Medical excellence and loving care for patients amid conflict, poverty and epidemics in northern Uganda

The 470-bed St. Mary's Hospital is an extraordinary example of capacity development, adaptation and performance in a region that has experienced two decades of civil war, extreme poverty, and outbreaks of virulent epidemics such as the Ebola virus. Known within the Gulu district of Northern Uganda simply as the Lacor Hospital, St. Mary's is a former Catholic missionary hospital that has become a centre of excellence within the entire Ugandan health system.

Dr. Piero Corti of Italy and his Canadian wife, Dr. Lucille Teasdale, began Lacor Hospital in the early 1960s with the mandate of offering love, care, and the best possible service to the most people at the least cost. Lacor was one of the few hospitals in the world to deal successfully with Ebola virus disease, although the virus killed 150 patients and 14 experienced staff, including Dr. Corti's designated successor.

The hospital, now the second-largest medical centre in Uganda, achieved excellence despite being in the middle of a region racked by internal war during which many people were brutally killed and thousands of children were kidnapped and forced to join the Lord's Resistance Army.

A study done by the European Centre for Development Policy Management (ECDPM)entitled Resilience and high performance amidst conflict, epidemics and poverty looked at reasons for the hospital's achievements. These include:

  • Continually reinforcing the founders' values by modelling them on the job and through regular staff meetings, supported by incentives and a management approach that shares responsibility and involves staff at all levels.
  • An inner core of 15 to 20 people supervise new staff members and act as guardians of the organisation's working culture and core values. The hospital also sets aside 13-15% of its annual budget for in-house and outside training, ensuring a continuing drive for excellence.
  • In order to ensure it is responding to the demands of its key stakeholders, the hospital regularly reflects on and applies lessons learned by experience while continuing to acquire new knowledge.
  • Although Lacor has formal administrative and professional standards, the management encourages staff to take responsibility for their own performance. Thus, control systems are less important than self-regulation by the staff.
  • Ongoing networking with the outside world has helped the hospital survive difficult political times as well as to raise funds to support its operations.

Hauck, V. 2004. Resilience and high performance amidst conflict, epidemics and extreme poverty: The Lacor Hospital, northern Uganda. (ECDPM Discussion Paper 57A). Maastricht: ECDPM. Summarized from a report in Capacity.org 19(10) October 2003.

 

St. Mary's Hospital Lacor, a non-profit charitable institution belonging to Gulu Catholic Diocese, offers quality accessible health care to all, especially the most disadvantaged (children, women and persons without economic resources). Lacor Hospital follows an extended and integrated approach to health care, including preventive medicine, health care, and training of health care professionals to promote long-term sustainability. Diseases are caused by poverty but also determine poverty, so accessible, good quality health care is crucial to fight poverty and stop this cycle. The hospital is located 6 km west of Gulu town; Peripheral Health Centres are located at Pabo and Opit.

 

The Teasdale-Corti Global Health Research Partnership Program, begun in 2005 by the founding partners of the Global Health Research Initiative (GHRI) — Canada’s International Development Research Centre (IDRC), Health Canada, the Canadian International Development Agency (CIDA), and the Canadian Institutes of Health Research (CIHR) — honours the couple’s legacy. The program will foster international partnerships and collaboration in health research, and will ensure knowledge generated is used to address pressing health issues and needs in low- and middle-income countries. It will train and support researchers, as well as foster collaborative initiatives among researchers, research users, civil society organizations, and governments. Some of the projects initially funded include the creation of new programs by a team of Canadian, Jamaican and Kenyan researchers to strengthen nurses’ capacity to deal with the HIV/AIDS pandemic; a Canadian-Mexican collaboration to look at the emerging problem of childhood obesity; and a team from Canada, Malaysia and Sri Lanka working on solutions to reduce human exposure to emerging infectious diseases often carried by animals.

 

For other stories about hospitals, see:

Old US hospital equipment, vital supplies bring new life in developing countries

International coalition makes hospital and health care safe, sustainable, healthy for all

Linking the health community to resources and each other in Nepal

Recycled phones and free software revolutionize health care for Malawi hospital

Village Leap helps Cambodians join global village

 


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