Debrief

Clinics: November 4-11

Total number of clinic days: 6

Total amount of registered pt's: 1001

Total amount of people treated: over 1200

 The whole clinic experience was interesting and challenging.  The most challenging was the mindset of some of the team members, the disparity between 3^rd and 1^st word medicine, and the challenge of creating a balance.  A balance between teaching the locals how things can be done and telling them how things should change.  Many times I would just hold my tongue, not saying things when my advice or how things could run more effectively was clearly disrespected.  Being viewed as some white rich girl has many drawbacks.  My past two trips to Uganda had, to an extent, equipped me for this attitude.  However when tired and frustrated already, adding these expectations seemed too much for me.  Even having the team members steal pens perturbed me at times.  You say...a pen...come on girl. Be real.  Well, you’re right....it’s true.  It’s just a pen.  But dealing with that attitude over and over again is difficult.  The attitude of dependency and entitlement was thick at times.  I was thankful that the clinics gave the team a glimpse into the needs of Uganda, especially when the medications had run out.

No matter how much I hate those attitudes, I can’t say too much.  Uganda is in the middle of having an upper class emerge.  The middle class is slightly growing as well.  The attitude to fend for oneself and to survive still remains poignant.  Even in the upper classes.  The people have worked hard gaining whatever amount of wealth they have, in whatever way.  To give up that wealth, even just a minimal amount, is not an attitude that has been adopted.  And so the country continues to suffer, grow and some even prosper.  To teach selflessness and a volunteering spirit is something to keep in mind when visiting this place.

“God’s work done God’s way never lacks supplies”.  Whoever said this was wise.  Not only because God will provide everything that we need....but it helps me realize that whatever God had in mind for the clinics WAS accomplished.  I was able to help out with that, even though it seemed like in a very tiny way.  God still used it I am certain.   Am learning that real love is a miracle.  Half the time I rationalize and ask myself “why do you love these people”.  Whether in Kampala or Edmonton, this question pops in my mind often.  My only answer...it’s not me.....the love comes from Someone else.

The Clinics Part 3

Mbarara in western Uganda.  This city is an approximate 5 hour bus ride west of Kampala.  It is higher in elevation than Kampala which makes for dryer, cooler weather and less mosquitoes.  It was a nice break from the steaminess of Kampala beside Lake Victoria.  The bus ride was somewhat uneventful...only with a white man’s bag being stolen.  Sounded like a bag that help some important things.  Arriving in Mbarara, the team ventured off the bus into the chaos on the sidewalk.  Everyone waiting for their bags. There was minimal space to move around, especially with big bags.  The team eventually found each other with everyone’s luggage accounted for.  Then we started walking to the hotel.  The walk took only about 5 minutes.  The hotel called Kash hotel was nice.  The beds were big, rooms clean, washrooms but no running water.  Back to the good ol’ spit baths in a basin.  After we dumped our bags, we treated Pastor Daniel S for Malaria.  Poor boy was sick for about 4 days, unable to help with the clinics.  Charles, Sara and I then ventured out into Mbarara to look for envelopes.  The little packages and envelopes we were using to package drugs were slowly running out....so off we were on a treasure hunt that lasted approximately 3 hours. 

Visiting half a dozen pharmacies, we soon learned that the they overpriced the envelopes....so we went for a hunt to find people on the streets who made envelopes.  To find a person making envelopes in Kampala was easy compared to this hunt.  After many different questions and inquiries, we quickly learned that finding these people would be difficult if not impossible.  No one knew of anyone.  So, we decided our best bet was to buy some from the pharmacy, choosing to only buy a few.  Then it was decided to find paper and glue to make our own.  After looking at the second place, paper and glue was bought.  Back to the hotel we ventured.  There we found the old Musau’s (health professionals) packaging drugs.  We joined the pill packaging party and soon had almost all the pills packaged.  Time for supper and bed!

 The next day we woke early, ate breakfast consisting of white break, fruit, tea and omelettes.  Sadly,  I never did see brown bread in Uganda.  Then after a lengthy bargaining session, Pastor Daniel K hired(rented) a vehicle for us.  Eight of us and the drugs packed into the car.  Now, in Africa jamming a car full of people is nothing.  They are all used to, what they call, “squeeze”.  Granted it was a 7 passenger car.....the two very “healthy” older Musau’s took one and a half seats each.  This limits space. 

