Where Death is Just Another Part of Life

Last month I spent three mornings a week (about 12 hours total each week) at Mbale Regional Hospital, volunteering in either the Pediatric Acute Care Unit or the Surgical Theater. There I came to know the dire need that Uganda needs for improved health care. Mbale Regional is a huge hospital, serving millions of people. It is very understaffed and under equipped. The staff who work there, however, are smart and innovative. They are trying their best to help the people who are ill. As you walk through the hospital you will see people lining all the walk ways and sitting everywhere, waiting for a doctor to see them. Pregnant women wait patiently outside a full delivery room until there is a bed available for them to deliver their baby. It is the most hopeless hopeful place I have ever been.

I once saw a mother holding her baby’s hand as the clinical officer drew blood for testing. I knew that if I was with my child in this hospital as it was (under staffed, ill equipped, dirty, and dark), I would be totally hopeless. However, as I watched this woman staring up at the clinician, I saw her eyes were full of HOPE. Compared to the health care we have in the US, Mbale Regional Hospital is the pit of despair, but for people who have never ever had even remote access to health care, it is a beckon of hope.

One sunny day I was in the surgical ward, waiting for an emergency to come up, because there were no scheduled surgeries. Andy and I cleaned and then folded gauze bandages for hours. Finally an emergency came in.  Any medical student loves seeing any kind of surgery and it (almost) excited when an emergency happens. Sometimes I see patients as nothing more than science. I was excited to see what emergency procedure we would be doing, when they carried in a little baby and laid her on the metal surgical bed in the pre-op area.  She was premature and had been badly burned. Her face—nose, eye lids, and lips—and arms were so burned they looked charred, like charcoal. Her little chest moved up and down, barely enough to be noticed. It was shocking—and horrifying. Even the medical staff in the theater was dismayed.  There wasn’t much to be done except try to relieve the pressure caused on the limbs by the burns.  I handed plaster (medical tape) to the clinical officer (a mere intern) as she cut open the burned arms to decrease the pressure and keep the blood flowing.  All I could think of was that this little girl was only a few days old and already was suffering so much hurt. A few days later, when I went back to the hospital I inquired about the baby.  No one knew what had happened to her. I assume she died. There is no way she could eat with her lips burned closed. It is heart wrenching for me to think she could not be saved. It is my first instinct to try to save a life at all costs. But, I do know that she is in a better place and is out of pain.

A few weeks later, in the pediatric ward, a toddler died while on the examination table. His mother walked out crying (Ugandans never cry) and the father held onto the limp body. Eventually they draped a coat over the boy and the father too, left.

Before I came to Uganda I had never seen death, but now I have stared it in the faith. I have watched as faithful nurses and doctors have tried, despite a limited supply of medicine and technology, to save every child who comes across them. I have a new appreciation for the healthcare we have in the US. I am grateful I will not have to have my baby in a mud hut, on a wooden bed. I am grateful that if my child gets sick or hurt, I can instantly get quality care for him. I am grateful health care has been prioritized and that so many people in America want to be doctors.  I will never forget the experiences I had at Mbale Regional Hospital. In fact, they have inspired me. I will come back to this place and do anything I can to improve the quality of healthcare given here. The people have the heart, they just need the road blocks removed.

CURE Hospital

CURE Hospital is one of my favorite places in Mbale. Run by an NGO, called CURE, they specialize in pediatric neurosurgery—mostly spina bifida and hydrocephalus—serving all of East Africa.  You may not know, but my biggest dream (regarding Africa) is to find an underserved population and start a hospital to serve them. So, walking into this hospital was like walking into my dream!

CURE is probably the nicest hospital in Uganda.  It is clean and bright. They have the latest medical technology.  Each patient has their own bed, with clean sheets. They provide support for the family and continually go to the field to find new patients and to check up on old patients. They also have paper-bead-making IGA (income generating activity) for patients, and they sell the necklaces and earrings at the hospital. This is a “charity” hospital, but they do require that patients pay what they can to help pay for the surgery and treatment. Although they do not pay the highest salary, and most of the staff would be making more if they worked at a government facility, they still have a very loyal staff.  These are Ugandans, and other East Africans, who want to make a change and do some good.

