Thursday, June 26, 2008

Hospitals and taxis...

Hello from Uganda! It has been an interesting week since I last posted, so I will try to fill you in on what I have been up to.

One of the things that I wanted to do while I was here in Uganda was to develop a better understanding of the Ugandan health care system. As most of you know, I have been involved in the planning and oversight of a clinic here on the church property in Mpigi, so I wanted to gain a better understanding of what health care services are available here, and how the clinic at the church fits into the bigger picture of health care in this area.

Here’s a bit of a side note…just so you know what I am referring to when I say Mpigi! Mpigi is the name of one of the many districts in Uganda…similar to regions, such as Metro Vancouver, in BC. And also in Mpigi district is Mpigi town, where the market, internet cafĂ©, taxis, and other shops are located. Mpigi town is about a 10 minute boda boda ride from the church property, which is in the village of Ziwangwe (not sure if that spelling is even close to correct, but you get the idea!)

So, step one was to meet the woman in charge of health care services in Mpigi District, Dr. Ruth. I had emailed a contact from my trip last year, and she had let Dr. Ruth know that I was coming. After a couple of awkward meetings with Dr. Ruth at the Mpigi Ministry of Health offices, which involved a lot of waiting and a lot of long (and for me awkward) silences, I had in my possession a letter of introduction to the in-charge at a few different health care centres around the district, so that I am able to go and see the facilities.

So the first place I went to visit was Gombe Hospital, where I have spent 3 days during the past week. Gombe Hospital is about a 45 minute taxi ride from Mpigi town. So the first morning, I showed up to the taxi stop at about 8 am. Taxis in Uganda are vans that are designed for 14 passengers – two up front by the driver, and then 4 rows with 3 seats per row. However, it is extremely rare for a taxi to only carry 14 – average is probably closer to 22, and often even more than that. And that is not counting babies and kids, bags of produce or animals, and other random supplies that people need to transport. And the other thing about taxis in Uganda is that they don’t leave until they are full…and full for the Gombe taxi is at least 18 people. So unfortunately, that first morning, I was one of the first people to arrive. So I waited…and waited…and waited for the taxi to fill, and by 9:30 the taxi finally left. Along the way we continued to pick up people, cramming them into every available space in the taxi. It was the same story pretty much every day that I went…although one day was especially bad, as I had to sit with my knees practically to my chest as there were two large rolls of sheet metal underneath the seats! Oh, and did I mention that I was the only mzungu (white person) in the taxi?

This is a picture that I took while I was sitting crammed in the middle of the taxi…

Anyways, I survived the taxi trips to and from Gombe (going home was not usually quite as bad, but still was pretty full!) My first day at Gombe was spent at the HIV outpatient clinic and touring the pediatric ward, and I spent the next two days at the maternity ward. The midwife that was working there, Christine, was very friendly and helpful, and I learned a lot! On the second day, I was able to see two births, which was great!
Hospital care is definitely different in Uganda compared to Canada!! For example, the pediatric ward has a typical nurse patient ratio of 2 nurses to 40 patients. The maternity ward is about the same. However, families are involved in much of the patient care, so that is helpful. The maternity ward does not have any running water, so water is stored in big barrels and scooped out as necessary. And there is definitely a lack of resources throughout…for labour, each women is expected to bring her own plastic sheet to cover the bed where she will deliver, as well as sheets for the baby to be cleaned off with after delivery. And after the baby was delivered, the midwife turned to me and said, “In Uganda, we improvise.” She then ripped the cuffs off of her latex gloves and used the bits of the glove to tie off the baby’s umbilical cord! Yet overall, in spite of a lack of resources, I was very impressed by the care that was provided to the patients at the hospital. The other birth I got to see was a C-section…but I’ll spare all you non-medical types the details!

So that’s a bit about what I have been up to since I have been here. And although life is very different here, I am learning a lot and definitely being challenged by what I am experiencing …both in the health care system as well as in daily life in the community. But I’ll save all that for another post, since this one is getting long!

Thanks for your emails and comments…I love hearing what is going on back home! Oh, and for those of you who have been on trips to Mpigi previously…the people here have definitely not forgotten you (pretty much daily someone asks me if I know how someone from a previous trip is doing), so if you want to send a message of greeting to anyone feel free to do so through me…they would really love to hear from you!

Here's a picture of some of the kids playing memory...
That’s all for now…take care!!

1 comment:

Cheryl said...

Enjoyed your stories about the maternity unit you'd visited.

Needless to say, thinking I might try and tie off a baby's umbilical cord with the cuff of my latex glove next time....just to see the reaction I'll get :)