- Written by Kimberly Pepmiller Kimberly Pepmiller
- Created: 20 August 2015 20 August 2015
Today began another beautiful day in Uganda! We had our typical breakfast of eggs, toast and pineapple at the hotel before piling into the bus, picking up the Ugandan cooks along the way, and enjoying the African spiritual music to brighten the morning. The crowds were waiting for us when we arrived at the Akor Primary School today (the site of our clinic). It sounds like patients are beginning to arrive around 6:00 or 7:00 AM in the morning.
Nelly was able to complete a variety of jobs at the clinic today, including weighing patients, working as a scribe in triage and assisting with taking patients' vital signs. This allowed Nelly to interact with patients and hear more personal stories. An 85-year-old man told her about losing family members to the LRA. She prayed with a twenty-year-old woman who had been thrown out of her husband's home because she has not been able to produce a son, and is depressed about her current life situation. Nelly and Kimberly interacted with a 90(+?)-year-old woman who was cheerful, happy and giggled like a school girl when we took her picture. She came to the clinic for eye sight assistance, and upon assessment, she had significant cataracts. We had to share a video of her giggling:
Kimberly spent the day taking vital signs and triaging patients. Kimberly also had time to spend speaking with patients and assessing them in a bit more detail. One elderly man was carried to the clinic by two young men who traveled five kilometers with him. He had a stroke five months ago and is paralyzed on the left side. In these rural villages there are not wheelchairs or other assistance devices other than large sticks. Two other young men were also carried to the clinic by family members. Both had significant wounds on their lower legs that need serious care. A seven-year-old boy with untreated hydrocephalus presented to the clinic with the inability to walk among other health conditions. Another man presented who lost the ability to walk at two years of age due to unknown reasons. He now manages to ambulate using his arms and hands. Another nurse on the team cared for a patient who shared that she was out of town when her daughter and three grandchildren were locked in their home and burned to death by the LRA. The patients presenting to the clinic seemed to be much sicker today. There was a baby in respiratory distress due to either croup or whooping cough. A blind man presented to the clinic and found out that his sudden blindness that occurred in March is due to a diagnosis of HIV that he just received today.
There are several great success stories from today, too. The malnourished child Kimberly saw on Monday was transported to the hospital today by our team and was seen in the nutrition clinic with hopes of being able to find nutritious feeding options for the child. The fear is that the child may have already missed many developmental milestones that may not be recovered. A boy who presented on Monday was taken to the hospital today as well by our team for a strangulated hernia. The hospital will operate on him for free tomorrow. Another boy was taken to the hospital with respiratory concerns, received a chest x-ray, was diagnosed with TB, and will begin treatment. The man with mouth cancer has very expensive treatment options in Kampala (about six hours away), and these options may or may not be feasible for him.
Our clinic was very busy today! We saw over 530 patients. After our regular lunch of rice and beans, the nurses went out into the crowd to triage to see if there were any sick patients who needed to be treated before the end of the day. This was an overwhelming task, and I imagine it felt kind of like trying to feed the 5,000. The crowd of 200–300 patients began to swarm and plead their cases for treatment. It's amazing how human nature takes over regardless of the country. It is also quite impossible to decide who gets seen and who does not. It simply does not seem fair. It would be most excellent if the people waiting would allow the truly sick to be seen first and then those just seeking out free medications would go last. At the end of the day, we all want to help everyone, but there is just not enough time or resources at this point.
In speaking with Violet, the project coordinator for the Lutheran Church Mission of Uganda, we learned a bit more about the school and healthcare systems in Uganda. Children can attend three years of nursery school and then begin primary school at age five or six. Primary school is seven years and then secondary school is six years after that. School fees can be quite expensive for some families, and even public schools charge fees for maintenance and such. In some scenarios, children do not attend school in order to stay at home and babysit younger siblings, to help with the farming and gardening or due to financial reasons. In these cases, the children are taken to jail, and then the parents receive education and lectures about the necessity of ensuring the children are in school. Those children who complete secondary school and have the aptitude can attend university for at least three years for most degrees and longer for more advanced degrees, such as medicine and law.
In Uganda, the average farmer makes $120 in four months by selling their produce and crops. In fact, there are women set up outside the school/clinic selling their crops to the crowds waiting for care. The average shop worker in a village makes $60 per month. In Kampala, a much larger city, the average monthly income is closer to $120 per month. More advanced positions make more money, and international workers are some of the best paid at $300 per month. For villagers, these wages are not enough to be able to afford healthcare. Therefore, people wait until they are gravely ill to go to the hospital, and then they use their livestock (goats, chickens, pigs, cows) as their savings account and sell one in order to afford the cost. However, especially for malaria patients, they are often so ill by the time they start walking or transporting to the hospital that they die on the way or soon after arrival at the hospital. Health centers are great distances from the villages. The only free care in Uganda is for HIV positive patients. USAID and the UN help fund the medicines and education for HIV treatment. One continued problem is that patients do not always continue their medication as prescribed. Then the HIV virus mutates, which leads the prescribed drug to no longer be effective. Education is key! Fetal maternal health is also a large challenge here due to the lack of prenatal care. STDs, birth defects and high risk pregnancies are not treated, which leads to complications at birth. There are just so many opportunities for education and treatment.
The bus ride back “home” to the St. Lira Hotel has become quite the African experience! The Ugandans clamor onto the bus and pack in as many people as possible, just as if they were riding a taxi bus here. Unfortunately, we still cannot fit everyone on the bus who would desire to ride. Today we managed to fit in 24 Ugandans and fourteen Mercy Medical Team members on a 25 passenger bus! It's a joyful ride with singing all the way back to Lira. What a great experience to end the day with.
The evenings have been filled with showers, debrief time with the group, dinners of fish fillets and potatoes and the devotions as a team. We have handed out numbers to 300+ people to be seen at clinic on Thursday. This is in addition to the hundreds of walk-in patients who will arrive throughout the day. Our efforts here in Uganda, as the hands and feet of Jesus, will continue.
“Hesed” is a Hebrew word that means “kindness”, “mercy”, “loyalty”, “loving-kindness” or “steadfastness.” It’s the way God intends us to live together—a “love your neighbor as yourself,” active, selfless, sacrificial, caring-for-one-another brand of living contradictory to our fallen natures. The “Heseders” are continually looking to work together to share some small measure of God’s extraordinary love. Won’t you join us?