In Eastern Africa, especially in the villages, there is a stigma about hydrocephalus and spina bifida. If your child is afflicted with one of these maladies, it is assumed that you (the mother) did something wrong or that the child is bewitched. They become outcasts to society. If left untreated, hydrocephalus causes the brain to swell, resulting in the entire skull expanding, sometimes to grotesque proportions.  Pressure on nerves can cause damage such as blindness. The procedure to fix hydrocephalus is very simple, and the one that CURE uses, is very non-invasive.

I was involved in a project at the hospital it which we volunteers taught nutrition, hygiene and first aid classes to the mothers who were there with their children.  We taught people from Uganda, Sudan, Kenya, and Ethiopia about how to eat a balanced diet, how to wash their hands and why it was important, and what to do if their child fell out of a mango tree. Most of the women were very excited to learn this information and put it to use. I don’t know for sure if every single woman will implement what we taught, but I hope that this knowledge will be a key factor in improving, or even saving, a few lives.

I want to come back to CURE. I don’t know when. Maybe I will do a medical internship there (while we have been here there have been medical interns from the States, Italy, Eastern Europe, and other places).  Or maybe I will just come back to visit. I would love to explore their other hospitals around the world. They are doing a great work and I am grateful for the chance I had to work with them.

sprinting to the finish line

i only have 5 weeks left here!

AAAAAAAGGGH!

I was really worried that when the second wavers left that all the projects would fizzle out. thank goodness for the awesome third wavers who are jumping right in to Uganda! I am now project lead on four projects- the CURE trainings, Mbale Hospital volunteering, handwashing outreaches, and the leadership class. I have kept really busy with them. Which is great! I do not want to be lame and die out these last five weeks. i want to keep sprinting hard core to the finish!

why?
I am not ready to leave! this place is honestly the best place I have ever been. I am content and happy. For the most part I live the Hakuna Matata lifestyle. The people here are the happiest people on the planet. They don't most of the "conviences" that we have in the US, but they have something more. They have family. They have community. They have relationships with God and with others that are undeniably strong. I love seeing children playing with homemade soccer balls (made from banana leaves and plastic bags) or homemade metal cars.  everyone here is so ready to learn knew things. they all want to make their life better than it was. they want to make Uganda a better place. They have such great hopes for the future. I hope and pray that they will all be fulfilled.

Well, I am almost out of time but I am going to really try to post more often in these last 5 weeks. Until later then...

the 5 senses of Uganda

Uganda smells like.....
- burning piles of garbage (i call them cancer piles)
- matooke and posho cooking
- raw cow stomach, intestines and fish in the market
- sewage in the gutters of the street

Uganda sounds like....
-crazy sounding birds that wake you up at 6 am 
- honking buses and yelling boda drivers
- rain pouring down
- drums and dancing
- children singing
- kids yelling "mzungu!"

boys from Sonset soccer academy

Uganda tastes like....
- fresh pineapple 
- rolex (chipati and fried eggs)
- a LOT of oil
- cadbury chocolate
- "Nice" biscuits

Aubs making a delicious chipati concoction

Uganda feels like....
- the hot hot sun beating down
- getting caught in a sudden downpour
- dancing for an hour, even though you are sweating bullets
- laughing with kids
- happiness

Becca, me, Kaylen after getting caught in a rainstorm

Uganda looks like....
- the greenest place you will ever see
- the happiest people
- insane roads
- busy busy busy, everywhere
- a lush garden
- red dirt

the view outside our compound!

pictures to follow i promise

ok i have 4 minutes. aah! I am still a live. 

i lov africa.

i might come home with a black baby named scovia.

or maybe i'll bring home benjamin from impact.

or gerald (aka jared) and his sister, sandra.

i'll put up pictures tomorrow when i am on a better computer with faster internet.

