Sunday January 5 2014

Clarke: I have felt at home since arriving in Uganda

Dr Clarke (front), participates in a sanitation campaign

Dr Clarke (front), participates in a sanitation campaign exercise in Makindye Division, Kampala. Photo by Joseph Kiggundu 

By Henry Lubega

Home away from home. Dr Ian Clarke, the Makindye Division Mayor, first came to Uganda in 1987. He had planned to stay for two years and then return. But the two years became six years and later translated into turning Uganda a home.

I first came to Uganda in 1987 under the Church Missionary Society, to what was then known as the Luweero Triangle. I came with my wife and family and started work in Kiwoko, on the road to Ngoma, with the initial plan for a two-year project.

I started training a team of village health workers, while also treating patients myself. The first clinic was under a tree but then we used the local church vestibule and from there we built the first one-room clinic, which was then expanded to include a maternity Centre and a TB Ward.

Instead of the two-year stay, we extended to six years, during which time we started a hospital – Kiwoko Hospital.

The money for the hospital was raised through donations: we started a group called Friends of Kiwoko Hospital, consisting of doctors and other friends we knew, mainly from Northern Ireland, to whom I wrote regular letters about what was happening.

We also asked aid organisations to help and Oxfam was the first organisation to give us a donation in the form of a land cruiser. This was a great help since the only vehicle we had was a small Suzuki jeep.

One could say that during the first phase of my life in Uganda, I was working in the ‘aid sector’. We were using donations to carry out development work, and part of my responsibility was to ensure that the money we received was used properly.

I left Uganda in 1993, so that my children could pursue their education. I used this time to do a master’s degree, before coming back to Uganda in 1995.

Making Uganda Home
The first night we spent in Wakyato, Luweero was pitch-dark. But despite this, I felt I had come home and have felt the same way about Uganda ever since. Interestingly when my son, Sean, finished studying in the UK and came to work with me about three year ago, he also said the same.

Shortly after my arrival in Luweero, while on a pastoral visit to the district, the Bishop of Namirembe, Misairi Kauma, came to visit us and decided that since we were working in the heart of Buganda we should have a clan.

He ‘adopted’ me into the Koobe Clan and named me Busulwa, my wife was adopted in the Monkey clan and was given the name Nakito.
Volunteer turned entrepreneur
After doing my master’s in UK, I decided to come back to Uganda, this time with the intention of providing private medical services to the developing Ugandan middle class.

I worked for a short time at ‘The Surgery’, but then started International Medical Centre, since ‘The Surgery’ was more geared to the expatriate market.

By that time, the corporate sector in the country was growing, the presence of international aid agencies was on the rise, and such organisations were looking for improved medical services. Mission hospitals like Nsambya, Rubaga, and Mengo were available, but mainly for the poor, and there was no fully-fledged state of the art private hospital.

When I moved to Kampala, I was targeting the urban middle class by providing something appropriate to their needs, for which they had to pay out of their own pocket. While I was in Kiwoko, I was targeting the rural poor, but it was subsidised by my friends from the UK and Ireland.

Along the way in Kampala I also had to do things for the poor, which I have done through our foundation called International Medical Foundation. In Kampala I was starting something which could be called sustainable development, not relief.

I started the International Medical Centre (IMC), the first clinic, in the former Kampala Pentecostal Church building, now Watoto Church on Bombo Road.

The first day I opened IMC, only one patient showed up, but with time, I became a popular family doctor in Kampala and had queues of people lining up to see me. But the question was how I was going to grow the organisation to a hospital.

We had to grow through stages, so that at some point it, was not all dependent on me being there all the time.

Pioneering medical insurance
While at the Watoto clinic in 1996, I was approached by the American Embassy human resource manager to start a medical scheme for the local staff. They didn’t want a complete medical cover, but just a capitation scheme.

This was not full insurance, but more like a membership. Under this scheme, the embassy paid a certain amount per person per year, for which I delivered medical services at the clinic. Such schemes have since expanded so that International Hospital and International Medical Centre clinics now have around 50,000 members.
I started with a staff of six people at International Medical Centre in 1996 and as of now, I have about 800 people working in the hospital, the clinics, insurance, the university, the foundation and the pharmaceuticals businesses.