One benefit of this method of traveling could be that when in an accident, the passengers will be the ones to break each other’s fall.  And being that the car is so full, your “fall” would not be very far.  J

Anyways, off to the village we were.  The village called Ishaka. 

 When we arrived, I noticed how seriously Pastor Guma was.  He had put up tarps for us to work under.  The tarps were strung from different banana trees.  The ground however was another story.  You see, holding a clinic in a banana plantation, when it has rained the day before, proves for muddy conditions.  Some men were able to cut some of the banana leaves and laid them on the ground for us....almost like a carpet.  We set up camp under the tarps and started treating people.  There was a speaker system present with music and the occasion advertisement and preaching from Pastor Guma.  The system proved useful as it helped us call people to get their medications.  More interpretation was needed when it came to the language in this area and Pastor Guma was very willing to step up and help. 

 As the people came, so did the clouds.  Eventually it started to drizzle and soon poured!  Three of us scrambled to get the drugs packaged while the rest of the team found refuge in the car.  Driving back to the hotel was an adventure.  The torrential downpour plus muddy road......well let’s just say I prayed a lot.

 The next day was full of more patients.  The word had spread and people came from far and near.  Witchdoctors even showed their faces and heard the gospel preached by Pastor Guma.  After seeing about 250 people over two days, the medications were once again finished.  Turning people away again was difficult as this site proved to have more sick people.  A seizure, more seriously malaria, a hospital trip for one patient was part of this place. 

 Let’s say it was very good to be finished.  After sitting in a hunched over position for 6 days, packaging drugs, working with the local mentality and mindset had worn me out.  The impact of the clinics, I do not know.  But what I do know is that one pastor said the clinics took the church there to the next level.  Being God’s hand and feet, loving people and taking care of them physically is all a part of God’s kingdom.  It means something.  My prayer, that the treatment we gave did not stay within the boundaries of the physical.  But were felt in the spiritual as well.  May God be honoured and glorified always. 

The Clinic Part 2

Butiki village is where the second clinic took place.  The village is located approximately ten minutes out of Jinga.  Jinga is highly esteemed in Uganda because it is the source of the Nile.  Many Ugandans are proud of this fact and rightfully so.  Jinga is a happening place located among a beautiful picturesque river.  This river is damned and supplies the country with a portion of it’s much needed and unreliable electricity.

The clinic started well.  Learning from the last clinic, the RN Sara and I were able to package a few drugs beforehand in order to make the job at the pharmacy station much more organized.  This allowed for the people getting drugs to receive them much quicker than before.  The setting: a field that had just been cleared the day before.  Two hired (rented) tents made our work stations and added much shade to work under.  The people quickly and orderly took the rented plastic chairs and lined up.  Three clerks-Ferista, Dorothy and Sara saw the people one by one.  Each assessed, diagnosed and prescribed.  The next step: the lab or pharmacy.  After getting treatment, the people were asked to see Pastor Daniel Sempa to be registered in the black book.  The black book was the only method of keeping track how many people we saw.  Pastor Daniel K and his wife took on the roles of photographer and translator and helping at the pharmacy station.  Pastor William was the contact to the church in Butiki.  He was there both days and was able to connect with the villages on both clinic days.  He ministered and loved the people as they sat and waited to see a clinician.

In Butiki, the people were sicker than in Kirerema.  Malaria, regular cold’s, peptic ulcer disease, fungus, worms, UTI’s were the main illnesses treated.  Some people even came to the clinics proclaiming that they had syphilis.  After questioning a few of these cases, the team realized that the people had learned about the STI and equated all their ailments to syphilis.  This is a good example of the power of knowledge!  If only the people were taught real helpful and basic healthcare, how would things change?  Change only happens with willing attitudes.  And often, people are generally stubborn.  But change...change CAN and WILL happen.

