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Health

OneDay Health: Providing affordable and accessible healthcare to rural Ugandan communities

"We want OneDay Health to be one part of a global movement to provide universal healthcare for all."

Nick Laing, founder of OneDay Health

Originally from New Zealand, OneDay Health founder Nicolas Laing moved to Uganda over 6 years ago. As a doctor working in Northern Uganda, Nick increasingly became aware of the lack of quality healthcare options for the 10 million Ugandans who live in rural ‘healthcare black holes’. With no access to professional medical treatment or centres within a 5km range, families and individuals are instead forced to take long, treacherous journeys to the nearest facility, seek unprescribed medicine from unlicensed drug stores, or left hoping to recover without professional care or support.

Nick launched OneDay Health in 2016 to respond to this need, with the organisation's name inspired by their ability to launch a remote healthcare centre in just one day, after a community in need has been identified and nurses have been trained to operate the facility. It is also inspired by Nick's vision that one day, every Ugandan will have access to the healthcare services they need, no matter whether they live.

Each OneDay Health centre can provide primary healthcare for between 2000 and 6,000 people, with an average of 200 patients treated monthly. The small fee from each patient, which includes consultation, testing and medication, allows the health centres to become financially self-sustaining within 6-12 months.

Currently, OneDay Health operates 13 health centres in the Gulu and Kitgum districts in northern Uganda, with an aim to expand to 30 centres in 2020, and 100 centres by 2023. Funding from QCT will be used to kickstart expansion, directly supporting 6 new centres in the Kitgum and Lira districts in northern Uganda. QCT will also work with OneDay Health to provide advice and guidance on impact measurement and safeguarding.

OneDay Health works towards SDG 3. Good Health and Well-Being.

Context

Approximately 10 million Ugandans live in underserved 'healthcare black holes', with no feasible access to qualified medical treatment within a minimum 5km radius. As a result, families are putting their lives at risk to reach facilities miles from their homes, or losing their lives to easily-treated illnesses and diseases.

Work

OneDay Health identifies locations and works to launch a facility within just one day. The centre is run by a trained local nurse, and charges a small, affordable fee to those in need of consultation, treatment and medicine, which supports the centre to become self-sufficient within 6-12 months of opening.

Impact

To date, OneDay Health has treated a total of 30,000 patients. Of these, they have cured 13,000 diagnosed with malaria; treated 12,000 children under 5 years old; given over 1,000 doses of potentially lifesaving emergency pre-referral treatment; and helped over 500 women access medical family planning.

"I’m really excited to join the QCT community of changemakers as we learn from each other, support each other and grow our change making organisations."

Nick Laing, founder of OneDay Health

Getting to know Nick Laing

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Tell us a bit about yourself.

I’m Nick, a doctor from New Zealand who has lived and worked in Uganda for the last 6 years. At medical school I became passionate about social justice and have always known that I wanted to use my medical skills to reduce inequality and fight injustice. My wife Tessa is a community organiser and activist, so together we make a great team. We moved to Northern Uganda together, and quickly found that our skills and passion could be useful to the wonderful Gulu community.

I first worked at Lacor hospital as a regular ward doctor, which helped me understand the range of conditions that people struggle with here. As well as typical tropical diseases like malaria and typhoid, people also still have to deal with chronic diseases like high blood pressure and hepatitis B. The distances travelled to hospital were also staggering. After working at Lacor, I was asked to manage health centres at the Diocese of Northern Uganda, which opened my eyes to the enormous healthcare needs in remote, rural Uganda.

Why did you decide to work in this area?

In my intern year, my wife and I worked for 3 months in Kisiizi hospital in Western Uganda. The Kisiizi hospital staff made us feel right at home, and we learnt so much from the wonderful nurses and doctors. This experience helped us to realise that there might be a permanent home for us in Uganda, and 4 years later we were back for good, this time in the North. While working both in hospital and health centre management, I became more and more impressed with the capability and commitment of the local nurses. I realised that the enormous potential of local nurses could be further realised by providing healthcare in the most remote areas, and so OneDay Health was born.

What were your first steps to get the project off the ground?

While managing multiple rural health centres of varying sizes, I noticed that the smallest facilities were actually the most financially sustainable. This made me wonder if we could provide remote areas with permanent healthcare solely through local resources. I crowdfunded about NZ$5,000 to launch a couple of remote health centres, identifying ‘healthcare black holes’ and training local nurses to run operations. These pilot centres quickly became indispensable to the community. I then met inspirational OneDay Health co-founder Pranav Sridar at the Unleash Innovation Lab, who convinced me that rather than just starting up a few health centres, we could make a bigger impact by launching multiple hubs of 8-10 health centres across Uganda. A year later we had the first hub of 10 rolling and we’re now moving onto hubs two and three!

