Uganda Medical Mission with Dr. Chris Ingram: Gorilla Guardians

Medical Visit to Uganda with Dr. Chris Ingram (Part 2)

Published November 2022
By Chris Dietrich

The second part of my trip to Uganda in February 2022 with Dr. Chris Ingram and Dr. Caspar Fithen (a British social anthropologist, and former United Nations colleague) focused on assisting a well-established non-profit organization protecting endangered mountain gorillas in the Bwindi Impenetrable National Park. Our mission is to help identify and develop health projects that directly impact rangers and local community members on the front lines of protecting Africa’s endangered species, and who often do not have access to medical assistance.

The organization we visited, Conservation Through Public Health (CTPH), is run by a renowned wildlife veterinarian Dr. Gladys Kalema-Zikusoka. It supports the Government of Uganda on gorilla research to diagnose and prevent the spread of disease among the gorillas, and to gorillas from humans living around the park, as well as other activities including supporting alternative livelihoods and improving the health, hygiene, sanitation and wellbeing of people living in proximity to the gorillas, and reducing human-wildlife conflict.

CTPH was formed after a fatal outbreak of scabies amongst gorillas in Bwindi, which originated from communities living at the boundary of the protected area. Part of CTPH’s holistic approach to the health of Bwindi’s approximately 450 mountain gorillas (of the 1,000 worldwide) is to support volunteer gorilla guardians and village health teams helping with a broader conservation doctrine of reducing human-gorilla interaction outside of the park, and bolstering the health of local populations.

The gorilla guardians, also known as HUGOs (Human-Gorilla Conflict Resolution teams), are tasked with safely shepherding gorillas out of community land and back into the protected forest landscape – gorillas will regularly forage for banana plants grown by local farmers.  Unfortunately, in doing so, the gorillas can be exposed to human pathogens and diseases such as dysentery, especially when households do not use pit latrines.  The areas surrounding the Bwindi Impenetrable Park are highly populated and cultivated; there is not an effective buffer zone, making the work of the gorilla guardians all the more important to preempt disease transmission.  The guardians also collect gorilla fecal samples so that CTPH’s laboratory can monitor their health, and direct medical interventions to prevent the further progression of disease among the gorilla families, if needed.

An additional line of defense are the Village Health and Conservation Teams (VHCTs), which assist local communities around Bwindi Impenetrable National Park to better understand hygiene and health, as well as family planning.  This not only benefits the local inhabitants by reducing the local disease burden, but also helps curtail the onward spread of pathogens to gorillas when they enter community landscapes.  Each VHCT is tasked with visiting a couple dozen households on average to help monitor health indicators.  Like the gorilla guardians, the VHCTs are unsalaried volunteers, and their work is vital to promoting better health outcomes.

Our visit to the CTPH site in Buhoma town, overlooking the main entrance to Bwindi Impenetrable National Park, was to help the NGO identify feasible medical projects that would assist the gorilla guardians and VHCTs. CTPH organized several meetings with teams of gorilla guardians so that we could better understand their work and assess any interventions or support that could benefit them.  It was through these discussions that medical assistance was first raised as a concern because health care insurance is not affordable for most of the guardians, who are mainly local subsistence farmers.  Furthermore, we visited a VHCT team leader in her village to learn about their community health education projects, and became aware that VHCTs also had no access to formal health care.  Through later consultations with CTPH we decided that health care coverage was a desired benefit, and something that could be obtained through the Bwindi Community Hospital located in Buhoma town.

The hospital is an incredibly impressive private, non-profit organization that provided a detailed tour of its facilities to Dr. Ingram during our trip to Bwindi.  It was founded in 2003 by U.S. missionaries under the Church of Uganda’s Kingizi Diocese. The hospital’s website notes that it serves approximately 120,000 Ugandans, and is staffed by a team of more than 100 individuals, including doctors, nurses, midwives, other health workers, and support staff.  As of this autumn, we were able to initiate a program through CTPH to provide an insurance membership for VHCTs and gorilla guardians living within the vicinity of Bwindi Community Hospital so that they could access free health care at this facility.  The insured group is comprised of 47 gorilla guardians plus 222 of their family members, as well as 164 VHCTs and 851 of their family members, totaling 1,284 individuals now covered by health care.  The services include outpatient, inpatient, eye care, chronic illness, antenatal, post-natal, and emergency care.

Editor’s Note: This piece was submitted by Chris Dietrich while in Zambia’s Kafue Flats protected area with Dr. Chris Ingram assessing the health needs of wildlife police officers and community scouts supported by the International Crane Foundation. November 1, 2022

(Part 1) Uganda Medical Mission with Dr. Chris Ingram: Elephant Eco-Guards

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