The out-patients services are available every day and 24-hours so maintaining our quality of services, and of the facility, is a constant effort. We were helped by Sadolin when repainting was due. Of great importance, a hopefully something other funders will note, is that alongside implementation funds for HIV treatment, JCRC also provided furniture and computing equipment.

DFCU were re-styling their offices and banks and so perfectly good screens, chairs and tables were offered to Hope Clinic and he happily use these to maintain a fresh appearance in our clinic. As well as medical posters we are supported by donations of art-work by young students of the International School of Uganda which brighten the clinic.

The purpose of Hope Clinic Lukuli is to make available the services that the community needs and to reduce or remove the barriers that they might face in making use of the services. Although price and being nearby are important, the attitude of staff, that equipment is current and available and that patients feel comfortable are significant attributes we seek to maintain.

The consultation rooms allow confidential discussions and the onsite laboratory means that our Clinical Officers can accurately diagnose the cause of the symptoms. Our dispensary (or night cupboard) means the correct medication is also available and we price these at slightly above the wholesale price we pay for them.

Due to the quality of the design and the construction of the Hope Clinic Lukuli, the physical maintenance of the fabric of the building is not a major demand on our time and resources. The doors and doorways have kept their shape, the windows don't leak, the roof keeps out the rain and helps the heat escape through its vents.

The plumbing and electricity systems have worked well since 2005 and although a few fittings have suffered the wear and tear of close to 10,000 patients per year, we have replaced them from our own funds. Where we do rely more on grants and supporters are for additional medical equipment as patient numbers grow or, in the case of maternal care, we want to give even better care. We have been helped by DFCU, Aggreko and Belgian Development.

The clinic's central area has many roles - which was what we expected - and so we maintain our flexibility. Child immunisation sessions on Monday overflow to the outside tent, Tuesday and Thursday the space is used for ante-natal clinics (including nutrition workshops) and on Wednesday and Friday it is the patient area for the HIV clinic.

Through the doors are the two delivery rooms and the maternity ward and these are being upgraded with foetal heart doppler machine from BTC and a new delivery bed from the International Women's Organisation (IWO).

The original equipment funded by Rotary International is still in good working order. The four-bed general ward has metal beds, screens for some privacy and chairs for visitors. The glass blocks and repainted, washable walls help the rooms stay bright and the mosquito screens on PVC windows allow air but not malaria or rain to enter the room.

The admitted patients are comforted by knowing a Clinical Officer is on duty at all times and the clinic has an inverter for instantaneous back-up power and a generator if the power cut exceeds 24 hours - which happens! We are now repainting the floor which faces considerable wear from the murrum and dust that is all around the clinic and the village of Lukuli.

As well as the bricks and equipment of the facility a hugely important feature is the staff and their commitment. Maintaining the confident workplace, with regular meetings, trainings and feedback sessions means we have productive staff.

Affordable Medical Treatment From Good and Friendly Staff is how the community described Hope Clinic Lukuli in 2009

We have over 20 staff and many have worked with us for more than five years despite long hours and often very busy days. This maintenance of staff and commitment are very encouraging that the clinic is working in the right way.

Hope Clinic Lukuli was founded by a committee of friends living in Lukuli and the adjoining villages. The founders included current and retired teachers, shopkeeper, retired and active public servants, an accountant, a civil engineer and an administrator. These six Ugandans and two resident Britons maintain close links to the community that relies on Hope Clinic Lukuli for their health services. The nearest government staffed site is 3 miles (5km) away and a larger hospital is also over 2 miles away.

In June 2010 we had a multiple celebration. The white-haired lady is Joyce Bbosa, the original midwife who has now retired. She is standing with a little girl, the first-born in the new facility and so celebrating her fifth birthday with the clinic. Also helping to plant our Ten Year Tree is co-chair and founder, Mrs Adalina Lubogo who helps with the board's ongoing supervision of the clinic.

The community leaders were invited and representatives from more than 15 of the zone administrative units around the clinic attended to hear of our plans for the future and to share the feedback from their constituents. Our strategy was updated from this consultation and is available for your review (see left side of this page). Hope Clinic Lukuli was community founded and maintains its strong community links as part of the health response in Makindye.