Today marks the 30th anniversary of the establishment of the Irish Embassy in Uganda. This year is also the 20th anniversary of transformative Irish Aid-funded programming in Karamoja, Uganda’s poorest Region.

In the first of a two-part series on Ireland in Uganda, Miriam Donohoe visits Karamoja to see the incredible impact Ireland has had on the area over three decades, especially in education and health.

MOTHER OF SEVEN Alice (35) sits on her hospital bed proudly cradling her thriving newborn twin boys in the bustling maternity unit of Moroto Regional Referral Hospital in Karamoja, north-east Uganda.

Looking at this smiling woman it is hard to believe that just four days ago she was on the brink of death after heavy blood loss following a caesarean section which was immediately followed by an emergency hysterectomy.

Having given birth with no problems at home to five other children, Alice was not anticipating difficulties with this pregnancy. She went into labour in her village in Nabilatuk District, but it was slow and difficult. A doctor at her local health centre referred her to the maternity unit of Moroto Regional Referral Hospital to have the birth managed.

Gynaecologist, Dr Denis Esayu, was on duty when Alice was admitted. “I was concerned at how the labour was going and decided the best option for the mother and her babies was a caesarean section”.

Unfortunately, Alice bled heavily after the section and the difficult decision was taken to do a hysterectomy. But the bleeding persisted. “She was losing a lot of blood, and her vitals were very poor. Her life was at huge risk. We needed to get her blood urgently.”

Within minutes Alice was being transfused with a unit of life-saving blood. But if this had been two-and-a-half years earlier, the outcome would likely have been a lot different. The hospital would have had to send to Mbale, Nagasero or Kampala – all involving round road trips that would have taken up to 10 hours – to get the blood. Alice could have died waiting. The blood was readily available thanks to the fact that Karamoja now has its first ever Regional Blood Collection and Distribution Centre, funded by Irish Aid and managed by CUAMM, (Doctors for Africa).

Programme Manager with CUAMM, Dr Lilly Boxtell Achayo, said health care has been transformed and the lives of countless patients saved – including that of Alice – because of the new Blood Collection Centre. Today the amount of blood collected and processed is meeting 70 to 80 percent of need in the Karamoja Region.

“The setting up of the Blood Collection and Distribution Centre in Moroto is one of the single biggest advances in health care here in the Region,” she said. “It has especially had a positive impact on maternal health services. There have been harrowing stories from the past of health workers desperately looking for blood at critical times, and having to wait hours whilst a mother or patient was dying. The new unit has contributed to the sharp decline in maternal mortality in hospitals and health centres in Karamoja.”

Meanwhile, Alice is very grateful that her life was saved. “I am feeling good. I might have died and my children left without a mother. I do not give blood normally, but I will in future as I see now how it can help people. I will encourage people in my village to give blood also.”

Life-saving changes

The Blood Collection Unit is just one of a number of life-changing initiatives funded by Irish Aid over the last 20 years in Karamoja, Uganda’s poorest region, in the areas of health, education, women’s empowerment and social inclusion.

On another floor of Moroto Regional Referral Hospital, there are four critically ill babies in the Neonatal Intensive Care Unit, their anxious mothers watching over them. Since the unit opened two years ago the lives of many premature and ill babies have been saved, according to doctors and nurses who work here.

Today mother of eight Olivia (36) is praying that her 11-day-old son, who has meningitis, survives. From a village 40 kilometres from Moroto town, she was alone gathering sticks for firewood in woods four kilometres from her home when she went into labour. She delivered on her own, and then cut the cord with her knife before walking home carrying her newborn son. He became very ill a few days later.

“I am very worried,” said Olivia. “But I know that he is getting the best care here, and I just pray he will survive. I am happy that the hospital has the facilities they need here to help him.”

Paediatrician Dr Alone Namabwe is in charge of the Neonatal ICU and says the setting up of new neonatal units and improvement in services in Moroto Regional Referral Hospital and in two smaller hospitals in Matany and Kaabong in Karamoja Region has been a game changer in the treatment of critically ill babies.