Medical business must put ethics above profits, which is something that many people don’t understand. One cannot do what is most profitable or even what the patient demands, one must do what is medically indicated for the patient.

Building a medical business
While at Watoto, I leased a building in Old Kampala, renovated it, and started a small hospital. This was where IHK was first housed until eight years ago when the first phase of the Namuwongo complex was finished.
When we moved to Namuwongo, the old hospital in Old Kampala was turned into a nursing school because we needed to train nurses.

With the nursing school running, I talked to people like Moses Galukande - our key surgeon - on how we could transform it into a university and the result was the International Health Science University, which opened five years ago and now has 1,400 students studying nursing, clinical officer training, lab technology, public health and health management. Within the next few years, we hope to start a medical school.

My major motivation for starting the International Health Science University was development, specifically in the medical sector. You cannot develop the medical sector unless you have the right people.

That’s basically the genesis for the past 16 to 17 years. From a mere $100,000 (Shs250m) in 1996 when IMC was opened, the organisation is now worth around $15m (Shs37.5b), excluding the university. This did not come without risk. Part of the initial amount invested included loans and mortgaging my house in UK.

About 18 months ago, we also took in two minority shareholders. One company is from Mauritius, while the other is from Netherlands. I remain the majority shareholder in the organisation, and I am also the chairman and CEO. I do not have any Indian shareholders.

In summary

Ian Clarke was born in South Armagh, Northern Ireland in 1952 to Thomas and Jean Clarke.

He trained as a General Medical Practitioner. Dr Clarke read about the AIDS epidemic in Uganda and decided to come see for himself which brought him to Luweero in the 1980s at the end of the bush war which he had been unaware of until he arrived.

He subsequently returned with his family under the auspices of the Church Mission Society to work in Luweero.

Dr Clarke initially treated his patients under a tree before going on to establish Kiwoko Hospital which now boasts a nursing school, a lab technician training school, a large community health programme, a neonatal ICU and full general hospital facilities.

Dr Clarke later moved to Kampala setting up his first clinic (International Medical Centre) within the Kampala Pentecostal Church Building/Watoto. Dr Clarke’s vision continued to grow and he subsequently opened International Hospital Kampala (IHK) in Old Kampala where the first open heart surgery was carried out.

IHK subsequently grew and moved to Namuwongo, Kampala and is now a modern well equipped hospital that boasts a number of specialties including obstetrics and gynaecology, paediatrics and plastic surgery.

The 110 bed facility is the only ISO certified hospital in Uganda and strives to continue bridging the gap in private healthcare provision in Uganda through providing quality, and affordable healthcare.

Joining Ugandan politics

improving country
I had written a social commentary for many years and did not wish to be the Mzungu who is always pointing fingers, so I decided to take on some civic responsibility.

I was very frustrated by the state of the roads, the garbage and the blocked drainages in Makindye. So I joined politics to improve the area, fix the portholes, collect the garbage and empty the toilets.

Makindye is not changing at the pace I would have liked to see, but something is happening and the situation is slowly improving. I have no interest in doing another term in this job and I am considering the future.
If the legislation over the city management was amended to make the position of the mayor more meaningful, I might consider standing. My aspiration is born out of the desire to work for the improvement of Kampala city, rather than confronting the government.

The two areas I am interested in are the development of the city, and the development of the health sector.

Uganda today is a much better country than the one I first came to in 1987. Apart from development, there is peace and security, and one should give credit to the government for this.

Infrastructure
The development in terms of infrastructure such as roads is improving, the private sector is dynamic, the banking sector is transformed from what it used to be, companies are generally doing very well. The negative development which I have seen over the years is that corruption, theft, influence peddling and the like, have taken hold throughout the society and are now seen as the norm.

This means that corruption is now worse than it was 27 years ago when we came. This is sad because it is hard to get anything done unless someone sees some personal gain.

On the other hand, there are hopeful signs, there are some focused and selfless leaders who have come forward, but we need more.

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