A dream has come true in Uganda - Fondazione Corti

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NEWS FROM LACOR
JULY
2012
Photo: Mauro Fermariello
News from Lacor Hospital
A dream has come true in Uganda
In this issue
Lacor Hospital and the local economy p. 2
Advancements of the “IDRC Health trends study” p. 4
Pursuing quality p. 5
Lacor Hospital through the eyes of children p. 7
News from the Canadian and Italian Foundations p. 8
TEASDALE-CORTI
FOUNDATION
FOR LACOR HOSPITAL
Bulletin for benefactors and friends
interested in keeping abreast on news
from Lacor Hospital and the
Teasdale-Corti Foundation
Year VIII – n. 3 – July 2012
Bulletin published by Fondazione Piero e
Lucille Corti - Milan (I) and Teasdale-Corti
Foundation - Montréal (CA)
Teasdale-Corti Foundation
8880 Boul. Lacordaire – Saint Léonard
QC - H1R 2B3 (CA) - Tel. +1.514.253.1737
info@teasdalecorti.org - www.teasdalecorti.org

Lacor Hospital and the local economy
A study assesses the impact of a non-profit business on development
The contribution of Lacor Hospital to the local community
goes beyond the possibility of providing medical
treatment to a population that cannot afford it; it is
a fact we never tire of underscoring.
It is an institution that provides medical services at
highly subsidised rates but also acts as a flywheel for
the local economy, thanks to the direct, indirect and related
financial flows it generates. To verify and measure
these flows, the management of Lacor commissioned a
study to provide a tangible evaluation of the contribution
which the Hospital provides to the community in
terms of its overall economic impact. Financed by the
Cariplo Foundation and Compagnia di San Paolo, the
study drew to a close last December.
A similar study had been carried out in 2003, in the
midst of war. In view of the major social and economic
changes brought about by the peace achieved in 2007,
the Hospital’s management felt it was important to repeat
the exercise, to understand whether the Hospital’s
role and perception had changed significantly with the
context.
The study was conducted by Maurizio Murru, a doctor
and expert in analysing international health policy,
programming and managing medical systems. He has
worked for many years in Uganda, amongst others as a
lecturer at the faculties of Makerere and Uganda Martyrs
University. Dr. Murru was helped by two analysts
with expertise in managing medical services, as well
as three local interviewers for gathering data from the
population, all from the Acholi ethnic group, and who
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were therefore an integral part of the local culture. In
addition to a thorough analysis of the economic data
and activities conducted by the Hospital, the study
involved conducting widespread interviews at all levels
with Hospital staff and management, patients and
their relatives, students at the schools, owners of businesses
near the Hospital and the main suppliers of the
Hospital, as well as with local and district authorities.
Interviews were also conducted in the three peripheral
health centres, which are located in areas more rural
than Lacor (which is located a few kilometers away
from Gulu, the capital of Northern Uganda, with an
estimated population of 150,000 inhabitants).
In particular, the study confirmed that the Hospital
continues to bring a sizeable and increasing flow of
funds into the local economy (€ 2.8 million in the last
financial year), both as aid from abroad and hospital
fees paid by patients from other areas. The latter and
their relatives, during their stay, put further resources
into the local economy with each purchase.
Much of these resources remain in the district, whilst
in any case the rest remain in Uganda: Indeed the Hospital
makes over 45% of its total expenditures in the
area in the form of employee wages and local purchases.
The remainder is spent mainly in Kampala, the capital
in the South of Uganda, principally to buy medicines
and fuel. Only 3% is spent abroad to purchase equipment
not available in the country, such as ambulances.
The employees in turn pour almost all their earnings
back into the local economy, thereby contributing to-
Photo Mauro Fermariello

wards the multiplier effect, which the study calculated
as around 60% globally.
Each Euro donated to Lacor and spent locally, is equivalent
to investing no less than € 1.6 into Gulu district’s
economy, a good return on the donors’ investment in
development!
The Hospital’s total financial contribution to the local
economy has thus been estimated at € 2.3 million per
year, a sizeable impact but one that decreases proportionally
as the local economy develops. In fact, with the
arrival of peace, the process of economic reconstruction
has also got underway. It is a process for which the Hospital
has no doubt been, and still continues to be, one
of the driving forces, both through the financial flows
explained above and its policy of low tariffs. These not
only grant access to its services to the poorer sections of
the population, but also avoid draining away any initial
savings made, which are the starting point for generating
local economic growth.
