“I want to be able to look after our children to make sure they live a happy, healthy life. I also want to be healthy by getting treatment appropriately.”
“Before the Health Access Connect outreach clinics came to us, we had to travel to a clinic in SIAAP Bugoma — which is too far. And it could be so difficult. The day you would go you couldn’t work at all because you leave at 7 AM and come back late in the evening. If both parents go, their children remain alone at home. At that clinic no one could talk to health workers because they had many clients.
I lost my brother. He got sick, and we failed to access the health center because it was far. By the time we managed to go it was too late. He died on the way.
When we first learned health workers were coming here, we never believed it. We waited to see if they would come. That morning we were asked to help prepare the place where the health workers would meet with us and so we prepared it. When they came it was like a dream — but it came true.
Our health expenses decreased…now we can even take care of our children.”
HAC Executive Director Kevin Gibbons is one of 10 people honored as a 2019 Global Good Fund Fellow. The Global Good Fund focuses on developing the capacity and leadership abilities of social entrepreneurs to scale up their impact. We’re looking forward to the mentorship, networking, and leadership development opportunities that this will provide for Kevin and HAC!
We are excited to share HAC’s Annual Report for 2018! Read the full report here: HAC Annual Report 2018.
Letter from the Executive Director 2018 was a year of success, opportunity, growth, and challenges for Health Access Connect. After some lessons learned from difficulty expanding in 2017, we have been able to reach over 30 villages with monthly outreach clinics! Our vision is to open and manage mobile outreach clinic services all over Uganda and then beyond. These are some of the challenges and opportunities we faced so that you can have an idea of what it takes to bring our services into a village:
1. Community Infrastructure. Within an environment that is not consistent in practices or robust with resources, we needed to reach out to and establish appropriate relationships with partners for the delivery of care and outreach clinic oversight. Community groups were at the center of our model for coordination and oversight of the outreach clinics, but it can be difficult to find reliable and effective partners. We found a key partner with community health workers (VHTs). This adjustment has made a huge difference in the quality and consistency of care. 2. Time to operation. It takes a lot of time, explanation, and assurances to be welcomed into a village. Sometimes you just have to go in and do it. Our amazing Field Officers work with the villagers, engaging them and earning their trust. Once need is established, our goal is to get on the motorcycles and deliver life-saving and life-improving healthcare as quickly as possible. 3. Talent. For our outreach clinics to expand, our organization must expand. We have a truly talented staff, but with expansion we need more people going to the villages, traveling with health workers, and doing what they need to do daily to make the outreach clinics work. 4. New and deeper relationships. Before we expand to new districts, we need to get approval from district government officials. As with many government bureaucracies, it can take a lot of effort and time to get Memorandums of Understanding (MOUs) signed! After some meetings with our management team, calls with our partners in Kalangala District, and showing evidence of our success, officials enthusiastically signed the MOUs!
I hope you see the common thread in all of the above: relationships. People helping people, people working together to save lives. People like you, who understand and support what we do and why we do it. This is what we do, on motorcycle, in remote villages, for those who otherwise will have no access to healthcare. By the end of 2017, we served nine villages. By the end of 2018, with your continued support, were serving 30 villages. By the end of 2019, we aim to be in at least 60. All of us here at HAC and I are looking forward to an exciting year ahead!
Effective philanthropy is a philosophy and a movement in philanthropy. Essentially, it describes making the most out of the money you give in a lifetime, and emphasizes finding the opportunities for volunteering and donating that will have the most impact. The goal is to find ways to best channel resources to improve people’s lives and livelihoods, and, ultimately, to improve the world in doing so.
As an example of what effective philanthropy looks like could be using data to find out what impact you could have if you give X amount of dollars and aligning that impact with your personal priorities. This way, your time and donations can be used in the best way to have the most impact.
Effective philanthropy is particularly popular and impactful in the global health sector, likely because of the clearly defined and easily trackable impact on human life in this field.
Effective Philanthropy and Health Access Connect
In the rural areas of Uganda in which we operate, there are tremendous hurdles to accessing healthcare services. Although the actual costs of medical care are free or very low, transportation to the facilities that provide the care is nonexistent or cost-prohibitive. As villagers have told us, 3-5 miles might as well be thousands when you are sick, pregnant, or trying to transport a sick child.
