University of Calgary

Healthy Child Uganda

Healthy Child Uganda

U of C physicians are helping African communities improve child health through education and empowerment.

By Marta Cyperling

One of the jobs of the local health workers is to report on child immunization rates. / Photo: Derek Castiglione

One of the jobs of the local health workers is to report on child immunization rates.
/ Photo: Derek Castiglione
The African nation of Uganda has one of the highest child death rates in the world and many die from diseases and conditions that are easy and inexpensive to treat.

Malaria is the leading cause of death and diarrhea is one of the top five child killers. Malnutrition, measles and pneumonia are other illnesses that are taking a terrible toll; 137 children in 1,000 will die before their fifth birthday.

Dr. Jenn Brenner saw case after case of this while working in Uganda as part of a volunteer program through the Canadian Paediatric Society. “The children were so sick and there were so many preventable deaths.”

In 2003, a group of Ugandans had an idea to train locals as volunteer health ambassadors to address these issues and help build healthier communities. They approached the society’s volunteers and asked for help. Healthy Child Uganda was born.

A community-based health education program in rural southwest Uganda, Healthy Child Uganda has started to address that country’s challenges with child health care by training volunteers to prevent and identify illness.

Dr. Jenn Brenner has been volunteering in villages across Uganda since she was a resident in 2000. / Photos: Derek Castiglione (

Dr. Jenn Brenner has been volunteering in villages across Uganda since she was a resident in 2000. / Photos: Derek Castiglione (top) and Rick Castiglione

“It’s a project for Ugandans, by Ugandans,” says Brenner, a University of Calgary paediatrician and clinical associate professor, and project director of Healthy Child Uganda since its inception. “I became involved because of the work I had done teaching and providing clinical support on the wards. When the Ugandans approached me with their project idea, I knew that working with the communities to prevent illness was a way to have the biggest impact.”

With her colleagues, Brenner has helped establish a network of 350 Ugandan volunteers who have been trained in basic health promotion. Last year, volunteer reports showed a 15 percent decrease in the number of children under five who died in their villages. Health workers at rural posts have also reported significant improvements in immunization rates and nutrition, and in parents bringing their sick children for treatment earlier.

Success stories include a young boy in a village near Mbarara who was suffering from cataracts. Because his disease was identified early, he was able to have surgery and see again.

Another young child was severely malnourished but because of village volunteers, was nursed back to health with local food and is now healthy enough to attend school.

“This program is a Ugandan initiative,” says Brenner from her office at the Alberta Children’s Hospital in Calgary. “It really is unique because we are working with the local university and the organizations that are already there. The partnerships we have established are what really make it work.”

Healthy Child Uganda is a partnership between doctors at the University of Calgary, Dalhousie University, the Canadian Paediatric Society and Uganda’s Mbarara University of Science and Technology. It is funded by the Canadian International Development Agency and through private donations.

U of C residents and paediatricians spend weeks of their time in Uganda; U of C researchers have assisted in project evaluation. The university provides project management support in Calgary, accommodates donations and helps with reporting back to donors on the impact of their gifts.
The program is brilliant in its simplicity. Each village elects two people to be trained as community health volunteers. There are no specific requirements on formal education and anyone can become a health volunteer. Of the 350 trained volunteers, 70 percent are women.

The volunteers spend five days in initial training where they learn about preventing and identifying illness. They then go back to their villages and serve as health ambassadors, giving health talks to pregnant and nursing mothers, offering health-care advice, and learning how to recognize when a child is sick and needs to be taken to hospital.

The volunteers also pass along practical information to mothers such as how to make a sugar, salt and water solution to prevent dehydration when their child is suffering with diarrhea. It is part of their job to register all kids under the age of five in their village. Each volunteer is responsible for 40 to 60 children and they keep track of their general health and immunization status. The community volunteers also make a commitment to upgrade their skills on a monthly basis.

U of C’s Dr. Janice Heard, MD’84, (centre) executive director of alumni affairs at the Faculty of Medicine, is a Healthy Child U
U of C’s Dr. Janice Heard, MD’84, (centre) executive director of alumni affairs at the Faculty of Medicine, is a Healthy Child Uganda volunteers. / Photo: Dr. Janice Heard

The cost of training a volunteer is less than $40. Yet, one volunteer can provide services and education to keep up to 60 young children in a village healthy. Treatment for a child dehydrated from diarrhea costs pennies and can be provided at home by the parents. A mosquito net, which can prevent malaria, the biggest killer of children in the area, costs $6.

Brenner has done volunteer work in Uganda and other developing countries for the past 15 years. “This project is particularly rewarding and the people, especially the Ugandan village volunteers, are very inspiring to me. Healthy Child Uganda is an amazing opportunity for me and others to use our skills and really appreciate the wonderful health system we have here in Canada.”

As a Healthy Child Uganda community development officer, Hakim Bbosa has seen many positive changes in local villages and says the program enlightens the whole community.

“Since this program has village health volunteers who are on the ground, they can easily move from home to home and give health messages and visit sick children,” says Bbosa. “The volunteers have knowledge about how to determine danger signs in sick children. Danger signs mean that the parent has to quickly take the child to the health centre. Parents do not always know what symptoms are dangerous and what are not, so this is a great improvement.”

