Uganda - the best and the worst
on Sam Elrick (Uganda), 15/Dec/2009 11:07, 34 days ago
The last week has shown me the best and the worst of Uganda.Work - the BestThe best would have to be the incredible warmth and welcoming I have received from my colleagues on Hope Ward as I continue my clinical time there. I have been struck by the resourcefulness and courage of the nurses that work there. I felt a bit like a fluffy pampered Persian kitten in with all the alley cats. They take life as it comes, they rarely complain and they make do with whatever they can find. We made a bucket of saline from scratch, that is boiling the tap water adding saline and waiting for it to cool and we made a soap and water enema (yes I know it is unheard of these days) using soap and lathering it in between the hands until the right consistency had been obtained. People keep telling me that Ugandan nurses don't care, well I am not sure I agree. I believe that they care but I think that the extreme conditions they work under grind them down and they 'appear' not to care. I think they care a great deal but there is little support and they are just doing the best they can.Work- the WorstThe worst of nursing work in Uganda would have to be the poor resources available in the hospitals and the poor condition of some of the patients. Nurses work with nothing, something we just wouldn't accept in Australia but something Ugandan nurses have no choice about. The only dressing supply available is gauze and subsequently it is used for everything even though it is useless against some of the extraordinary wounds that you encounter here. They did have hydrogen peroxide however, which got poured over a patients fungating leg wound, doing little good except for causing the man extreme pain and possibly killing what precious little good skin remained (if anyone from Clark is reading this don't tell Nik!).The patients that you see here are very challenging in so many ways. The average age is much, much, much younger than what you would find in Australian hospitals and because of the lack of preventative health you see people presenting with end stage conditions which can only get palliative care as the condition is so advanced. This includes things such as cancers that are detected late to HIV/AIDS that is ignored due to the perisisting social stigma until it is way too late. It is a challenge for Ugandan nurses to be confronted with this every day. They are smart and knowledgable and they are caring for people with advanced conditions that could be cured if they were detected early. Breast cancer is a significant issue here but unfortunately there are not many survivors as early detection is an extremely new and misunderstood concept. As a result there are alot of fungating breast cancers that can only be treated palliatively. Now back to the good things...Social - the BestMy friend Hazel and I went to stay with some other friends who have been working for three months in a little villiage about an hour or two (depending on traffic) passed Jinja. They have been doing public health education from a clinic that was set up by the Ugandan High Commissioner for Australia. It was a pretty impressive clinic actually but again by what we are used to it was quite sparse. They are doing some great work there and the outlying community has good access to health care and education so that is fantastic.The real highlight of the weekend as the hospitality of the residents of the village. We were welcomed with open arms and taken around all the houses. We had to do all the traditional Ugandan greetings at each house so it gave us a good chance to practice the language. We have learned some Luganda and although the language of this area is Lusogo there are lots of similarities and we seemed to get by OK. We were taken out to see all the crops and the brick making area. They also taught us how to hull maize (we call it corn), that they turn into posho. It is important to add here that posho is a thick white substance that looks like solidified clag glue and should be banned, I am not sure how you could get a thing as fine as a corn-cob to turn into posho!Anyway just as we were saying our goodbyes - that take almost as long as the hellos - one of the grandmothers came along and had cooked us food. We ate cassava, and BBQ maize and jackfruit. Then we finally left laden down with paw-paws, eggs, mangos, cassava, popping corn and jackfruit. The village folk were so incredibly warm and welcoming it was really a magical experience. It is normal for Ugandans to be so hospitable and to give so readily to visitors. We also got to visit the village's chicken farm which was surprisingly interesting. I would also like to report that we found the best eggs in Uganda, I think they are doing something right as the eggs were fresh and yellow yolked. Most of the eggs here have a very strong flavour have yolks that are a pale lemon colour, I think it's because chickens often eat alot of rubbish and not much else. Some of the villiagers helped us carry the produce home and even returned Hazel's mobile phone that she had accidently misplaced earlier. This day was the very, very best that Uganda has to offer, but there is a flip side....Social - the WorstYesterday after a quick change after work I left the house to head out to the movies. A few meters down the road a scuffle was taking place. The scuffle turned nasty and a man was kicking and punching a younger man who couldn't have been more than about 16 or 18 years of age. I had to actually walk around them giving them a wide berth. I knew not to stop and intervene as this was a scene to stay well away from. It was as if the street was suspended in stillness (expept for the beating) for a few minutes as bystanders watched and surveyed the scene. Suddenly the stillness was broken and men started running from all directions to join in the mellee. I could hear the punches and the kicks as I walked away but worst of all I would hear the screams of the boy who was being beaten. The whole situation made me feels quite sick and coming the day after we had seen such warmth and kindness from Ugandan's it was particularly hard to bear. I think there were tears in my eyes as I walked away and left the man to his fate... whatever that may be.I have no idea what the issue was that precluded the beating but I know that 'mob-justice' is commonplace in Uganda. Recently I read that a man was beheaded by a mob for being suspected of stealing a chicken, not quite sure if the punishment fitted the crime there. So perhaps it was a domestic issue but more likely the boy was suspected of some wrong doing and had to endure the consequences. As a 'muzungu' or 'white person' you cannot become involved no matter how strongly you feel. Having to walk away and leave the boy to his fate was almost as sickening to me as having to witness the incident in the first place.Ugandans are essentially good, kind, relaxed and warm people but every now and then something happens to make you question every expereince that you have had in this country so far.....