The stakes are very high. People suffering from malaria and HIV/AIDS too often have to go without treatment. It is crucial to get pregnant women to give birth in hospitals or health clinics because many life-threatening pre-and-post-partum complications can be prevented. Otherwise, these complications need to be treated. For example, without proper medical attention, a ruptured uterus during birth is deadly. However, women cannot get to health centers to give birth, even though it is very inexpensive to get care there. The costs of transportation are so high and prohibitive that villagers have told us they used to have to sell land, an acre of corn (livelihood), or even sex to afford transportation to get medical treatment. Because we bring our outreach clinics directly to the villages, we are truly providing life-saving care to thousands of people. This is why we do this work and why we continue to do it.
We give donors the opportunity to connect with our mission and see the impact of our work. HAC uses donations to target people and places that really benefit from the investment. Your donation will provide access to health services for thousands of people throughout the year, helping targeted portions of the population that are ignored by typical nonprofits. The money that people donate goes so far and we have incredible programs that are saving people’s lives.
Earlier this year, our previous Board Chair, Chelsea Takamine, stepped down from her role. We thank her for her service!
Please help us welcome our new Board Chair, Jan Baskin! Jan took over the position officially in August and presided over her first board meeting a couple weeks ago. She joined HAC as a board member last year.
“As the chairperson of Lwabalega, I coordinate the HAC outreach clinics in our community. Before Health Access Connect, people were badly off and used to spend a lot of money going for health services.
It used to take a full day to get treatment plus the cost of transport to the clinic and back — 15,000 Ugandan shillings to go and again 15,000 Ugandan shillings to return.
Health Access Connect helped people so much because a person can be working at the lake, and then he comes up to the clinic, visits with a health worker, gets his treatments and medications right here and goes back to the lake. Instead of spending 30,000 Ugandan shillings, he spends 2,000, and is taken care of in one hour instead of the whole day.”
– Saazi Francis Salongo, Chairperson of Lwabalega, Fisherman, & Farmer,
Our Executive Director Kevin Gibbons was awarded the Rising Star Alumni Award from the Nelson Institute of Environmental Studies at the University of Wisconsin-Madison. Kevin received his Masters of Science from the Nelson Institute, and his thesis research there was when he had the opportunity to research the links between fisheries management, livelihoods, and food security in Lake Victoria fishing villages. That’s when he first saw the gaps in access to healthcare in remote communities.
Here’s the blurb from the Nelson Institute website:
Kevin Gibbons, M.S. Conservation Biology & Sustainable Development (2010), Nelson Institute for Environment Studies, University of Wisconsin-Madison
As the co-founder and Executive Director of Health Access Connect in Kampala, Uganda, Kevin Gibbons works to provide residents of remote villages with access to health services, such as anti-retroviral treatment, perinatal services, malaria treatment, child checkups and more. Launched in 2014, Health Access Connect is the culmination of Gibbons’ education and determination. A member of the Peace Corps, Philippines for three years and a dedicated student at the Nelson Institute, Gibbons has spent much of his life seeking out ways to solve challenges through service, innovation and collaboration. In fact, while working on his master’s degree, Gibbons traveled to rural fishing villages on Lake Victoria in Uganda to learn more about how food insecurity and livelihoods were impacted by fisheries governance. While there, he listened to people in remote areas describe the challenges they faced in terms of health and environment. There were free life-saving health services available at the health facilities, but people could not reach them. Determined to create a solution, Gibbons started Health Access Connect, which helps Ugandan health workers to serve over 13,000 patients per year. Of his work, Gibbons says, “I see my life as one of service to find long-term solutions to connect people with resources. The world is rich, and service helps distribute that wealth.” You can find out more about Health Access Connect at https://www.healthaccessconnect.org
I attended the AIDS 2018 Conference in Amsterdam on a scholarship from the International AIDS Society to present a poster on our work at Health Access Connect. Here are the highlights of my experience of the conference.
I passed Nairobi airport on my way to Amsterdam. The first thing that I noticed in Amsterdam is the ease of transportation. The metro and trains will take you anywhere! And there are bike lanes and pedestrian walkways all over the densely populated city. It’s a dramatic contract to Kampala in which traffic is often at a standstill and pedestrians are shoulder to bumper with cars and minibuses.