Last but not least, it is also very interesting to note how
the population’s perception of the Hospital has changed.
In 2003, war was at its peak, and beyond Lacor, the
missionaries and the humanitarian organizations, there
was nothing except for immense refugee camps. Each
night, thousands of women and children would take
refuge in the Hospital courtyards, escaping from the
guerrillas who attacked villages at night, killing anyone
that opposed them as they ransacked and kidnapped
children to enlist them by force. And there were still
fresh memories of the terrible Ebola epidemic, during
which the Hospital distinguished itself by discovering
the virus and joining the battle to contain the epidemic
which killed half of the people it infected. Lacor lost 13
staff members who became infected during their work,
including medical director Dr. Matthew Lukwiya, who
had been fronting the battle. It is no surprise then that,
in those years, Lacor was considered a sort of sanctuary
by a desperate population, one without which survival
was impossible. Today, in answer to the question “What
would you do if Lacor Hospital didn’t exist?” the most
common response is: “I would look for another hospital”.
The attention today has finally, and quite rightly,
shifted to the quality of services provided.
Laura Suardi
Schools, banks and businesses: Lacor Hospital is at the very heart of a great social hive which pumps up the economy and promotes
development. According to the economic study conducted, each Euro donated to Lacor, which is spent locally, is equivalent
to investing €1.6 into Gulu district’s economy
Photo: Mauro Fermariello Photo: Guido Coppadoro
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Advancements of the “IDRC Health trends study”
The IDRC, one of Lacor Hospital’s important partners,
is a Canadian Crown corporation established in 1970
for the purpose of helping developing countries to reduce
poverty, improve health, support innovation and
safeguard the environment in developing regions.
It encourages, supports, and conducts research in the
world’s developing regions, and seeks to apply new
knowledge to improve the social and economic conditions
of those regions. It offers researchers based in
poor countries with the financial resources, advice and
training that will help them find solutions to the local
problems they identify.
The latest project sponsored by IDRC involves Lacor
Hospital as well as other local health institutions. It is
aimed at understanding the changing social, economic
and epidemiological environment and using this knowledge
to improve services for an area that is experiencing
peace after having been devastated by a vicious, 20-yearlong
conflict.
Hospitals and health systems, particularly in these contexts,
are complex organizations beleaguered by very
serious constraints, especially regarding funding and
human resources. Making the best possible use of the
scarce resources available is even more vital in these circumstances
and must be based on in-depth knowledge
of changing trends in the health needs and expectations
of the local population.
Redirecting efforts to meet emerging or re-emerging
Lacor course in Epidemiology and Statistical Tools, Lacor, Gulu, Uganda, May 2012
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needs and expectations of the population is complex
and requires time. The study will take 11 months and
will pursue the following main objectives:
- Understanding the current trend in needs and the
demand for health services
- Assessing the possible impact of increased border
movements with neighboring South Sudan
- Providing guidelines for possible re-allocation of resources,
if needed
- Building key capacities
- Improving local health strategies.
This study involves all major health providers in the
Gulu area who stand to benefit from the knowledge:
Lacor Hospital and its 3 Peripheral Health Centres in
Opit, Amuru and Pabbo, Gulu Municipal Hospital,
Gulu Medical District office, employees of Lacor and
Gulu hospitals, Gulu district administrators and managers,
Juba (South Sudan) hospitals, and the Gulu University
Medical School.
One of this study’s main objectives, capacity building,
was aimed at the existing gaps in: health data quality;
data management; applied clinical research capacities;
operational research; and project management. Professor
Donato Greco, whom we interviewed in our July
2011 issue, carried out the first capacity building activities
last May. He is a medical epidemiology consultant
at the Istituto Superiore della Sanità (ISS), Italy’s na-

tional centre for epidemiology, monitoring and health
promotion. He was formerly Director of Research, Epidemiology
Laboratory and Biostatistics at the ISS and,
from 2004 to 2006, General Director of Healthcare
Protection with for the Italian Ministry of Health. He
is also a volunteer professor at Faculty of Medicine of
Gulu University.