the boy and the mango tree

Monday night of last week, we were all hanging out at the house when suddenly Suzanne (our CD) and Jenner (a boy on the team) rushed out saying that
there was an emergency. They are both EMT's and Charles (a man from
church) had called them saying aboy had fallen out of a mango tree! So
they rushed over there. Charles had already picked up the boy
(something very bad to do because the boy had fallen on his head!) and
taken him to a "hospital". When Jenner and Suzanne got there the boy
was lying on the one bed in the "hospital", unconscious with blood and
cerebral spinal fluid coming out of his ears and nose. All the
villagers (these are the same people who we had a dance party with
last week) were just sitting there, sure that he was dead. But he
wasn't. After a while of searching, Suzanne and Jenner were able to
contact the only ambulence in Mbale to come get them. The ambulence
had a stretcher, but NO neck brace or straps to hold the boy down.
Suzanne and Jenner jumped in the back to help stabilize the boy (his
name is Ivan) on the way to the hospital. Can you imagine going on the
bumby roads in a sketchy ambulence when you already might have brain
damage? Ivan was unconscious for most of it (thankfully), but
sometimes he would wake up and thrash out. They finally got to a
private hospital- they didn't go to the regional state hospital
because there mayn't have even been a doctor on duty. At Mt. Elgon
hospital the doctors there didnt' even really know what to do, so
Suzanne and Jenner ended up doing alot of it. they didn't even have
any gloves for them! Ivan needed a CT scan, but becaus this is a
private hospital (not a state hospital, where all services are free)
they had to pay BEFORE the procedure could happen. the family of
course did not have the money (250 thousand shillings- or about $150)
to pay for it. Finally Jenner convinced the doctor to just do the
scan! He asked anyone on the team who was willing, to donate 20
thousand shillings to help pay for it. HELP doesn't do stuff like
that, but if individuals are willing to do that they can. the scan
discovered that he had a skull fracture and a subdural hematoma (blood
on the brain) that was starting to clot. there was nothing else they
could do at that time so they simply put Ivan in a room for the night.
If he lived they would evaluate him in teh morning. In the morning
Jenner and Suzanne went back over there  and had Ivan referred to CURE
hospital- the very reputable neurosurgery hospital here. He is VERY
lucky that CURE is so close because he probably would have died! He
was able to get into surgery that afternoon and did great. From this
week learned of the dire situation the healthcare system is in. About
70 kids (probably more) die from head injuries every day in Uganda.
That is so many! The villagers, and even Charles, had no idea what to
do when Ivan fell and took him for dead. Even the doctors were
unskilled and had very limited supplies. It is sad to see the poor healthcare system here. It has really impacted me. As a result, I am trying to find a way to get supplies over here to at least one of the hospitals!

dance party!

Well uploading pictures is a little crazy here so I wont be able to do it today. It all just depends on the computer you are using. So hopefully next week. But there are a few pictures on facebook that people from my group have stuck up.

It's weird to think that I have been here for one week! It seems like i got here forever ago.So last time I wrote you I believe our water was off. On Tuesday it got turned back on. It was wonderful!  I finally was able to wash my hair. We went out to some clinics on tuesday. We went to CURE which does surgeries for spina bifida and hydroencenphalitis. They mostly do them on children. CURE is an NGO hospital run by an American but staffed by all Ugandans. They make everyone pay for the surgeries, but not a set price, just whatever they can pay. It is a really important work because there are so many children who have these conditions and so many bad stigmas attached to them.  Next we went to the Mbale Regional Hospital run by the government. Talk about squalor. They have such limited staff and supplies. IT is filthy there. They have no clean bedding and the people even line the hallway waiting to get a bed. It is so sad. HOwever the head doctor is not dumb or uneducated! He has had to be very innovative in his approaches to treatment because they are so limited. He could also tell just from the cry of a child that they had one of 3 illnesses! He is doing th ebest he can with what the government offers. There are probably 20 doctors who cover 13 districts- about 6 million people (numbers might be off). We are so blessed to have good healthcare! 

On wednesday we went to schools. BOth the schools we went to are private schools and are run by churches. I think that was the day I e-mailed last. WE also went to an Indian restaraunt for lunch. I got vegetable curry, rice and naan. It was real good. Indian food is very popular here and they have quite a few Indians living here.

On Thursday we weren't sure if we were gonna go into the city. It was the day that the opposition leader returned from Kenya and riots were possible. However, with the reassurance that we would be ok, we got a taxi. OUr friend Charles, from church, brought along his police friend to protect us if need be. However, both Musevini and the opposition like Americans, so chances of them targetting us are slim. And if there ever is a riot while we are in town, don't worry because we have a plan. We will immediately catch a Boda back to our house, or if that is not safe, then we will go to the Rix's (missionary couple). So first we went and learned about Charles's NGO that he satarted. They give small loans to people, many of them disabled, so that they can start their own business. Next he took us to an AIDS support group. It was interesting becase I've never met anyone with AIDS. They are just normal people. They were so kind to us and although most did not speak english they tried to talk to us as much as they could. Then we went to a small village. When we got there the men were in the middle of making a homemade xylophone out of banana wood! How cool is that! There were a TON of children there. SO we sang songs with them for a while until the xylophone was finished. Suddenyle it was like a HUGE party! Everyone was dancing and singing with the xylophone and other instruments they had. And when I say everyone- I mean from the old grannies to the tiny babies. they thought we danced pretty funny. But they loved it. I was amazed at these people, who have so little could dance with no cares in the world. The kids were adorable! WE were hot and sweaty and thirsty but we kept dancing. That was probably the highlight of my trip so far. AFter the dancing we sat down and talked. Come to find out, most of the children were orphans. Many of them are being raised by their grandma's because their parents are dead. They dont have money for school and most of them eat only 1 meal per day. I hope we can do something to help them! That afternoon we went to a BBQ at our neighbors. They are a bucnh of old men miners from South AFrica. they are really nice and always invite us over- becasue they never see anyone from the outside world.

