemented, hence both geographical and chemotherapeutic coverage are extremely low sometimes as low as 5% in some communities.
Perhaps due to similar reasons, limited support has been extended to the islands in form of health education, safe water supply and sanitation improvement leading to continuous high re-infection rate. Furthermore, due to their unstable residency, it is difficult to gather large numbers of people for sensitisation or treatment. This implies that many people inevitably continue to miss treatment during the formal mass treatment days which is done once a year. Collaboration between health, fisheries department and affected communities can play a major role in improving the treatment coverage but this approach has never been attempted due to insufficient funds. To involve the communities, it is vital to sensitise them about preventive, control and curative measures, train community volunteers including community leaders on control issues and train health workers on disease management. Most islanders do not own land, they live in temporary low quality hats with poor sanitation, lack of clean water and they are overcrowded and all these factors favour schistosomiasis transmission). Hence the objectives of this project will be:-
Areas of Focus
Which area of focus will this project support?
Disease prevention and treatment
Disease prevention and treatment
Which goals will your activity support?
Improving the capacity of local health care professionals;Promoting disease prevention programs, with the goal of limiting the spread of communicable diseases and reducing the incidences of and complications from non-communicable diseases;Enhancing the health infrastructure of local communities;Preventing physical disability resulting from disease or injury
How will you measure your project’s impact?
Number of recipients of disease
Do you know who will collect information for monitoring and evaluation?
Name of Individual or Organization
Briefly explain why this person or organization is qualified for this task.
He is qualified because he has undergone data analysis training by WHO and he is now a trainer for WHO Africa Region. He currently managing Vector Control Division Data.
Location and Dates
Where will your project take place?
City or town Province or state
Ddagye Kalangala District, Ssese Islands(Bugala), Lake Victoria
When will your project take place?
2018-05-15 to 2019-03-31
Cooperating Organizations (Optional)
Plot 15 Bombo
road P.O Box
Do any committee members have a potential conflict of interest related to a cooperating organization?
Why did you choose to partner with this organization and what will its role be?
The Vector Control Division(VCD) was created to enable Uganda achieve a status of a country free of neglected tropical diseases(NTDs) and related Morbidity and disabilities, the division has tackled a wide range of diseases and public health issues in addition to training many young scientists and assisting a wide range of research projects.
The role of VCD will be to procure the necessary drugs and equipment and implement the project given its expertise in this area.
List any other partners that will participate in this project.
Rotary Club of Cardiff(UK), Rotary Club of Kampala- Ssese Islands(Uganda), Vector Control Division(VCD), Ministry of Health, Kalangala District Health Office.
Volunteer Travelers (Optional)
No. Name Email
Describe this person’s role in the project.
Host sponsor confirmation of volunteer travelers
Describe the role that host Rotarians will have in this project.
The Host Club(Rotary Club of Kampala-Ssese Islands) has completed the needs assessment. The Host Club will have overall management of procurement of equipment and materials. They will establish a bank account for the Grant, and co-operate with Vector Control Division(VCD),
Ministry of Health in procuring the equipment and materials needed. Vector Control Division(VCD) will take the lead in the practical aspects of procurement following discussion with the Host Club.
Monitoring of project implementation and compliance will be undertaken by the Host Club through regular visits. Monitoring of performance against indicators after project completion will be undertaken during visits by Host Club Rotarians. Throughout the project and after completion the Host Club will make reports to the International partner (Rotary Club of Cardiff) updating progress and success against agreed PIans. The Host Club will be responsible for preparation of required reports for International Partner &The Rotary Foundation (TRF) post Project completion.
Describe the role that international Rotarians will have in this project.
Assessment of costings and project plans
What local currency are you using in your project’s budget?
The currency you select should be what you use for a majority of the project’s expenses.
U.S. dollar (USD) exchange rate
Currency Set On
What is the budget for this grant?
List each item in your project’s budget. Remember that the project’s total budget must equal its total funding, which will be calculated in step 9. Every global grant includes a match of at least $15,000 from The Rotary Foundation’s World Fund. Project budgets, including the World Fund match, must be at least $30,000.
Advocacy of Health Center
staff political, community and
Training of health workers
Outreach services And
Equipping The Rotary Health
Center with Medical Sandries
Solar Energy for Health
Tell us about the funding you’ve secured for your project. We’ll use the information you enter here to calculate your maximum possible funding match from the World Fund.
Cash from Club
District Designated Fund
Cash from Club
*Whenever cash is contributed to the Foundation to help fund a global grant project, an additional 5 percent is applied to help cover the cost of processing these funds. Clubs and districts can receive Paul Harris Fellow recognition points for the additional expense.
How much World Fund money would you like to use on this project?
You may request up to 15,050.00 USD from the World Fund.
