GLOBAL HEALTH SPOTLIGHT: ST ANDREW'S CLINICS FOR CHILDREN

By Professor John Briggs, Chair

t Andrew’s Clinics for Children (STACC) was founded in 1992 by staff and students at the University of Glasgow.

Initially, STACC arose from a request by some Sierra Leone colleagues of Professor David Crompton of the then Department of Zoology at the University to see whether some students from the University of Glasgow might be interested in travelling to Sierra Leone to help in a children’s deworming programme. An appeal campaign was launched in the Sunday Post to raise the funds to support the two students’ travel to Sierra Leone, as well as start-up funds for the deworming project. The appeal was so successful that there were surplus funds raised and it was agreed with Robbie Ewen, then the University’s Secretary of Court, that a formal charity should be established in the University with the aim of raising funds to support primary health care in children’s clinics in sub-Saharan Africa. Thus, STACC formally came into being on 4 September 1992, with Robbie Ewen as the first Chair.

Thirty years later, STACC is still going strong and now provides financial support for six children’s clinics in five different subSaharan African Countries, these being Uganda, Nigeria, Kenya, Ghana and, most recently, Malawi. The deworming programme in Sierra Leone continued to be supported financially by STACC for 25 years before being absorbed fully into the national government’s Ministry of Health scaled-up programme for deworming. Recognising that the Sierra Leone government was now funding the programme in a sustainable manner, it was agreed that STACC would discontinue its funding in Sierra Leone and focus its activities on the other clinics which it supports elsewhere in Africa.

The types of clinics which STACC supports vary. Two of them are the children’s wards at two rural hospitals in remote areas of Uganda, these being St Kizito’s in Matany and St John’s in Aber. In both instances, STACC is able to fund about 35-40% of the operating costs of the children’s wards and so make a significant contribution to primary health care for the children of these areas. In Nigeria, STACC supports a mobile clinic system in Ile Ife which is 100% funded by STACC, unlike the two Ugandan clinics. The mobile clinics visit 12 villages in the region on a monthly basis to provide primary health care support to the local populations. Inevitably, one of the biggest challenges is keeping the vehicles on the road, as the state of Nigerian roads, once away from the main roads, rapidly takes its toll on the vehicles and STACC is currently engaged in a specific appeal at the time of writing to replace one of the vehicles which has come to the end of its life. Like Ile Ife, STACC also provides 100% of the funding for the clinic in Kenya. BION, an acronym from the Maasai language which broadly means ‘Health for Mothers and Children’, focuses more on preventing ill-health among children through feeding programmes and a very active mosquito net distribution programme.

One of the longest-supported activities has been in Ghana through STACC-Ghana. Initially, the focus of this support was on controlling schistosomiasis among the child population in northeast Ghana, and then reducing intestinal worms. More recently, STACC-Ghana has supported the purchase of vital medical equipment to the paediatric department at the Komfo Anokye Teaching Hospital in Kumasi, the central part of which was a ventilator and monitor which Dr John Adabie Appiah, the Head of the Paediatric Intensive Care Unit at the hospital, has described as an absolute lifesaver.

The most recent venture for STACC has been support for a children’s clinic in Masambuka village in a remote part of Machinga district in rural Malawi. The agreement to support STACC-Malawi was signed in early 2022, and the first phase is to upgrade the physical buildings of the site and to install a solar energy plant to support the refrigeration of medicines for the first time at the health centre, as well as to supply electricity more generally to the centre and the surrounding community.

During its 30 years of existence so far, STACC has been able to raise £2.6 million to treat just under 1.7 million children in the clinics, most of whom would not otherwise have received any treatment at all, or, at best, only partial treatments. The one thing that all the clinics have in common is they all share the same three main diseases treated: malaria, by far the most common illness; upper respiratory tract infections; and intestinal disorders. Of course, there are other conditions treated, but these three account for about 80% of all presentations.

Because STACC is run entirely by volunteers, about 95 pence in every pound raised goes directly to the clinics to provide the primary health care required. The reason that this figure is not 100% is because there are unavoidable costs here in Scotland, such as the annual audit, insurance, bank charges and postage. We only wish that were not the case!

In its operations, STACC adheres to the following principles. All clinical and managerial decisions are taken by the directors and staff of the clinics and not by STACC Board members based in Scotland; all treatment and medication is to be provided free of charge to patients at the point of delivery; our focus is on communities which otherwise would have limited or no access to primary health care facilities; clinics should commit to using only bona fide medicines in their treatments; and finally clinics should have in place policies related to safeguarding and equality, diversity and inclusion.

There is no doubt that STACC currently operates in a very challenging funding environment, but is no different from any other charity in this regard. The supported clinics in Africa are equally challenged. The demand on their services by the parents of children is immense, and for most there are no alternative sources of treatment for their children. STACC has been around for 30 years, and it certainly plans on being around for another 30 years.

For further information, please the STACC website at: www.standrewsclinics.org.uk.