He said the number of infant deaths per month in the Karamoja Region has dropped by more than half from 44 in 2021 – when the Irish Aid supported health project with CUAMM, (doctors for Africa) started – to 19 today.

In the hospital’s Accident & Emergency Department Dr Moses Omongin (28) takes a break from his busy shift. Over the last hour, he has been trying to stabilise a critically ill 18-month-old boy who was admitted with an unexplained high temperature.

Dr Omongin is a local, coming from a village at the base of Mount Moroto outside Moroto town. He said he has the Ireland-Karamoja Bursary Programme, which offers school scholarships to children, to thank for helping him achieve his dream to become a doctor.

Help from Ireland

Ireland has had a huge impact on education in Karamoja in the last 20 years. Almost 4,000 children have been awarded bursaries, some of which have extended to support students in college and university. To date, 350 Karamajong bursary students – including Dr Omongin – have graduated with degrees, diplomas and certificates.

As well as bursaries Ireland has supported the building, renovation or expansion of 48 schools in Karamoja and in refugee settlements where Irish Aid supports. Teachers have been trained and vocational schools established to give young people practical skills.

Dr Omongin is the third of five children. “My father died when we were young, and my mother didn’t have regular work. Raising her children was a struggle. She believed in education but just didn’t have the money to send all of us to school.”

The first two children had to drop out of the state school system at a very early stage to find work.

“The same would have happened me but I was a good student and before I left Primary 7 my teacher encouraged me to apply for the Ireland-Karamoja Bursary Programme Bursary Programme and I was accepted,” he said. “This has changed my life and put me on a different path. I studied really hard in order to get into university to study medicine. I wanted to be a doctor ever since my mother spent two months in hospital with TB.”

When he graduated as a doctor from the prestigious Makerere University in Kampala Dr Omongin was offered jobs in hospitals in Kampala. “But my dream was to come home to Karamoja and Moroto and to use my skills as a doctor to give back to my community, even if it meant less salary. My mother is so proud of me. She never thought she would see her son a doctor. Her first time ever in Kampala was for my graduation, and it is a day I will never forget.”

Irish Ambassador to Uganda, Kevin Colgan, said the impact of Ireland in Karamoja and other parts of Uganda over the last 30 years cannot be underestimated. He was first posted to Uganda between 1996 – 2000, when the Embassy worked with local government in Kibaale and Kiboga in the west and in Kumi in the east. He returned as Ambassador in 2021.

He said: “Support for the education sector has addressed low levels of access, retention and completions in primary and secondary schools. Up to 2023 over 280,000 Karamajong pupils in 368 primary and 32 secondary schools have been reached. Literacy levels have increased and last year Karamoja achieved an 80% pass rate for primary school learners, surpassing the national pass rate of 78%. This would have been unthinkable 20 or 30 years ago.”

The Irish Fellowship Programme has given 374 early to mid-career Ugandans great opportunities to advance their education and many are now giving back, holding positions of power in their districts. One of those Fellowship alumni is Lady Justice Jane Frances Abodo, the first woman DPP in Uganda.

In addition, over 4,000 young people, mostly women, have benefitted from vocational training over the years, with an estimated 76% employed on completion of their training in 2023.

“Through UN agencies Ireland is also supporting 1.36 million refugees with cash and food assistance across 13 settlements in Western and North-Western Uganda. And thousands of women have received support under special programmes in Karamoja designed to protect them from gender-based violence. Ireland also led out on the SAGE project, where elderly receive a monthly payment from the Government. This was piloted in Karamoja and expanded around the country.”

The Ambassador said Ireland’s support for Karamoja and other parts of Uganda will continue. “Our development policy is clear – we focus on those furthest behind.“

“We are now one year into a five-year mission strategy which will see us focus on Karamoja, but also in the areas of climate change, access to human rights, and building resilience of Ugandans.

He added: “We will be by the side of Ugandans as their country moves to become a place of inclusion and equality, a place where all young people will receive an education and have opportunities, a place of peace, and a place where all its citizens, young and old, are respected and cherished .”

Miriam Donohoe is a journalist and media professional.