DDF contributions: 10,000.00
Financing subtotal (matched contributions + World Fund):
Total funding: 35,150.00
Total budget: 35,150.00
Describe the community needs that your project will address.
Treatment of schistosomiasis and other helminths endemic in the region, otherwise known as “Neglected Tropical Diseases”. Population surveys have confirmed the high incidence of schistosomiasis amongst the island population in common with other communities in and around Lake Victoria. The life cycle of the schistosomes is well established and understood as is the life cycle of the fresh water snails that carry them.
The project will establish a centre for disease diagnosis at Ddagye Health Center II, partner with Ministry of health to deploy laboratory personnel, improve schistosomiasis management in health facilities, improve health seeking behaviour, improve knowledge of health workers and affected communities on issues concerning schistosomiasis prevention, control and treatment, improve treatment compliance and hence treatment coverage consequently eliminating schistosomiasis morbidity in the catchment area and above all greatly improve community participation and ownership factors that are vital for programme sustainability. Unlike the ongoing vertical approach, this project will completely ride on existing health structures hence completely integrate the control efforts in existing health system another factor that promotes sustainability of the programme.
How did your project team identify these needs?
The Rotary Club of Kampala- Ssese Islands does a good number of projects from Ssese Islands,and its from here that the Rotary Club of Cardiff and the imperial college picked interest in doing more with Rotary and Ministry of Health in trying to solve the problem of Schistosomiasis in Ssese Islands.
Schistosomiasis was first detected in Uganda in 1909 but thorough investigations occurred between 1950 and 2007. All studies showed the disease to be a serious problem and wide spread particularly along large water bodies including Lake Victoria.One of the studies described the infection to be very intense, more so than any other area ever studied. Hospital records over a 30 year period between 1951 and 1980 showed this condition to be the first cause of hospital death and the second cause of hospital admissions in adults in north western Uganda. Control of the disease was initiated in 2003 when Schistosomiasis Control Initiative (SCI) of Imperial College provided the required funds. The interventions hinged on annual mass treatment (MDA) with praziquantel and Health Education and these have been implemented since then to date. By 2006, the prevalence and intensity of infection in majority of the foci in the country had been drastically reduced and transmission interruption seemed potentially possible in majority of affected areas.
How were members of the benefiting community involved in finding solutions?
The Rotary Club of Kampala-Ssese Islands has built Ddagye Health Centre II and equipped it with medical accessories, supplies and staff in partnership with the Wamala Family and Ministry of Health. The Health Center is now fully running with a fully established laboratory which will be equipped with a microscope and CCA cassettes for rapid diagnosis of S.mansoni in urine samples. Ministry of Health will train the current personnel who are running the laboratory. In addition, Ministry of health has provided the general staff who are working in the Health Centre. The existing staff in majority of Health Facilities in Uganda has limited skills in the diagnosis and management of schistosomiasis. The Grant will be used to meet training costs of the Health workers using Central Ministry of Health personnel as facilitators. The centre based schistosomiasis diagnosis will utilize two methods namely “the Kato Katz Technique” in stool and or Circulating Cathodic Antigens (CCA in urine). The approach at the health centre will be “test and treatment of all identified positive cases”. The staff will also be trained on use of signs and symptoms to decide whether to treat or not.
Using Ministry of Health personnel, a KAP study to determine knowledge, attitude and practice of the people will be implemented using a simple questionnaire. Knowledge from the KAP study will be utilized to design appropriate IEC materials. The IEC messages will be utilised by the trained Health Centre Staff to sensitize communities in their catchment area. The central Ministry of Health and district staff will supervise all activities to ensure quality. Mass Drug Administration (MDAs) will be supervised by relevant Central & District staff. Ministry of Health will cater for radio jingles to promote treatment compliance.
How were community members involved in planning the project?
Rotary Club of Kampala, Ssese Islands has well established links with the island communities and was instrumental in raising funds to provide the building for the Health Centre which cost $28,000. The Health Center is now fully operational and often being used by the community on a regular basis but also often hosting medical outreaches which include more clinics like eye, dental and cervical cancer screening.
The community will be involved in planning and will provide community volunteers who will be trained in skills to support implementation. The community will be effectively mobilized to regularly seek for treatment in the health facility and to regularly take medicines at the community level. The project will be helping to improve impact of the ongoing schistosomiasis
Purchase of Health Center
Equipment including Laboratory
equipment and supplies
District Advocacy and
Advocacy of health Centre staff
# Activity Duration
and political, civic and community leaders within the catchment area
4 KAP study (VCD)
7 Training of laboratory personnel
1 week 1 week each round to sensitise communities to go for treatment at the health centres and to take drugs during routine MDA days.
Once each year for a week for surveillance. Supervision will be done during community sensitisation. During surveillance, the Rotary staff will supervise implementation.
Will you work in coordination with any related initiatives in the community?
Briefly describe the other initiatives and how they relate to this project.