i danced with this cute for like a half hour!

On Friday we went to another school in one of the poorest slums in Uganda. Most of the people there are from the North and came down here as refugees. As we walked thruogh the slums, children came from all over and attached themselves to us! Although they were totally filthy and ragged, you can't help but love them. They mostly know very lttle english beyond "Mzungu how are you?" but they are so adorable! Their parents go into town every day to work and leave them to care for their siblings. They literally live in mud and grass huts. you know how you picture them- round, mud, grass roofs? like in national geographic pictures. this is REAL. sometimes 10 people live and sleep in these tiny rooms! The sanitation is horrible too. During lunch break I went to the market and got my first street food. don't worry, i watched him cook it so it would be safe. i got rolex- which is chipati (like a tortilla) with fried eggs in the middle. SOOOO good! I'll try to learn how to make chipati so you guys can try it. That afternoon we met with an NGO in senior quarters (where we live). we walked there in the POURING rain. Adam, i'm sure its like the philippines. It is like a bucket got dumped on your head. This NGO sells baskets and other Uganda crafts that are way cool! I'll probably be buying some stuff for ya'll from them. They are a Christian group who tries to help especially small remote villages. Last night the hotel next door to us put on a movie night for us. Something about the Ugandans I have met is taht they all want us to be happy here. Every place we go they feed us or offer us soda. The hotel is very accomidating and lets us use their kitchen and bathrooms (when ours don't work). the people at the church are so nice too!

Today is our day off and I've just been doing laundry (by hand) and cleaning. I also had interviews with our CD's. They are really great in helping us make goals. They also are helping me cope with homesickness. They are awesome.Tonight we are going to eat at a hotel because it is Whitney (one of our cd's) birthday tomorrow. We are also getting a cake made by one of the investigators at church! I miss American food a lot more than I thought I would!!

PS this is just a letter I send my family each week. I dont have time to write both. But hopefully next week I'll have picutres to put up! Sorry about all the spelling mistakes.

welcome to Uganda!

well I made it here in one piece with all my luggage! We travelled a total of 2 days, hitting up three different continents, 4 countries and flying about 24 hours total. Phew. It was a long one. Where to start? So much has happened! I think I'll skip over the flying and the layovers and London because I simply don't have time. We flew into Uganda about 9 am yesterday (Friday) morning. We met our CDs (country directors), Suzanne and Whitney, at the Airport where they introduced us to our bus driver Fred. He is legit. The bus ride was looong. But fun! Our team is bonding so well already. I guess when you have been travelling together for 2 days you get pretty close ha ha. I was going to try to upload some pictures but they aren't working today. Anways, Uganda is ca-razy. The traffic is insane! There are no rules. Trucks go as fast as they want even if there are people in the way! Little motorcycle taxis, called boda boda's whiz around and between cars. And people selling things come right up to your window and try to get you to buy their products.

back of the taxi= always a party

We stopped at a couple places on our way to Mbale. First we got a fridge in Mukono. There was this adorable little boy who would not stop waving at us! We even taught him to blow kisses! Pretty soon a bunch of kids were there, all waving and blowing kisses (even though they had no idea what they were doing). After Mukono we stopped at an orphanage that HELP built back in 2007, run by a lady named Margaret. She is really cool! Something about Ugandans is that they are really friendly, so the fact that Margaret hugged us, without knowing us, isn't too strange. The kids there were so adorable! They loved us! And we loved them. They live in such small, cramped, dirty situations, but they are so happy!

cute boy in mukono :)

whit and some boys at the orphanage

I'm out of time for today, but I am loving it here! I'll post again soon ASAP!