I met some of the other scholarship recipients and networked with other people who work in Uganda. The recipients whom I met included advocates for LGBTQ rights, a social worker who works with prisoners, quantitative public health researchers, journalists, clinicians, and pharmacists. My interactions with scholarship recipients was where I caught my first glimpse of the diversity and sex-positiveness of the conference.
The place was packed! The conference was overwhelming. Hundreds of sessions. Protest demonstrations. Quiet dance parties. Corporate presentations. It’s a lot to take in.
My goals going into the conference were primarily to 1) find organizations that are funding work similar to ours (aka look for money), 2) learn about cutting edge programs, and 3) connect with potential partner organizations.
The tracking-down-funding thing made the stakes pretty high! In this photo you can see a section of the exhibitors’ area. Lots of corporations (especially large pharmaceutical companies), foundations, and government aid agencies had booths (some with free espresso!) mostly for selling therapies and talking about their programs. I got a few good leads, but mostly people responded, “Ooooh, cool program. I’m not sure who’s funding that kind of thing.”
I spoke on a broadcast to the ViiV Healthcare staff. ViiV gave us the Connecting to Clinic Incubation Prize in 2017, and they continue to support our work with advice and contacts. It was nice to meet them in person and get their advice on where we should go next. The gist of what they said: “We want your model to spread all over the world! We don’t have funding right now, but we are willing to help in whatever way we can.” We feel fortunate to have this continued relationship, and it’s nice to get some pats on the back!
HAC’s work relates to other “differentiated service delivery” (DSD) models of healthcare. DSD takes the patient and his/her/their needs as the starting point for developing a model to reach them. Some key populations for HIV/AIDS are men who have sex with men, sex workers, injectable drug users, adolescent girls, and fishing communities (that’s where we target!). So under DSD, rather than having one strategy for giving anti-retroviral treatment, you would set up special programs for sex workers in Dar es Salaam, which would be different from injectable drug users in Kiev, etc.
Here’s our poster that I presented. I met a lot of people who were interested in what we are doing. People in the HIV/AIDS space are excited about a few things:
We are reaching the most difficult-to-reach communities that other organizations can’t.
We are using transportation networks that already exist in the country, rather than setting up something new.
We are using microfinance and cost-sharing so that the program is low-cost and sustainable, even as funding for HIV/AIDS has declined.
I racked up quite a few business cards, and since the conference I’ve been meeting with researchers in Uganda around the world to learn from each other.
It’s hard to distill all that I learned (or all that I’ve forgotten!), but here are some highlights:
The global push is 90-90-90. 90% of people living with HIV know their status, 90% of those are started on treatment, and 90% of those have suppressed viral loads. The costs of reaching remote and undeserved populations are high, and HAC is playing an important role in helping Uganda meet those targets.
2% of international HIV-related funding is dedicated toward key populations but over 40% of new infections outside of Sub-Saharan Africa involve these populations.
1/3 of sex workers in Sub-Saharan Africa are HIV positive.
Only 1.4% of funding spent on combating drug abuse and addiction is spent on “harm reduction” programs, like clean syringes, pre-exposure prophylaxis for HIV, and antiretroviral outreaches. Most is used for law enforcement, including police action and imprisonment. Yet the public health community has mountains of evidence to show that harm reduction saves lives and is cheaper.
One of the important topics at this conference of “self-testing” for HIV. There are cheaper, easier testing kits to use, but researchers and policy makers are discussing how to implement these kits because post-test counseling is a core part of testing. (Imagine people who find out they are HIV-positive; they need a trained counselor to help them understand what that means and think through next steps.) One approach that is getting traction is “supervised self-testing” so that there is an increase access to HIV testing and a health professional to help patients understand the results.
Currently, the burden of HIV/AIDS is being shouldered by adolescents, especially adolescent girls. There was a lot of advocacy for programs that target schools and homes of adolescents.
I also want to mention that there was a lot of representation from Africa and the Global South.
