SUSTAIN
TRAIN
EDUCATE
PROMOTE
in Uganda
What is Step Up?
“STEP-UP” (Sustain, Train, Educate, Promote-Uganda) is an all volunteer project working in Northern Uganda, an area which continues to suffer from the effects of a 20-year armed conflict. Our mission is to improve the health and psychosocial well-being of families in the region through collaborative medical and psychosocial capacity building. Volunteer U.S. health and social work professionals work in partnership with Ugandan colleagues at our sister NGO, called SUU (STEP-UP UGANDA), to offer training and consultation to professionals and community members. The project is predicated on the belief that medical and psychosocial well-being are inextricably related to the process of peace and reconciliation. US trained medical and social service personnel bring knowledge, skills and resources while local Ugandan practitioners and community leaders hold social, cultural, and indigenous knowledge and wisdom. Thus, the project is built on a foundation of collaboration based on shared respect, planning and decision making, leading to sustainable capacity building.
In the words of a member of the Ugandan branch of SUU, “we envision a world in which individuals, families, and communities have the health, psychosocial well-being, capacity and hope to build a society where people can experience education, good governance and pursue sustainable livelihoods. We appreciate how STEP-UP treats us with respect, values our skills and commitments, while sharing their valuable insights and knowledge. Together, we have already had an impact on improving maternal and child health and helping clan and religious leaders to work on confronting the long-standing trauma from the armed conflict that has not left our community.”
OUR TRAININGS
Psychosocial Capacity Building
The combination of a brutal 20-year armed conflict that left 95% of the population living in Internally Displaced Person’s (IDP) Camps, and other factors – ethnic marginalization and isolation of the Acholi tribe in Uganda, poverty, increasing difficulty farming due to climate change, the lack of a comprehensive and effective peace and reconciliation process – has led to unresolved collective and individual trauma. During the armed conflict, when people were living in IDP camps, many cultural traditions were neglected and not passed down to younger generations, social cohesion was frayed, and the clan leadership structure of extended families was placed under severe stress. Consequently, there are high rates of conflict within and between clans, domestic conflict and violence, suicide, alcohol and drug use.
STEP-UP’s psychosocial capacity building work focuses on training medical providers, catechists, tribal and religious elders, community organizers and administrators, women’s leaders, police officers and others to recognize the many ways that collective trauma is manifested and to help people to develop the skills to prevent further social fragmentation and to intervene with individuals and families who are suffering. Cultural practices are centralized and Ugandan and US team members collaboratively plan strategies, interventions and training programs. Internationally recognized and validated psychosocial programs that respond to war and conflict are adapted by the Ugandan and US volunteers so that they are culturally and socially meaningful and appropriate. In an area where talk therapy and counseling are not normative, there is an emphasis on narratives, story-telling, problem solving skills, instilling hope, and the use of music, and dance as culturally meaningful healing strategies. There is also a focus on strengthening families. A training of trainers model is utilized so that those who are trained can in turn train others.
OUR TRAININGS
Medical Capacity Building
Medical training has been primarily focused on maternal/child health:
- Six skilled midwives, nurses and clinical officers have been trained to train others in Helping Babies Breathe and Bleeding After Birth
- The Ugandan trainers, in turn, have trained approximately 120 health care workers staffing the 26 health centres in Aswa County in Helping Babies Breathe and Bleeding After Birth
- Additional trainings have been provided in both curricula annually to 40 newly hired medical staff.
- The trainers have continued to facilitate ongoing practice in the skills of Helping Babies Breathe and Bleeding After Birth at each of the 26 health centres, eight weekly modules, one hour a week.
- In February 2020 eight skilled midwives were trained to teach the WHO approved curriculum Pre-Eclampsia/Eclampsia and Essential care for Every Baby. Large scale implementation to over 100 skilled health care workers, delayed due to the COVID-19 pandemic, resumed in 2022.
- We have distributed equipment to ventilate newborns, blood pressure cuffs, educational materials, thermometers and other supplies to all health centres in Aswa County to promote safe deliveries and newborn care.
- In January 2023, STEP-UP will train trainers to teach Essential Care of the Mother in Labour and Delivery.
In 2017, upon the recommendation of our Ugandan colleagues we started a training program for over 200 Village Health Team workers and Traditional Birth Referral Agents (former Traditional Birth Assistants), noting that often they are the first, and at times the only, health care sought by people living in remote villages. The emphasis was on the importance of their leadership role within their villages, even if they are not allowed to perform deliveries, utilizing that role to educate expectant families, encouraging them to seek care from skilled health professionals in the health centres, and knowing when a situation requires urgent, advanced care. The training was extended in 2020 and was updated with content from the curriculum provided to the skilled health workers. Although the COVID-19 pandemic interfered with the large scale implemation, this very important training plan will be resumed in January 2023 when STEP-UP is on the ground again in northern Uganda.
STEP-UP medical team completed their 2020 trip on February 26, 2020, after having implemented training of Pre-Eclampsia/Eclampsia and Essential Care for Every Baby. Plans for large scale implementation were in place. In addition, widespread training of content appropriate to Village Health Team members and Traditional Birth Referral Assistants was planned. Shortly afterward the COVID-19 pandemic changed the world. Appropriately our plans for follow up training were halted. STEP-UP and our SUU partners quickly responded to the crisis and changed our emphasis. Throughout 2020 and 2021 STEP-UP has provided financial support for the following:
- Personal Protective Equipment for the 26 health centres within Aswa County.
- COVID training by SUU medical team to 120 skilled health care providers.
- COVID training by SUU medical team to over 200 Village Health Team members.
- COVID training by SUU to community leaders.
This training has been greatly appreciated and recognized by observers from the World Health Organization as a model that should be implemented throughout Uganda. The Gulu District Health Officer stated that the trainings were “very participative and quite interactive and informative to the participants” noting that “the community once engaged will own the efforts toward achieving and sustaining their own health.”
Team Members & Participants
UGANDA TEAM
U.S. TEAM
Past Step Up Participants
Ashley Brant, M.D. (2014, 2016)
Leah Cantler, MSW, LICSW (2012, 2013, 2014)
Pamela Cavanaugh, P.T. (2016)
Sallie Lake-Deans, LICSW (2019)
Jane Fields, M.D. (2016)
Eileen Giardina, R.N. (2010)
Sandy Kobylarz, P.T. (2016)
David LaLima (2010, 2012)
Heather Summerby, R.N. (2012)
Maria Torres, Ph.D., psychologist (2020)
How Donations Are Used
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Giving By Check
Checks can be made out to Sponsor, Inc or Mission.Earth (our new fiscal sponsor), adding STEP-UP to the memo line and mailed to the following address:
Mission.Earth
1257 Worcester Rd, #312
Framingham, MA 01701
The Power of Your Donation
Your support is greatly appreciated and goes a long way in helping the people of northern Uganda.
$100
4 reusable newborn bag/ mask ventilators. Each health center needs this life saving piece of equipment in case a baby does not breath at birth.
$100
2-day training of Helping Babies Breathe for 3 health care providers.
$100
Training books for 80 health care providers.
$250
3 “Neonatalies” (portable training babies used to help providers learn to care for a baby who is not breathing).
$1000
4 Mama Natalie interactive training models, used to train providers how to assess and respond to post-partum hemorrhage.