on Thea's Blog (Uganda), 09/Oct/2010 09:51, 34 days ago
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Normal0MicrosoftInternetExplorer4st1\:*{behavior:url(#ieooui) }/* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";}This week I got a taste of public healthcare inUganda. Luckily for me, I wasn’t actually the patient, only the chauffeur. The patient was a 16 year old relative of Mary, our maid, whose leg was horribly mangled in a bus crash in November last year. I actually narrowly avoided the same bus crash myself, just happening to be on a different bus on the same road a few hours earlier. At the time I was so shaken by the near miss that I sent a furious email to the VSO Country Director telling him he was putting our lives at risk by forcing us to travel in ‘flying coffins’ to pointless meetings in Kampala. I haven’t been invited to a meeting since so I guess the message got through.Buhinga hospital, the regional referral hospital, is quite an eye-opener for a sheltered, privileged westerner like me. Everywhere you look, huge queues of people sit patiently, resignedly, despairingly in some cases, waiting for someone to help them. On the congested wards, sick people lie on shabby, closely-packed cots, elbow-to-elbow with no dividing curtains. Patient privacy doesn’t seem to exist as a concept. When I went to the surgical ward, I found a group of about ten doctors and trainees bunched around a bed examining a post-operative patient. Any other patient who was well enough was craning their neck to hear the prognosis of their neighbour, while another group ofpeople were poking their heads through the glassless windows like it was some kind of spectator sport.There are none of the reassuring hallmarks of hygiene and sanitation we take for granted in a western hospital. No comforting smell of disinfectant, or nice clean patient gowns or well-stocked storerooms full of gloves and drugs and catheters. I found myself trying not to breathe too much in case I picked up something nasty. I thought of how things work back home, with patients demanding more and more for information, explanation, choices and services. Here people are passive, disempowered, powerless. They don’t, or believe they don’t, have any right to claim for a good service. They just hope if they wait long enough a doctor, with God’s will, will help them get better. And if they can’t be helped, so be it.Trying my hardest to blot out the queue of 150 people patiently waiting people in outpatients, I realised I would have to start throwing my mazungu weight around if we were to have any chance of getting out of there in one day. As it turned out, I didn’t really need to do much weight throwing, as everyone seemed happy to bend over backwards to accommodate my requests. I was ushered up to meet the surprisingly young surgeon, who finished his rounds then came straight away to see Rosette. In five minutes, he had diagnosed a persistent infection and proscribed an x-ray, antibiotics and physiotherapy. Meanwhile I diagnosed him with a dreadful bedside manner and hopeless communication skills but attributed this to being overworked, underpaid and the fact that gruff, unapproachable doctors are clearly the norm inUganda. We then went up to the X-ray theatre, where I found myself offering my first ever bribe to the radiologist to make sure Rosette bypassed the long queue of patiently waiting sick people. I am utterly ashamed in retrospect, but at the time all I could think about was getting out of that hell hole as quickly as possible. Thanks to my temporary loss of scruples, we were in and out in about two hours (less than a trip to A&E in theUKI couldn’t help but notice), and Rosette is hopefully a little further along the way to recovery.