Personnel from both a radio station and tv station came out to view the work.  The radio lady interviewed Pastor Daniel K. And Pastor William.  Their words was spread and heard in certain parts of Uganda about the work that was happening in the village.  Kind of exciting yes?  The TV man filmed the team as they worked.  He also interviewed a few people including myself.  The footage is to be used in a documentary sometime in the future.  Only God knows if and what will be seen.  All in all, like nothing I have ever experienced in Canada.  Normally I’m only the viewer, but to be part of something seen as important is quite the different perspective. It’s exciting, exhilarating, intimidating and scary all at the same time. 

As the day drew to a close, the sun had gone down and we were working in the dark.  We pulled a 7-8 hour day, hoping to get rid of most of the drugs.  The next day was shorter and we worked only about 4 hours.  Over 300 people were seen at that site.  Turning sick people away again, the team slowly began to see the needs in the villages.  However who do they bring their concerns to? The person they see expect to have money: the white girl. This being a regular bias in African countries.  Most believe having white skin equals having money.  It’s a tough mentality to break as the Western world has allowed and encouraged this mentality.  It’s easy to see where the mentality comes from especially when many NGO’s swoop in, provide a service, give out handout’s and then leave.  Or containers of clothes, resources and needed items make their way to these nations.  The people becoming reliant on these handouts and forget and unlearn how to take care of themselves.  These statements are very general, however I have seen the effects of this time and time again.  I was glad to see our medical team see and feel the needs in the villages but I will be ecstatic the day I see the people of Uganda solving their own problems.  Seeing the need, for the moment, is a step in the right direction.  Off to the next village.....

Mobile Clinics Part 1

Arrived on a Tuesday and the first clinic was started on Friday.  Wednesday and Thursday was full of introductions, organizing, repacking, travel and getting over jet lag.  Thursday night, half the team (lab assistant, RN, Pastor Daniel, his wife Keddy and I) traveled to a little town called Busembatja.  The guest house had a nice bed, mosquito net and even nice bathroom.....but in true African style had no running water or power.  J Welcome home!

 The next morning the team headed deep in the village.  Destination: Kirerema.  The road in proved not so bad and we arrived there safe and sound.  Another member of the team joined us at church in Kirerema.  A clinician named Dorothy.  A clinician there does the same sort of work as a general practitioner would do here in Canada, however they do not have to have a degree but a certificate. 

 As we pulled up, the amount of people at the church surprised me.  Perhaps only twenty stood around patiently waiting for us.  After much deliberation, we got everyone set up in certain places scattered in a school building and under the tin roof of the church.  As the people arrived, they were directed to the pastor.  The pastor wrote down specific information to register each patient.  The patients would then see one of the clinicians- Ferista.  She would write down their information on a sheet of paper and take blood pressure and temperature.  From there, the patients were requested to see Dorothy to be further assessed.  After being assessed, given a diagnosis and prescription, the patients would travel to the lab station or to my station: the pharmacy.  Packaging drugs took two people as the amount of people continued to grow throughout the day.  Each individual was prescribed no less than 2 medications.  Most were prescribed 3-5.  And the people came.  After about 4 hours, we decided to call it a day after seeing just over one hundred people.  Lunch was at a local family’s home down the road.  Pastor Daniel decided to delegate driving the team over there to me.  It was my first experience driving in the right side of the car and on the left side of the road.  This still confuses my brain!

 Turning away people the first day was difficult, however we gave each person that day a piece of paper.  The paper indicated that they were to be given priority the next day.  By the time we arrived to Kirerema on Saturday, a crowd of people had gathered.  The word had spread.  Free clinic=free drugs.  With half the drugs gone the first day, I had no idea how long this day would be.  We switched things up.  Two people “clerked” meaning they assessed, diagnosed and prescribed.  The pastor continued to register while the lab tech and I tackled both the lab and pharmacy.  Not being able to speak the language was my biggest downfall and required a translator.  English is a language that is spoken and taught in Uganda but most do not have any education.  When things were very busy I tried speaking simple English to a few. However that proved not be the best as my accent was too thick and many times I wondered if the people were just nodding to be polite or if they truly understood. 

 Quickly we ran out of antibiotics, then pain medications.  Vitamins and steroids were left.  During the time I handed out drugs, I quickly realized that people were given prescriptions and antibiotics for common colds.  Also antibiotics were given as prophylaxis.  The mindset of the clinicians and nurse were very different to what I knew back home. 

