Tuesday 20 November 2007

Healthcare Uganda Style




Ugandans are good at improvisation. They have to be. If you haven’t got a drip stand in the mission hospital, you hang the infusion bottle on the slats of the louvre window. There are no 20 ml syringes today – no matter, just draw up 5 mls four times from the bottle of intravenous glucose, using the same needle each time to pierce the (non-sterile) rubber bung. The drug of choice for meningitis is out of stock? Well, we have a couple of other antibiotics in stock, so we will try one of those. If that doesn’t work, we’ll try the other one.

But improvisation really comes into its own in community healthcare. A child health clinic can be set up anywhere, provided there are a few shady trees, a wobbly table and chair or two, and a handy branch from which to hang the weighing scales. During the long wait for immunisation or treatment, mothers dress and undress the babies in the shade of the 4x4 in which the team came – underneath the chassis. Well, it’s cool and dry, and the babies don’t seem to mind looking at the grimy underside of a very old Toyota.

The old woman in the picture is in her 80s – although average life expectancy in Uganda is 50 years, there are some who live to old age. And she can still sit comfortably on the floor to have her blood pressure taken! After this clinic for old people, which was held in her house, she produced a meal for the healthcare team of matoke (plantains steamed in a parcel of banana leaves) outside the house on a charcoal stove. Kitchen gadgets, even pots and pans, are redundant here.

But sometimes improvisation is not enough. A mother turned up towards the end of a rural outreach clinic carrying a small child, very sick with malaria, in her arms. She had gone to her local health centre, and been told the child needed to get to hospital quickly. The health centre had neither drugs to treat the baby nor transport. She heard our team was doing an immunisation clinic under a tree in a nearby village, and that we had a vehicle. She walked with the child for an hour or so to find us.

We packed up the clinic early and put mother and child in the vehicle with us for the 20km drive back to the hospital. The child was unconscious, with laboured breathing. There were no blue flashing lights as we drove back at normal speed, the team chatting among themselves. The mother was silent, with an expression on her face that suggested little hope and a familiarity with loss. Just as we drew into the hospital gates, the baby died.

Some transport was found to return the mother and dead child to her village.

Malaria is largely preventable, and deaths from the disease almost always avoidable. If the mother had used a mosquito net, if stagnant water near her home had been drained, if she had given effective medicine at the first sign of fever, if she had got help as soon as the baby deteriorated ……if……if……….

4 comments:

Jo Lacey said...

There aren't really words in response to that. Just tears.
Hearing of people like this that makes me thankful to have a Father who I can cry out to and ask for His comfort for this lady and the many others in her position. God must love these people so very much and I can imagine He feels injustice much more deeply than w e do. Tears well up inside of me as I even start to consider this mother's heart and the normality that loss may have become to her and her community. Here there would be law-suits and complaints in the lack of resources. There, I can imagine only desperate sadness and a complete ignorance to the fact that somewhere else in the world, that simply would not happen. That is inequality in its most brutal form. I'm humbled and saddened by that. I must remember to pray that there be less 'if...' stories in our world.
Thank you for sharing something that shook me to the core and reminded me of God's heart and the need to pray with knowledge of the raw-reality of life and death in places like Africa.
I love you both very much,
Take care,
Jo xxxxx

kathy s said...

hi just read this to Ivy over the phone as she was asking after you. Sounds like hard work and we are thinking of you.
Kathyxxx

Bill & Susan Dunigan said...

After hearing about the old lady of 80+, the death of the young child was truly shocking. As Jo says there are no words to respond with.
Love to you Both.

Anna J said...

I'm with Jo. There are too many ifs in the world.

But then, if all those other children hadn't been immunised, if the mother hadn't had care shown to her and her child in its last hours, if you weren't there to tell others about this....

Thank you for sharing the low points as well.