The capacity building activities were the following:
A three-day training course in Applied Statistics in
Excel which was designed to teach the use of a tool that
can improve data quality control and analysis for health
data officers working in local institutions. Among the
23 participants, 19 were Lacor Hospital staff. The course
took place at Gulu District Administration Block and
was free of charge for participants.
Lacor Course in EXCEL, Lacor, Gulu, Uganda, May 2012
Pursuing quality
IDRC has sponsored a project at Lacor Hospital that
started on May 1st, 2010, and lasted until December
30th, 2011. The goal was to review and strengthen management
processes to determine impacts on the quality
of services provided by the Hospital. The main implemented
improvements were focused on empowering
middle management, introducing regular quality assurance
processes (including inspections and supervisions),
and reviewing the scheduling of shifts among nursing
and support staff, with special focus on wards requiring
qualified staff on a 24/7 basis (like the General Medicine,
Children’s Ward and Maternity Ward, etc.).
Improvements in quality of services were assessed through
external audits carried out at the start and at the end of
the project. The final results highlighted significant im-
A course on Epidemiology and statistical tools which
was aimed at increasing the skills needed for handling
individual clinical records and basic statistical analysis
oriented on clinical research. The course included basic
knowledge of epidemiological methods and design,
as well as of the newly-released CDC/WHO Epinfo 7
software.
Most of the 29 participants were Lacor Hospital medical
specialists, doctors, medical officers and nurses and
took place on the Lacor Hospital University Campus.
During the closing ceremony, each participant received
a certificate of attendance and the “Lacor Pen”, a handmade
tropical wood pen with gold-plated parts and
enameled Lacor Hospital logo created by Prof. Greco.
All students gave enthusiastic feedback.
provements especially in the quality of nursing care, with
a significant reduction in the Hospital-Acquired Infection
(HAI) rate, which decreased from 28% at the beginning
of the project, to around 14% at the end. External
audits of nursing practices also highlighted significant
improvements in the observed compliance with agreed
practices compared to the start of the project.
An analysis of the results of the HAI survey as well as of
the External Nursing Audit strongly suggests that these
improvements were promoted mainly by the introduction
of regular and standardized Quality Assurance
processes, as well as by reviewing and strengthening the
role of middle management. Better scheduling and a
new rostering model which allowed for better planning
of nursing staff shifts may also have contributed to the
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improvements, although the impact of this is less direct
and thus harder to assess.
Finally, the project suggests that by empowering middle
management and giving them an active role in the
change process, new management practices can be developed
in a way that does not conflict with local culture.
Thomas Molteni
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Department
Surveyed
patients
Patients with
HAI
HAI
prevalence %
2010 2011 2010 2011 2010 2011
2010-
2011
Diff. %
Medicine 72 83 17 14 23,6 16,9 -29%
Surgery 94 101 45 21 47,9 20,8 -57%
Maternity 60 30 14 5 23,3 16,7 -29%
Paediatrics 184 104 39 5 21,2 4,8 -77%
TOTAL 410 318 115 45 28,0 14,2 -50%
Photo Mauro Fermariello
Photo Mauro Fermariello

Lacor Hospital through the eyes of children
Schools interested in hosting a presentation on Lacor Hospital can contact Diane McKay at the Teasdale-Corti Foundation,
by phone at 450-629-9622 or by email at d.mckay@teasdalecorti.org
NEWS FROM THE CANADIAN FOUNDATION
PROGRESS ON THE REORGANISATION OF LACOR PHAR-
MACY
Thanks to the financial contribution of the Marcelle and
Jean Coutu Foundation, Canadian pharmacists, under the
supervision of the organization Pharmacists Without Borders
(PSF-Canada), have now been working on the reorganization
of the Lacor Pharmacy for a period of two years.
The reorganization has already had an important impact
on the management of pharmacotherapy as well as the
physical reorganization of the warehouses. Additionally,
the Department of Pharmacy has become a training centre
for Ugandan pharmacists.
In order to continue supporting the reorganization, the
Marcelle and Jean Coutu Foundation has accepted to continue
its financial commitment for another three-year pe-
riod. PSF-Canada and the Teasdale-Corti Foundation will
also contribute to the project’s financing. We are extremely
grateful to the Marcelle and Jean Coutu Foundation and
PSF-Canada for their support with this project.
