Alison Fletcher

Alison is Head of Physiotherapy & HIV Clinic Management with CMS in Uganda.

Alison's road to Uganda.

While still a student, I felt a specific call to work overseas. I was reluctant to follow it as I enjoyed working at Queen’s Medical Centre and didn’t want to leave Nottingham. I joined the family of St Nic’s when I moved to Nottingham to begin work in 1999, and I was greatly encouraged by those who prayed for me as I explored the possibilities of overseas work, and finally it was easier to follow God’s direction than try to keep on protesting. I wanted to use the skills God had given me in physiotherapy to serve those less well-off, in a resource-limited setting, and I moved to Kiwoko Hospital (www.fokh.org.uk) in rural Uganda in early 2003. 

I came to Kiwoko to establish a physiotherapy service, and that has involved raising its profile within the hospital community, training others in physiotherapy skills, and treating a broad range of patients over the years. My involvement in physiotherapy is now largely supervisory, with our very capable Ugandan physiotherapist and physio assistant managing the daily work. I oversee their work, provide ongoing training and see the more complex or problematic patients. I now have a additional role within the HIV clinics, with a remit to improve clinic efficiency. We have around 1000 clients registered in the adult and children’s clinics, and I have taken on management of the CD4 testing service, a blood test that gives us an indication of disease progression, and coordination of the clinic’s nutrition support programme, offering food parcels to those who are underweight in an effort to boost their ability to fight the disease and stay well. I have a particular desire to see change in the children’s clinic and it is encouraging that improvements are happening all the time. Since 2004 I have coordinated monthly club days for HIV+ children, and this now combines both roles in physiotherapy and the HIV clinics. In addition to my official ‘work’ roles, I lead a weekly bible study with our Ugandan nursing and laboratory students, and enjoy visiting them regularly in an informal capacity.

Funding and Future

I work with the Church Mission Society (CMS), supported by several churches throughout the UK. I am very grateful to the support they offer, and particularly the practical and prayerful support of the St Nic’s family. I am planning to return to the UK in the spring of 2012, which will be just as significant as moving from the UK to Uganda in the first place. I often wonder why I live in Uganda when my own country has its own needs, and while at the moment I am not sure what I will do, I believe that everything I have done and currently do at Kiwoko will inform and lead to what comes next.

For Prayer

• For ongoing development of the physiotherapy department, for Moses our Ugandan physio as he continues to gain skill and wisdom.
• For the HIV clinics and all the staff involved in the programme – for improvements in the health of our clients and especially for continued accessibility to the important antiretroviral medicines.
• For me, as I start to make plans about leaving Kiwoko in 2012.

In the last year we have been seeking to make our care for teenagers living with HIV/AIDS more comprehensive. It is quite a new problem to have teenagers who are HIV+ due to maternal transmission still alive, due to improvements in access to and quality of social and medical care. This group of young people have some very particular needs, as they deal with the loss of their parents or other siblings, with their own uncertain future and at times poor health, and with the stigma that they face from others as well as the usual problems of being teenagers. We have had two residential trips for them and much good has come out of each, especially in building relationships with the staff and between themselves. We are now looking at the next step of helping the oldest ones become independent adults, and to integrate them into the main adult clinic. We are facing several challenges, mainly due to their fear of being identified as being HIV+ by others in their villages, and their preference just to hide. We are continuing to discuss how we can best help them – as they have so much potential!