Uganda News #5
A Report by Cynthia Margeson
Arlington Academy of Hope
November 12, 2006
The State of Health Care in Bududa District
The addition of the Beatrice Tierney Clinic on the compound of Arlington Academy of hope has improved the status of health care tremendously for those residents living in and around the villages of Bumwalukani and surroundings. FIMRC has now become an important partner to this project as well as they have begun the funding of the nursing staff: a fulltime nurse, Edwin and a part time nurse, Viola and a health assistant.
The clinic is now seeing about 30 patients per day, free to AAH students and staff and an “administrative fee” of 2000 shillings (just over $1) for a patient to be seen, diagnosed and given the necessary meds for treatment. Believe me, this is a BIG addition to the community.
That aside, I traveled with the nurse and the headmaster one Saturday afternoon to the nearest hospital facility: it’s only about 10 kilometers away, but once again involves an eventful taxi ride. We got off at the taxi circle and walked the final kilometer to the hospital grounds. Walking around here has the same pedestrian atmosphere of walking in Arlington on a snowy day. Everyone is walking in small groups or alone, you can walk on either side (or right down the middle for that matter) and there is a congenial feeling as everyone greets everyone else. If a vehicle comes by, you step aside and watch it pass. As we entered the hospital grounds, we were greeted by one of our school parents who runs the canteen/snack shop at the hospital.
The hospital is spread out in 7-8 low barracks like wings which are connected by a covered walkway. The outside is fairly well maintained and the vegetation is trimmed. There is evidence of torn screening (in a country where malaria is the disease which probably affects more people than any other ailment.) but few to none window panes are visible. The first area we visited was the outpatient hall. It was a large room with a few benches and about 8 different doors with handlettered signs but this room was empty today as it was a Saturday.
As we entered the first ward which is the female wing, we are met with an incoming rustic style gurney with obvious fluids remaining on the surface. As we step further, we find a fully dressed woman on the FLOOR! We quickly learnt that she has just returned from surgery and her family members or friends had not yet arranged a bed for her. If you are to stay in hospital here, you must bring family members or friends to prepare your bed for you, cook your meals, help you use a bedpan or walk you to the pit latrine and help you bathe. This means while you are ailing, someone must think of charcoal burner, food to pack, lantern, basin, bedding. If you are fortunate to see a doctor, you may be given some medicines (although sometimes for less common drugs, the family member must go searching for the meds in a nearby town). Did I mention the cooking facility is outside. The school parent sells small quantities of rice, paraffin, crackers, soda, onions and other necessities for the patient and the caretakers!
We were visiting the hospital to see one of our students who is undergoing treatment for TB. She is in isolation which means the nearest bed is 5 feet away from her instead of 3 feet. She has a young sister with her that day who is sound asleep resting on her bed. As I turned away from her, I see a mother of twins nursing two at a time! Our student is feeling better and said her mother will probably come by evening to be with her. By the time we leave this ward, the lady from surgery is now on a bed which has been made with a blanket on top of the spring form –no mattress is available.
The men’s ward is the next on our itinerary. There are only about a dozen patients here in a room which is designed for about 3 dozen beds. The boy who immediately catches my attention here is one whose leg is lightly bandaged around a splint, all of which is elevated with a pulley. The leg and pulley can easily be adjusted by raising or lowering the cement cylinder which is at the end of the rope.
The saddest and most malodorous wing is that of the children’s ward. (They can be up to 5 years in this wing). Here the beds are like cribs with 3 sides and most beds have mattresses- the source of the stench therein. Most children do have a parent sitting on edge of the bed or actually curled up sleeping on the bed. Three different infants have IV;’s in their scalp- a new technique for me. One such infant has a young teenage girl who looks as if she could easily be one of our primary school students, but upon questioning, we learn she is indeed the mother of this child who has been stricken by malaria.
Next on our tour is the maternity ward. There are four very modern looking obstetrical beds (you know with stirrups!) in the hallway. We asked why they were not in use and were told that they were a donation but no one had left any instructions on how to use them. They had been in the hall since April and they thought someone might come back to show them how to use them. The faces in this ward are already tired. A typical stay is 24 hours for baby and mother. Traditionally labor is short and birth weight is low.
The final area which we toured was that of the surgical theater. That was the only area where there was any sign of attempts at sterilized conditions. (We were asked to take off our shoes here and put on a waiting pair of flip flops. There was something which was boiling medical instrument, scrubs hanging on door pegs and a clothesline of laundered surgical soaking rags.
Visiting Bududa Hospital could only make me feel worse as I shudder to think of the conditions these patients come from if their hospital stay under these described situations can in fact be considered better than their home stay or nothing at all.
Saturday, November 11, 2006
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