Submitted June 2026
By Chris Dietrich
Dr. Chris Ingram and I traveled to Uganda in November 2025 to review four health projects treating wildlife rangers, their families, and associated communities on the frontlines of conservation. These are managed by non-governmental organizations (NGOs) that have worked closely with us for several years, and which we visited previously. Funding to support these programs is provided through our 501(c)(3) Wildlife Ranger Health Initiative that we established in December 2023, together with John McGillian.
The main goal of our trip was to give Dr. Ingram the opportunity to assist the staff and patients of two health clinics – one bordering Murchison Falls National Park, and the other Queen Elizabeth National Park. Additionally, we planned to review the outcomes and future needs of two other projects supporting the health of communities, helping wildlife, and natural habitat conservation. During our past Uganda medical trips in 2022 and 2023 we were joined by my former United Nations colleague, Dr. Caspar Fithen, a social anthropologist with a storied career in Africa. (Prior trip reports can be found at the end of this article.)
Throughout the article, please click any image to see a larger version and to scroll through all the galleries. Photo credit to Chris Dietrich and others.
Murchison Falls Park Community Health Clinic
We began our medical mission at the St. Jildo Irwa Health Centre operated by the Ugandan organization Natural Resource Conservation Network (NRCN). This clinic serves an agrarian community of several thousand mainly subsistence farmers living next to Murchison Falls National Park (in Lii Parish, Nwoya District).
We first chose this location in 2022 because it had been at the forefront of NRCN’s anti-poaching work and community engagement, then led by the award-winning Ugandan lawyer and wildlife conservation advocate Vincent Opyene. This area also featured ongoing human-wildlife conflict due to routine incursions by elephants from the park destroying crops. Moreover, there were no nearby health services – for example, roundtrip transportation to a government hospital costs the equivalent of US$12, making this unaffordable except in case of very serious illness or injury.
Dr. Ingram provided health checks and first aid training for the village’s Eco Guards during our first trip to Uganda. We then decided, in consultation with NRCN, that a clinic, though a significant investment, would be the best remedy to provide health care to this community on the frontlines of conservation. We secured funding for the project in early 2023, and visited the newly constructed clinic later that year so that Dr. Ingram could work with medical staff and patients. Two years later, and with the clinic running well in the interim, we decided to return so that Dr. Ingram again could consult with staff and patients. This also provided us with first-hand knowledge of the clinic’s many achievements, and areas for additional support.
There are six full-time staff at the St. Jildo Irwa Health Center: a doctor, two nurses, midwife, lab technician, and cleaner. The clinic provides inpatient and outpatient services; laboratory services; family planning, antenatal care, delivery and maternity services, and postnatal care; health education and counseling; and referrals. It further supplies subsidized medications to patients following diagnosis – previously medications had to be purchased in larger towns/ trading centers where prices are higher, and incurring transportation fees.
Dr. Ingram tirelessly consulted with all staff and dozens of patients for three days, only taking brief lunch breaks under the shade of a nearby tree. He examined routine illnesses, acute injuries, chronic issues, and infectious diseases, including the interpretation of in-house laboratory tests, and recommended treatments. The medical consultations were expertly facilitated by Diana Okello, who is a consultant for NRCN and prepares comprehensive monitoring reports detailing the clinic’s operations.
During our visit I was fortunate to speak with Molly Aceng, a prominent Eco Guard, farmer, and mother of three. We first met her in 2022, and she told me about how the clinic has benefited her family since its construction. She noted that providing medical services at this location helped reduce wildlife poaching because it significantly cuts costs for those seeking medical care, especially for their children. We have seen repeatedly how unforeseen illness or injury, and associated medical fees, can create a financial shock for subsistence farmers, which in turn incentivizes wildlife poaching to acquire immediate cash. Importantly, NRCN has implemented innovative methods to address the issue of human-wildlife conflict by distributing beehives – bees can deter crop raiding elephants, and honey sold – and by planting chilis – a cash crop that elephants avoid.
Wetland and Crane Conservation in Southwestern Uganda
Following our work at the clinic in Murchison, we drove to Mbarara, a large city in southwestern Uganda, where we reviewed projects implemented by the International Crane Foundation (ICF). This global organization does a remarkable job protecting endangered crane species and wetlands critical to these birds, other wildlife, and humans. This is especially important in Uganda where about one-third of the country’s endangered grey crowned cranes – a national symbol – live in the catchment area of the Rwizi River, which flows through Mbarara.
Unfortunately, in southwestern Uganda, as in many parts of the world, wetlands and riparian buffers vital for clean water, as well as for wildlife habitat, are being degraded or converted into farmland. Furthermore, the banks of streams and rivers are used for livestock grazing, and for extractive industries such as sand mining and brick making. Additionally, human and livestock waste flows easily into waterways feeding the Rwizi River.
We funded three ICF projects over the last several years to examine degradation of the Rwizi catchment area and determine how to address it. The broader aim was to protect wetlands at a larger scale while promoting community health. The first, in conjunction with Mbarara University of Science and Technology, conducted a baseline study of Rwizi River pollution and possible areas for intervention. Among many contaminants examined were pathogens that cause waterborne diseases such as typhoid and cholera.
The subsequent annual programs run by ICF showcase dual conservation and health interventions at the village-level. Primary focal points are crop diversification and the introduction of more nutritious vegetables planted within villages rather than in wetlands. A second is innovative rainwater storage, capturing large volumes for irrigation, household needs (including sanitation), and livestock consumption (keeping animals away from waterways). These reduce river pollution and human encroachment on wetlands, and simultaneously improve household clean water supplies, food security, and health. ICF also works with the district health office to conduct community health screenings.
