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.

Farewell Impact Primary School

For the last 12 weeks I have been holding a student leadership course at a local primary school- Impact.  This is sort of my "baby" project. I stumbled upon it. I came here thinking I would just be doing health related projects. However, there is a HUGE need to empowerment and life skills to be taught to school age children.

We taught the class to all of P7 (ages 12 and up), as well as the class monitors (sort of like a class president) from all the other classes. There were so many kids who I met there who are just on fire! They are smart and sharp and have big plans for their lives.

As I said good bye to the students, it was surreal. I don't really feel like I am leaving. Do I really only have 18 days left here? AH. That is a little freaky.  I will miss these kids! I loved going and seeing Gerald's smiling face, tickling little Benjamin and Joel, and singing "OH Happy Day"with all of them.

It has been a great experience to work with this school! I hope that all those kids DO follow their dreams and are able to make a change- in their lives and in Uganda!

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...

tippy taps

whats a tippy tap?

its a handwashing station. many people in uganda don't wash their hands and so they get really bad diseases that are born by fecal matter. so for one of our projects we build a handwashing station at a school and then teach them about handwashing

this is a tippy tap we built at St. Kizitos baby home!

project update

umm ok a month later.... i finally post. sorry about the long absence. in case you are wondering, i have not died in africa. but i have been sucked in. i absolutely love it here! i only have 10 minutes but i want to give a quick update on the three BIG projects i am working on. (i'll try to post some pictures tomorrow.)

#1- CURE Hospital Trainings.
CURE Hospital is an NGO in Mbale that specializes in pediatric neurosurgery- specifically hydrocephalis. It is a great facility and run by awesome staff. A group of us go every week and teach the mothers (who are there with a child getting surgery). We teach nutrition and boiling water (me), handwashing and basic hygiene (Aubrey and Rem), and First Aid (Jenner and Paul). I was really nervous to teach nutrition at first, since i am not an expert, but it is really fun! I just teach the 5 food groups and show them foods that they have here which are included in each group. We are hoping to spread the classes to the Regional Hospital and surrounding villages.

i love this hospital!

#2- Leadership Class at Impact Primary School
Impact school is my favorite. I love the kids there SO much! I had this great idea to start a student government. It turned into a leadership class, ebcause these kids don't really get much leadership training or opportunity.  We go once a week and teach all of P7 and then 2 or 3 kids from all the other classes (they are the class monitors).   I love teaching there because I hope to empower these students (most of whom are orphans) and show them they can make their life better than it is now!

me and some girls

human pyramid in p7

the P1-P4 class monitors

#3- Volunteering at Mbale REgional Hospital.
Ever since the mango tree and boy experience i have wanted to do somethuing in the hospital. We started volunteering there a few weeks ago. my goal ultitmately is to make contacts and friends with staff there so that i can remain in contact with the hospital when i go home. i want to create my own NGO to provide the hospital with suipplies and possibly volunteer doctors (to go over there like once a year). I volunteer in the pediatric acute care unit of monday and the surgery (OR) ward on Thursday and Friday. I have been able to see some crazy and sad stuff. i am more convinced that I WILL come back and help these people one day! they deserve a chance at a healthy, long life. And the staff deserve the supplies and equipment to fit their training.

this is what we had to wear in the surgical ward. i felt legit.

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!