Here’s the graph of the number of patients seen by each clinic every month. Note Obanga Pe wany only has one dot – the clinic has only been running for a month. I’m not currently collating the data for conditions seen (its available at the health centres), but over 60% of these patients had malaria.
Two Thirds of our patients are kids under 12, which is great from a saving lives perspective, but not so good for our sustainability as they pay less money.
Patients pay a flat fee which covers Consultation + Test + drugs. This means someone knows before they walk 2 hours to the health centre exactly how much money they need. Patients 0-4 years old pay USD 0.70c. 5-12 pay US $1. 13+ pay $1.50. Even in Uganda where people have very little, this is a relatively small amount of money, and always less than transport to the nearest other health facility. You won’t find cheaper healthcare in Northern Uganda outside the hopeless government system.
Over 90% of our running cost are drugs + the nurse’s salary + rent, and from our current experience it takes around 235 patients a month to raise the money required to pay for this. Here’s the graph showing how much money our health centres are losing/gaining each month. The line in the middle is the “sustainability line”, which the health centre has to stay above on average to be viable. Keep in mind a couple of really good months can offset 4-6 not so good ones (see Ocim) If you’re wondering why its US rather than NZ dollars, its because the New Zealand Dollar is a backwater currency and we want to be taken seriously. A beautiful backwater though…
As a side note, we also give some stuff out for free, like condoms, family planning and mama kits for pregnant mothers. Nurse Naume at Ocim gave out 300 free condoms one month. Awesome.
Take away points
- Around 235 patients a month is what’s needed for sustainability
- Even after only 4 months, Ocim is doing well enough for us to say they can continue indefinitely. Sustainability win and compounded good!
- Obanga Pe wany had a fantastic first month, if this continues it should also become sustainable.
- Cetkana is doing a great job, but is unlikely to become sustainable,.
- Elegu has started very slowly and is losing a lot of money, but its early days.
- Stats alone don’t show the good these places are doing. Stay tuned for the non evidence based stories to pull the heartstrings and give the majority of people who didn’t read this blog a warped view of how awesome these health centres are...
- 2/3 of our patients are kids, which is great for their health and their future.
PS: We’ve decided to extend Cetkana’s trial another 3 months to 9 months. Despite their currently unsustainably low number of patients, they’ve actually lost very little money. Unfortunately I doubt they will reach the magical 235 number to be able to continue, but we wanted to give them every chance. Their deficit is only USD $40 a month. You might say, why don’t we just fund that shortfall? That’s so little money to help provide healthcare for 150-200 really poor people a month. People have already offered. Maybe in future we will run centres with small subsidies. For now though lets shoot for the moon and go for 100% local sustainability. It may hurt to shut places down, but we can always go back and through this approach we’ll find the areas which desperately need quality health care, rather than just a lot.
If you got to the end my respect for you is immense. More exciting and inspiring stories coming soon.