The Ministry of Health has been carrying out a program through their SCI initiative, SCI has been supporting routine surveillance but the support is quite inadequate hence limited surveillance and supervision have been ongoing. In addition, SCI has been funding community mobilization to take drugs and to create awareness about prevention and control of the disease but again this has been inadequate and to date many people refuse to take drugs fearing side effects. Hence the fund will support extra sensitization costs. Please also note that the fund will also support Rotarians involved in the monitoring and evaluation of the project.
Please describe the training, community outreach, or educational programs this project will include.
The training will include;
All trainings will be facilitated by Ministry of Health personnel in collaboration through VCD and Rotarians from the Rotary Club of Kampala-Ssese Islands. All health workers both general and laboratory staff, all beach management leaders (community leaders in charge of fishing), and all Community Volunteers will be trained to support schistosomiasis control efforts.
How were these needs identified?
Through a needs assessment done by the Rotary Club of Kampala Ssese Islands and collaboration of the Rotary Club of Cardiff. Already great analysis of the need has been done by the Ministry of Health through the Vector Control Division. It was also established that the need for this initiative is there when the Rotarians of Kampala Ssese Islands interacted with the District Health Officer Dr. Hillary Bitarakalamire in May 2018 during one of the Medical Outreaches.
What incentives (for example, monetary compensation, awards, certification, or publicity), will you use, if any, to encourage community members to participate in the project?
Routine recognition of the Health workers
Acknowledgement of the political heads of the communities during the mass sensitization Rotary Certificate awards
Transport refund and meals & stationery where necessary and improved health care both during out- reach services and in the facility.
List any community members or community groups that will oversee the continuation of the project after grant-funded activities conclude.
The Health Workers at the Ddagye Health Center
The district Health Office of Kalangala District The
Ministry Of Health through their SCI Initiative
Will you purchase budget items from local vendors?
Explain the process you used to select vendors.
All equipment will be sourced from local vendors, apart from CCA cassettes which are produced and sold in South Africa.
A market research helped us come up with the best price and quality of equipment.
Did you use competitive bidding to select vendors?
Competitive bidding will be carried out as soon as the Grant is approved. The bidding will be done in line with the Rotary Club of Kampala Ssese procurement policy.
Please provide an operations and maintenance plan for the equipment or materials you anticipate purchasing for this project. This plan should include who will operate and maintain the equipment and how they will be trained.
There is already planned training for the staff at the health Center, so the staff will be well trained in maintenance of the equipment.
Ddagye Health Centre II will own the items purchased with grant funds at the end of the project. The District Health Office has committed to monitor and maintain equipment through their qualified Biometric Engineer Mr. Kasirye Samuel (Profile Attached)
Describe how community members will maintain the equipment after grant-funded activities conclude. Will replacement parts be available?
Ministry of Health will maintain the Health Centre and all medical equipment, pay the Health Center Staff and sustain supply of CCA after the project. And the Distric Biometric Engineer will maintain the equipment.
If the grant will be used to purchase any equipment, will the equipment be culturally appropriate and conform to the community’s technology standards?
All recommended equipment by the Ministry of Health has been used before for the same project in the same area.
In addition there will be installation of Solar energy to be able to handle any need of power, already assessment has been done to determine the amount of power needed for all necessary equipment.
After the project is completed, who will own the items purchased by grant funds? No items may be owned by a Rotary district, club, or member.
Ddagye Health Centre II will own the items purchased with grant funds at the end of the project.
Have you found a local funding source to sustain project outcomes for the long term?
Please describe this funding source.
Ministry of Health will maintain the Health Centre and all medical equipment, pay the Health Center Staff and sustain supply of CCA after the project
Will any part of the project generate income for ongoing project funding? If yes, please explain.
Authorizations & Legal Agreements
Global Grant Agreement
I confirm and agree to the following:
Terms and Conditions. Upon cancellation, TRF shall be entitled to a refund of any global grant funds, including any interest earned, that have not been expended.
legal representatives, and permitted successors and assigns.
11.Sponsors may not assign any of its rights under this Agreement except with the prior written consent of TRF. Sponsors may not delegate any performance under this Agreement without the prior written consent of TRF. Any purported assignment of a Sponsor’s rights or delegation of performance without TRF’s prior written consent is void.
12.TRF may assign some or all of its rights under this Agreement to an associate foundation of TRF. TRF may delegate any performance under this Agreement to an associate foundation. Any other purported assignment of TRF’s rights or delegation of performance without the Sponsors’ prior written consent is void.
photos have given their unrestricted written consent to use their likenesses and to license use to third parties.
Primary contact authorizations
By submitting this global grant application, we agree to the following:
All Authorizations & Legal Agreements Summary
Primary contact authorizations
Name Club District Status
Name Club District Status
David Rogers Kintu
District Rotary Foundation chair authorization