PROJECT: INCINERATOR
One of the priorities of the Lacor Hospital is the management
of medical and domestic waste. A large portion of
the medical waste requires incineration to avoid bacterial
contamination. The current equipment is no longer adequate
to meet the demand. With the support of the organization
Engineers Without Borders Quebec, and the donations
from the dinner benefit organized last year by the
members of the Order of Engineers of Quebec (Regional
Chapter of Québec and Chaudière-Appalaches) and the
R.I.R.E 2000 Centre, Engineer Gérard Gosselin travelled to
the Lacor Hospital to evaluate the situation and, in light of
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his findings, recommended the appropriate equipment.
Mr. Gosselin’s report was filed last April and recommended
the purchase of a new, more effective incinerator that
also complies with international environmental standards.
The next step is to find financial partners for the purchase
and installation of the new equipment. The Teasdale-Corti
Foundation and Engineers Without Boarders Quebec are
currently seeking financial partners for the project. We sincerely
thank Mr. Gérard Gosselin, the directors of Engineers
Without Borders Quebec (Regional Chapter of Québec and
Chaudière-Appalaches), and the R.I.R.E. 2000 Centre for
their active participation in this project.
DOMINIQUE CORTI IN THE MEDIA
During her visit to Canada, Dominique Corti participated
in many events with the Montreal media. We invite you to
listen again to these interviews by accessing the following
links:
Radio Canada International’s broadcast Tam Tam hosted
by Raymond Desmarteau.
http://www.rcinet.ca/francais/chronique/tam-tam--lesplus--de-rci/12-28_2012-04-26-nouveaux-defis-pour-lhopital-lacor-en-ouganda/
CBC Radio’s broadcast Homerun with journalist Sabrina
Marandola.
http://www.cbc.ca/homerun/2012/04/26/doctor-corti/
We would also like to inform you of Marina Orsini’s participation
in the broadcast “Ricardo” last March 26th, when
she took the opportunity to mention the life of Lucille Teasdale
and her hospital.
http://www.radio-canada.ca/audio-video/pop.shtml#
idMedia=undefined&lang=fr&pl=0of1&posMedia=0&s
tartPosition=19.686&urlMedia=http://www.radio-canada.ca/Medianet/2012/CBFT/2012-03-26_11_00_00_
ric_1307_800.asx
Lastly, Francis Reddy mentioned our Foundation and Lacor
ThE TEASdAlE-CorTI FoundATIon
The Teasdale-Corti Foundation is a charitable organization
created to contribute to the support of the Lacor
Hospital in northern Uganda.
Reg. N. : 890520745RR 0001
donATIonS
Donations to the Teasdale-Corti Foundation
can be sent by mail to:
8880, boul. Lacordaire, St-Léonard,
QC, H1R 2B3 (CA)
or online: www.teasdalecorti.org
Hospital during the broadcast of “Des Kiwis et des Hommes”
last April 24th. Follow the link and place the cursor
on 21:50.
http://www.radio-canada.ca/emissions/des_kiwis_et_des_
hommes/2012/document.asp?idDoc=216303
We warmly thank all of the hosts and journalists.
NEWS FROM THE ITALIAN FOUNDATION
THE MAÎTRISE DES PETITS CHANTEURS DE QUÉBEC IN
MILAN
The Maîtrise des Petits Chanteurs du Québec is a school
where about one hundred young singers between 6 and
17 years old learn music and choral singing through strong
leadership, while following their academic training in two
schools in the Capital School Board. The young singers
have given a concert on July 3 at Santa Maria degli Angeli
e San Francesco Church in Milan. All profits will be donated
to the Fondazione Piero e Lucille Corti onlus. We are very
grateful for their support.
ConTACT
Filippo Campo - f.campo@teasdalecorti.org
Tel.: +1.514.253.1737
8880, boul. Lacordaire, St-Léonard, QC.
H1R 2B3 (CA)
revision: Raynald Adams, C. Tr.
nEwS From lACor
is a bulletin offered to all who wish to receive news on
the Lacor Hospital and the Teasdale-Corti Foundation.
It is published by Fondazione Piero e Lucille Corti (Milan,
Italy) and Teasdale-Corti Foundation (Montreal,
Canada).