WINCHESTER, United Kingdom — In rural Uganda, the non-profit organization Interoots has been collaborating with the community of Kasasa to create a project that is “for the community, by the community.” The result of their hard work and dedication is the TaSCA project. While it was initially based on three pillars; a secondary school, the Institute of Indigenous Cultures and Performing Arts (ICPA) and a credit union, the community has now decided to extend the project further, with the construction of a health care clinic. The clinic will serve the students of the secondary school and residents of the community, and provide hands-on experience for students interested in a medical career. This facility will be life-changing for the people of the community, who currently have to travel hours to receive primary health care.
In recent years, Uganda has experienced improvements in health and well-being, and access to healthcare has increased. From 1991 to 2014, life expectancy rose for both males and females, from 45.7 years to 62.2 years and from 50.2 years to 64.2 years respectively. Additionally, under-five mortality rates fell during this time period, from 187 to 55 deaths per 1,000 live births.
However, geographical disparities in health status mean that rural areas, like Kasasa, have been left behind. These communities, along with the rest of the country, experience the burden of communicable diseases, such as malaria, HIV/AIDS and TB, but they also suffer as a result of Neglected Tropical Diseases (NTDs). As a country, Uganda is endemic for all five NTDs that USAID’s Act to End NTDs East program targets: “lymphatic filariasis (LF), onchocerciasis, trachoma, schistosomiasis and soil-transmitted helminth infections.”
The First Medical Facility in the Community
Access to health care in rural areas is limited, and Kasasa is no exception. The clinic will be the first medical facility in the community; previously its citizens had to travel hours to larger towns, such as Kyotera, in order to access health care. Scott Frank, the Executive Director and Co-Founder of Interoots told The Borgen Project more about the specifics of the project. The clinic will be housed in a three-story building, and it will function as a sick bay for students, whilst also providing primary health care for the community as a whole. It will not be on the scale of a hospital, there will be no ICU, but there is the possibility of a surgical suite that visiting doctors can utilize. Instead, the clinic will be more akin to an urgent care facility, with anywhere between three to 10 circulating staff.
Total costs for the first year, including construction, staff hiring and medical resources could be around 101 Ugandan shillings, which equates to approximately $30,000 USD. While this figure may seem low, in the context of rural Uganda it is a significant amount.
Educational Opportunities and Economy
The clinic is not a standalone venture, and it ties in closely with other aspects of The TaSCA project. It will provide educational opportunities to students from secondary school, specifically those interested in a medical career. This will take the form of a work-study; students will combine first-hand experience in the clinic with science lessons. The hope here is that while initially, the medical professionals working in the clinic will not come from the community itself, they will be able to train students from the academy so that eventually the members of the community can run the clinic.
The clinic will also contribute economically to the community, through a connection to the credit union. Instead of a pay-per-service system, members of the community will pay a lump sum at the beginning of each year to cover any medical services that they may need. Any profit generated will go into the union, which aids anyone in the community who borrows from it. So the clinic is not just a medical facility, but also a source of income for the community.
Currently, two-thirds of the clinic are complete. While the project is still on track to be open at the end of the year, stringent government regulations surrounding health care slowed down the initial stages. Frank explained that there is a fear of abuse of trust from international organizations, and therefore the government wants to have a clear idea of who is entering the country to practice medicine and to what end.
A Different Approach
Interoots functions in an unconventional fashion compared to other NPOs. It employs a model called “non-colonial philanthropy” whereby the communities themselves design, propose and implement projects, like the TaSCA project. While Interoots funds the projects through microgrants, it does not work on the ground, and once it distributes the money and the project becomes self-sufficient, it ceases its involvement.
In fact, most of the community is not even aware of Interoots’ involvement in the project. Interoots believes that this is the best method of philanthropy since the community members have the best knowledge of the issues that need a solution and it prevents problematic cycles of giving that are often associated with non-profits.
The TaSCA Kasasa Community Board (TKCB) leads the TaSCA project. The board is the center of all decision-making, while Interoots acts as a partner of the board and the funder of the project. The community requests funds and explains what they will use it for and Interoots provides this money in the form of microgrants.
A Non-Antagonistic Relationship
Frank emphasized that while Interoots may question the board’s requests, and start a conversation in this way, it never directly instructs the community on how to carry out the project or distribute money.
Frank describes the relationship between Interoots and the TKCB as a non-antagonistic one and explains that the two never directly communicate. Instead, Interoots employs a liaison, an individual from the community, and while “We [Interoots] draft the letters that the liaison signs or drafts with us, the words are always the liaison’s at the end of the day.”
The overall aim is self-sufficiency. Every aspect of the TaSCA project aims to create streams of revenue so that the project will one day fund itself. This goal is already coming true: after just three years the secondary school is paying for itself.
The Community’s Roots
There is a theme that runs through the TaSCA project: the preservation of Ugandan culture. Frank made sure to emphasize that the clinic will collaborate with community elders to incorporate traditional medical practices that have existed for generations. Their knowledge of treatment methods that utilize local plants is still relevant today, but currently, these methods have been all but erased by colonialism. The Tat Sat Community Academy, the secondary school built during the TaSCA project, aims to update education in the community, whilst holding to indigenous traditions which people have often abandoned in favor of Western-style schooling. Additionally, the ICPA’s primary aim is to preserve the community’s heritage.
This goal is fundamental because, currently, 78% of Uganda’s population is under 35, meaning that if traditions are not preserved now they could be lost forever.
By taking a backseat, Interoots has allowed an organic, community-run project to emerge, which should continue to succeed without external help. Its approach to philanthropy encourages community members to become actively involved in the project and have the freedom to address their needs as they see fit. The TaSCA project is the beginning of a new era for the community of Kasasa, but it will not leave the tradition behind.
– Lily Cooper
Photo: Courtesy of the TaSCA Project