Much of the health education is aimed at mothers to help them better care for their children. / Photo: Rick Castiglione

Much of the health education is aimed at mothers to help them better care for their children. / Photo: Rick Castiglione

Brenner says the program’s initiatives grow out of the individual needs of each community. The volunteers work to prioritize their health needs and come up with their own solutions to address them. “One village may decide to build a road so families can more easily get to the health centre in case of sickness; other communities have started clean water initiatives to help prevent diarrhea,” she says. “For many, malaria is a concern, so communities come together to clear bushy areas and swamps in their village. They also look for ways to access mosquito nets.” Bbosa says villages have made great improvements in hygiene and sanitation. “In particular, the latrine coverage has improved immensely. Now, all families have a place to put their waste. This is so important because we still have unprotected water sources in our communities that easily become contaminated causing diarrhea and cholera outbreaks.”

Erin Kiley joined the U of C’s International Centre as the Canadian project coordinator for Healthy Child Uganda after spending two years working in the development sector in Botswana and Sierra Leone. She was drawn to the U of C staff position because she wanted to continue working on health and volunteer projects in Africa. She travels to Uganda twice a year, for six to eight weeks at a time.

“In the spring I visited a family who had taken in an orphaned newborn from relatives,” she says. “Without its mothers’ milk the baby had become malnourished. Our village volunteers quickly notified project staff who used some of our funds donated by private individuals to buy milk, clothes and blankets for the baby.”

Kiley says that often a few months of food support is all a family needs to make it through a rough patch between harvests. “When I saw the baby in April, she was still small but quickly catching up.”

A liaison between the Canadian and Ugandan project teams, Kiley says that, overall, more families are following healthy practices. “With their newfound knowledge of food groups and nutrients, many villagers have developed vegetable gardens and new crops.”

Hand-washing facilities and properly designed latrines are being built. “Since we have been measuring child mortality, we have seen a drop in deaths and in some particularly remote areas, the drops have been dramatic,” she says.

Young children with disabilities such as club foot and blindness have been referred to proper care and, in many cases, have had their conditions reversed.

In only five years of operation, Healthy Child Uganda is already making waves in the international development world. Last June, the program won first place for outreach and community relations at the Association of Commonwealth Universities global conference and second place in the National Civil Society Capacity Building Project. World Vision has named Brenner as one of the top five Canadians to watch.

“This model has great potential. It is low cost and the incredible motivation of the volunteers is notable,” said Brenner.

Despite the positive changes, there are still challenges. Poor infrastructure makes it difficult to reach the most vulnerable children and some villages are very isolated.

“Addressing child health needs is hugely complex,” says Brenner. “We have decided to focus in these areas step-by-step, addressing the needs their communities prioritize.”

It’s that grassroots approach that will ensure Healthy Child Uganda continues to help African communities keep their children alive and healthy for years to come.

Open hearts

A love of travel has led Ted and Bette Best to donate to Africa projects at the U of C.

Ted Best first visited Africa in 1997 and was moved to help communities with education and health care./ Photo: Ewan Nicholson

Ted Best first visited Africa in 1997 and was moved to help communities with education and health care. / Photo: Ewan Nicholson
The lessons from the Depression informed Ted and Bette Best as they reared a family in Calgary and while Ted excelled in his career, rising to president of BP Canada’s oil and gas division before establishing a consulting company.

“My generation remembers the Depression,” Ted says. “It had a huge influence; we were cautious, never extravagant.”

Eventually, the Bests would become a little extravagant with their philanthropy, donating to projects at the U of C such as Healthy Child Uganda and the Dr. Ted Best African Fund.

The focus of much of their giving is Africa. The couple first travelled to Kenya and Tanzania in 1997, where they visited a local school. Ted recalls the children in uniform, the classroom with dirt floors and cardboard as blackboards. But most disturbing were the children outside. “Little kids were standing there peering in, thinking ‘if only we could go.’ It was heart-rending.” The couple sent supplies and the seeds for involvement were planted.

When they returned home, supporting Africa through the U of C seemed like a natural fit. Daughters Wendy, BComm’75, LLB’79, and Carolyn, BComm’83, had been students. Ted had spent six years on the Board of Governors in the 1970s and collaborated with then-president Norm Wagner and others to launch the International Centre.

“The university was quite parochial then,” he says. “I wanted to encourage a more international outlook.”

The Bests chose to support Healthy Child Uganda, launched in rural southwest Uganda in 2003 to train local volunteers to prevent and identify illness in children. The U of C’s Dr. Jenn Brenner says a key aim is to ensure that children see their fifth birthdays. “There’s high impact for little input,” she says. “It makes a difference for a large number of children; it’s providing knowledge and skills as tools, to empower them.”

It is just one of the projects the Bests have supported over the years. The Dr. Ted Best African Fund was established to finance six weeks of student travel. Masters student Jason Bau, BHSC’08, went to Ethiopia for an “eye-opening experience” when he was in the Bachelor of Health Sciences program. “We learned many new ideas on how to improve our work, while experiencing a unique and beautiful culture,” he says.

Ted believes that such early experiences can have a lasting effect. “It has an impact on them at an important time in their lives—when they are young and interested in the world,” he says.

“Once you travel to a place, you are always interested in what happens there.”

—Janice Paskey