We were fortunate to be hosted by ICF’s wonderfully engaging and knowledgeable team: Dr. Adalbert Aine-Omucunguzi, East Africa Regional Director; Patrick Engoru, Uganda Country Director; and Sarah Kugonza, Program Officer. The ICF staff provided us with a comprehensive tour of five rural sites outside of Mbarara where they implemented the pilot studies, introducing us to village groups involved in agriculture and animal husbandry. It was truly inspirational to see what they accomplish on a limited budget, using innovative ideas to genuinely assist health and wellbeing, all while enhancing environmental stewardship.
Queen Elizabeth Park Community Health Clinic
Our third stop was the Enjojo Wildlife Foundation, where we stayed at their enthralling eco-lodge bordering Queen Elizabeth Park’s Ishasha sector (just a few miles from Congo’s Virunga National Park). Enjojo assists with wildlife conservation within and outside of the park, particularly by supporting local livelihood projects (even finding employment opportunities for former poachers), and conservation education outreach. It is run by Kris Debref, a Belgian who has spent many years in Uganda and South Sudan developing innovative ways to improve park-community relations. She works closely with Umar Turyakira, who is from this part of Uganda, and expertly managed the construction of the health clinic we funded.
We decided to collaborate with Enjojo during our prior visit to this location in 2023 after observing the lack of sufficient medical facilities close to the adjacent town of Kameme and other nearby areas. Furthermore, Enjojo is a dedicated local NGO that would enthusiastically manage this type of project, and in support of the neighboring populations. We determined that, like the Murchison example, supporting Enjojo’s development of a similar clinic bordering the park could help address human health needs, and provide a tangible benefit for environmental stewardship and wildlife conservation.
We secured funding for the clinic in early 2024, and it was constructed later that year. It is now staffed by a medical clinical officer, nurse, midwife/ sonographer, and lab technician. They are able to provide the following services: inpatient and outpatient care; family planning, maternity, and antenatal care; and laboratory services. Plus, a medicine dispensary offers subsidized prices for patients.
Our trip to Enjojo provided an opportunity for Dr. Ingram to integrate with their team and observe how the clinic’s staff managed and treated the high volume of patients who arrived daily, some of whom with terrible illnesses and diseases. For my part, I could not have been more impressed by how Dr. Ingram took ample time to fully discuss each case with the patients. Many of them had rarely visited health professionals previously, and did not have clear medical histories that could be referenced during consultations. Similar to our time at Murchison, the stoicism of those lacking medical care, due to availability or cost, by no means suggests they are any less scared of serious ailments than those of us who can readily afford doctor visits and medicine.
Health Insurance Program Bordering Bwindi Impenetrable Forest
While Dr. Ingram was busy at the Enjojo clinic, Caspar and I spent a day on the road driving to Buhoma, bordering the Bwindi Impenetrable National Park, home to Uganda’s mountain gorillas. We visited the NGO Conservation Through Public Health (CTPH), which is staffed by an incredible team and run by the renowned veterinarian Dr. Gladys Kalema-Zikusoka. We initiated a program through CTPH in 2022 to fund yearly medical insurance coverage for individuals assisting the organization to protect mountain gorillas and critical habitat. This was accomplished in partnership with a state-of-the-art facility in Buhoma, Bwindi Community Hospital, which maintains an insurance program named eQuality. The insurance now covers more than 2,100 Gorilla Guardians and Village Health and Conservation Team (VHCT) members, and their dependents (accounting for about 8% of the active eQuality subscribers in the hospital’s catchment area). It is a small individual cost of about US$5 (Ugandan shilling equivalent) annually, but this is often still too pricey for a subsistence farmer to cover him/herself plus spouse and children.
Caspar and I interviewed Gorilla Guardians and VHCTs, and then met with the hospital’s leadership and the eQuality insurance department chief – a gregarious man named Brian Aryatunga we met a couple years ago who has a mastery of databases. The Gorilla Guardians and VHCTs greatly appreciate the insurance plan, and gave examples of when they, their families, or colleagues receive services from the hospital at a substantially lower cost due to the insurance. Some had chosen to seek care expressly because the plan was purchased for them.
The Gorilla Guardians and VHCTs also cited difficulties because the reduced fees for many hospital services still can be too expensive for them, especially related to procedures like surgery. They mentioned tough decisions about when to seek treatment, and how to raise money for health care they or their families need. Additionally, there are some insured individuals who cannot even afford transportation to Buhoma from outlying parishes. These interviews provided lessons about accessibility and ability to pay for health care when it is inexpensive, but not completely free.
Future Projects
Dr. Ingram and I have conducted six medical trips to Africa since early 2020, and our 501(c)(3) now supports ten health projects in the Central African Republic, Namibia, Uganda, Zambia, and Panama. These have utilized various methods to address the human health needs of underserved communities on the frontlines of protecting wildlife and natural habitats. Moreover, such modest investments in this manner can have tangible conservation benefits. It is our hope that this might attract additional support from other organizations and possibly help influence international wildlife conservation funding priorities. Personally, it has been thrilling to work with enthusiastic NGOs to assist them in developing bespoke interventions suitable to their unique locations and circumstances. And we look forward to further supporting our partners and finding new ones in Africa and beyond.