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The organisation's name inspired by the fact that they are able to launch a community based healthcare centre in just one day, after a community in need has been identified and nurses have been trained to operate the facility.

What challenges have you faced along the way, and how did you overcome them?

Our journey with OneDay Health is not even 4 years old. Our basic health centre model of a centre being run by one nurse, is a new way of thinking about quality health care, so we don’t fit neatly into Uganda’s health system. It’s tricky for us to register our facilities under the current regulatory environment. Despite this challenge, we’ve managed to work well with district health teams, collaborating on vaccination and health education.

We also operate in some of the poorest communities on earth, so even though our fees are low and cost less than transport to their nearest existing health facility, people still struggle to find the money. We try and be lenient by allowing delayed payment and treating very sick patients without demanding money, but there’s no easy answer.

What has been your proudest moment with this work?

Our most isolated health centre is in the extremely remote Pwunu Dyang. It’s over 4 hours from Gulu town (where I’m based) - almost too far away to be practical! However, when I first visited Pwunu Dyang, it was clear to me that the need was so great we just had to launch a OneDay Health centre there.

That particular health centre has now been in operation for over 3 years, and just 3 months ago a community leader called me to say that they had already burnt 10,000 bricks to help us build a permanent health centre building. We had no idea this was something they were even considering, so it was a wonderful surprise! Constructing health centre buildings isn’t part our model (we tend to rent existing buildings rather than take on the additional infrastructure costs and time burden of building our own), but we will honour the community that has decided both with their hearts and their hands that OneDay Health should forever be part of their community. We should be finished building in 3 months!

What is the most important thing you’ve learnt?

People are everything. People are more important than your systems, your plans or even your idea! Hire the right people, then support them. Our most successful OneDay Health centres are where we have our best nurses. When our nurse struggles, the health facility struggles too. Carefully selecting the most talented nurses, regularly visiting our health centres, and constantly communicating with staff is far more important to us than having the right operating procedures or strategic plan.

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Each OneDay Health centre can provide primary healthcare for between 2000 and 6,000 people, with an average of 200 patients treated monthly.

What are your future goals for OneDay Health?

Although we have the ambitious goal to have 30 OneDay Health centres operational by the end of 2020, our long germ goals aren’t focused on OneDay Health as an organisation. We want OneDay Health to be one part of a global movement to provide universal healthcare for all. Our overall goal is that one day, every rural citizen in Uganda will have access to high quality health care, and we don’t care whose name is on the health centre sign!

OneDay Health can’t do it all alone – we need partnerships. We would love for local community organisations, NGOs, and the government to see the potential of our simple yet super effective model. Together we can make sure that in 5 years’ time, there are no more healthcare black holes in Uganda.

Why do you think it’s important for young people to be equal partners in driving change in the world?

The earlier young people are engaged with the major issues of this world, the better. The sooner young people are empowered to know that they have the power to make real change, the better. We’ve seen through leaders such as 17-year-old Greta Thunberg, and 34-year-old Finnish Prime minister Antti Rinne that young people can achieve far more than just adding enthusiasm or coming up with fresh ideas. They can lead and implement radical change, both in their communities and globally.

What are your top 3 tips for young people who have a great idea, but are wondering how to get started?

1. Get started NOW. If you’re passionate about your idea and you’re convinced it will work, then get started! Don’t waste months or years with endless planning and talking, trying to refine your idea and make it perfect. Get started today and give it a go, rather than looking back and wondering ‘what if’.

2. Connect and Learn. Find the young leader out there who’s already implemented your idea, or something similar to it. There will be someone somewhere in the world who has done something aligned to your great idea. Instead of being jealous, think of this as a great opportunity, as they can help you get things off the ground. Find that person, learn from their successes and their failures, and give your idea the best chance of success.

3. Keep failing. We are part of a culture which is all about success, success, success. The picture painted by social enterprises and businesses on social media displays all the good and none of the bad. Their failures might be hidden, but there will still be many there. So, don’t be scared to make mistakes and fail sometimes, or you’ll become paralysed. Things will go wrong. Let yourself fail, but don’t let those failures stop you.

What does working with QCT mean to you?

QCT gives us a platform share our work with the world and helps us to collaborate with others across Africa and beyond, working to solve the problem of healthcare black holes. I’ll have the opportunity to draw on their enormous experience and expertise in organisational strengthening - which is not my strength at all! I’m also really excited to join the QCT community of changemakers as we learn from each other, support each other and grow our change making organisations.

Learn more about OneDay Health by visitng their website.

Article published: May 2020

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