After two days and about 10 hours of clinic, the drugs were finished and approx. 250+ were seen.

The Time is Soon

Soon the learning will begin.  :)  Bring it!

How to run a medical clinic in rural Africa

So. As I get prepared for Uganda, google has become one of my main information gateways.  How to....is a common question many people asks for certain things.  The answers one finds can lead a person down quite an interesting path.  The answers to my question however, have been limited.  The question being: How to run a medical clinic in rural Uganda.

Amidst my search, I have found a few snipits of infromation that will help me in Uganda to do as the statment says....set up and run medical clinics in Uganda.  However, finding helpful hints on this subject has been very challenging.  Challenging to the point of discouragment.  I didn't think this task would be so daunting! But the reality here is that these clinics are not in my hands.  PTL! That doesn't stop me from searching but allows me to feel hope and peace with the work ahead.

Many people have been involved with medical teams and clinics around the world.  Multiple resources were found on different opportunities to get involved with on the subject.  However, finding specifics on how things were done is limited.  If you by some miracle read this blog and have any tips that you could send me, please do! I would appreciate any hints. 

And the search continues.........

Hope is Rising

HOPE IS RISING

I've lost all my earthly optimism,
That it's all going to be alright,
That the good will win this fight.
Somewhere between youth and disappointments,
The dream became despair, the love became a lie,

Just now, I've reached the end of my line,
Just now, I'm to tired to keep on trying,

Chorus:
Hope is rising, it's a sunrise, for the end
Hope is rising, and it's breathing for me again,
Hope is rising again.

Soon beneath the roses I will lie,
All the memories of my days, gathered to the sky,
Soon all my work will find it's worth,
And all my strength returned, to the water and the earth,

Just when I reach the end of my life,
Just when my eyes dim out the last light.
By the band DOWNHERE

Sweet Faces

A New Adventure in the Making

It has almost been two years since my adventures in Mawanga Uganda. Since then, much growing has happened on my end. Also too in Mawanga. New wells, buildings, sponsorship and hope have been brough to that little place on the map through the NGO ROWAN. Development has invaded this little place and I am interested to see how things have changed. This November I will be heading out there.

Mawanga will be only a small stop on this new trip to Uganda. My main mission this time is to hang out with friends in Kampala and do some nursing along side locals. Kirerema in Namatumba district has been a glimmer in my eye for some months. The vision was first given to Pastor Daniel and his wife Keddy. Pastor Daniel is aUgandad who has been working in Singapore over the last few years. There he fell in love and married his wife Keddy. The couple have a vision that take them back to Pastor Daniel's home of Uganda. His mission: to empower his village through prayer and education. Development being a by product of those things.

Kirerema is a rural community full of farmers. :) My type of people. The rural community is taking a big hit these days because the majority of farmers can not read and write. They are easily swindled into selling their products for the lowest price. And even sometimes given less money than was promised. The farmer not knowing the difference as he is unable to do simple arithmatic. As business becomes a regular part of the newer generation in Uganda, the older generation is falling pray to sketchy business. Not only is the older generation being negatively affected by "development", the young are also falling pray to the generosity of the first world. Gifts and charity have taught many children and adults in Africa to be dependant on handouts. This sad story is something I am passionate about. Giving, giving, giving is not the only part of the answer. No matter how good it makes one feel. As I walk through church, watch different young people get involved in organizations to help the third world, all I can do is cringe. Pastor Daniel is actively assisting his home community in a way that discourages dependancy and encourages empowerment and self sufficiency. How I love the vision! And in November I get to see the people of Kirirema.

My biggest excitment includes working with a local team of nurses and doctors. Working with them as a team in three different villages. Talk about being the minority! :) Talk about a learning opportunity!

The plan: Stay with local Ugandan friends. Nurse and encourage others.

The mission: Loving the people of Uganda, specifically Kirirema and Kampala.

The goal: Learn and get my hands dirty. Stay healthy.

I can't explain my excitement on here. But what I can say is this. HAve you ever talked about something that makes you excited? Something that makes you beam? Something that gives you enough energy to jump out of your chair and want to tell the world? This is it for me. :D