Have you ever heard of the meme “Congratulations, you have an all male panel!“? It’s meant to draw attention to how conferences and sessions prioritize the voices of men. Well, none of the sessions that I attended had an all-male panel, and quite a few had an all-female or an all people-of-color panel. Kudos to the organizers.
There were some celebrities in attendance! I was able to see Bill Clinton, Elton John, and Prince Harry. Many people were energized by these marquee names, who emphasized, “What you all are doing is important, and together we can eliminate HIV!”
I did get to do a teeny tiny bit of sightseeing. And I made a few new friends at the conference. My favorite non-conference parts of the week were long walks through downtown Amsterdam checking out street performers, eating Indian food, smelling the … smells in the air. At the end of the day I got to chat with my Airbnb hosts about the conference, their lives, and whatever political news was swirling around.
Lastly, here are some of the photos from the morning runs that I had in northern Amsterdam. Notice the geese waddling in the mist and the lovely bike and pedestrian paths.
Peace out, Amsterdam! #AIDS2020 will be in Oakland-San Francisco. I hope we get the chance to attend!
In preparation for the meeting, Executive Director Kevin Gibbons and Monitoring & Evaluation Officer Bridget Nanyonjo met with district health leaders from HAC partner clinics that would be attending the meeting in order to have a more in depth discussion with them one on one. Bridget is seen above with female health workers at HAC partner Health Centre 3 Bwendero in the first photo. In the second photo, Kevin is meeting with Jimmy Kazibwe, Clinical Officer at Health Centre 3 Mugoye.
HAC outreach clinic sign outside of the Stakeholders Workshop which was hosted at the HAC partner organization KAFOPHAN office in Kalangala town on Buggala Island.
Miiro “Mpola Mpola” Deo, HAC Field Officer, Kalangala, helps to lead main discussions about, past and current successes and lessons to be learned for areas for improvement in the HAC model with district health leaders, HAC field staff, and other community members.
Livingstone Musoke, a counselor with HAC partner organization Kalangala Comprehensive Public Health Services Project, presents on his experience working with HAC outreach clinics and the positive responses and impacts in remote villages.
Meeting participants are divided into teams of community members, health workers, and partners to discuss their unique challenges from their perspectives and brainstorm solutions.
Motorcycle taxi driver Mike Nsubuga explains some of the problems and solutions from the community perspective. Many groups stressed the importance of keeping time and improving coordination between health workers and community members.
Kalangala District HIV Focal Person Dr. Edward Muwanga discusses how the difficulties of medicine stockouts and staff limitations at the health facilities can interrupt outreach clinic activities.
Scovia Namaganda, in-charge of Health Centre 3 Bwendero, discusses the challenges that she and her colleagues have faced in bringing care to remote villages and gives some ideas for how HAC and community members can help make their work easier, specifically with improved coordination and giving health workers their travel allowances on time.
I’m currently interning at Health Access Connect for 3 months through a study and work abroad program called Insight Global Education. My coursework as a Global Public Health and History major at NYU has sparked an intense curiosity in me and has called me to a career in social impact. The study of public health is interdisciplinary and covers diverse sectors including health sciences, statistics, environmental health, business, policy, and much more. I’m on a journey of discovering not only which areas best suits my interests, but I am also devoted to discovering where I can have the most impact. At Health Access Connect, I’ve been given the opportunity to involve myself in a variety of tasks to help the organization and gain more clarity into what careers I might pursue. At a month and half in, I’ve taken an interest in development/fundraising and program management as I’ve witnessed the necessity to support more small community-based nonprofits like Health Access Connect that work to build local capacity.
So what do I actually do?! I spend most days at the HAC office in Kampala learning how to work in various databases and management softwares, including Salesforce, The Non-Profit Leadership Lab, Grant Station, and Asana. Managing a small and growing organization is not easy! Kevin Gibbons and I then figure out how we can use these tools to improve HAC’s ability to fundraiser, oversee staff, and serve people in the remote communities where we work. Intermixed with this are field visits to the communities were HAC works, various small administrative tasks, social media management, and attending networking meetings. I’ve even been able to work on my first grant application, and I’m loving it! I’m learning so much working at HAC, and I’m so lucky to have the opportunity to find my passion so I can have a successful and well thought out career. I’ve got another month and a half left in Kampala and I can’t wait to see what else is to come!
