Sunday, 9 August 2015

Goodbye Kampala, and to all those doing health work in Uganda (and the goats)

Yesterday I walked around the Mulago Hospital in Kampala. It is the largest state hospital in Uganda. It was a very challenging end of my busy programme in Uganda which started, over a week ago with a breakfast meeting on the terrace of my hotel in Kampala. I was in Uganda as part of the Global Health Exchange placement programme and also and partly to scope out opportunities to contribute to the Uganda UK Health Alliance programmes aimed at establishing more generalised health partnerships and collaboration. After breakfast it was off in a small minibus to tackle the traffic on our way to Maya, a small rural community just outside of Kampala. The final mile of the journey was on an unmade and treacherously slippery road carved out of the red mud of a hillside.

I was travelling to meet John and to look around his Community Clinic that was emerging from the hillside, one brick at a time. John once lived in one of the shanty towns that are sprinkled around the city of Kampala. He lived there with his parents, his Father working as a servant to a wealthy Englishman. During the brutal terror reign of the tyrant Idi Amin the wealthy Englishman was exiled from Uganda, only returning on the end of Amin's presidency. Johns Father had kept the house in good condition and as a reward the Englishman agreed to send John to the UK to gain an education.

John studied first at St Davids College and Wales, and then took his degree at Liverpool John Moore’s University. He returned home to find his Mother now on her own, living in a one room shack in the same shanty town he had left. The first thing he did was to build his Mother another room and that 2 room brick built house still stands, and is rented out. The process of building his Mother another room inspired him, and he was able to raise enough money from his friends in Uganda and the UK to buy some land upon which the Community Clinic now stands.

He built the first consulting rooms himself, which now house a general clinical space and a dental surgery. He pays for a dentist to attend twice a week, and patients pay a contribution towards their treatment (£1 for a tooth extraction – something that costs £5 in Kampala city and £51 in the UK). The dentist equipment (drill, suction, lights, laptop for clinical notes and so on) were all powered by solar power, and the steriliser uses boiling water fired by gas from a biogas plant, fuelled from the waste from 2 cows.

I was truly humbled by his approach to sustainability. Last Christmas I had bought 14 solar panels for the House in Scotland, and apart from collecting the cheques from Scottish Power every 3 months don’t do anything as worthy as John. His ambition was to use his education to help the community from which he had come. He did so quietly and confidently. There was often the help of others, and sometimes this help was in form of money, others the forms of help were more unique.

He collects and stores rain water from the clinic roof. This water goes into a 1000 gallon tank buried in the ground, and need to be pumped manually up the hill to other storage tanks before it is fed by gravity back down to the clinics taps and toilet. Patients are asked if they would spend 5 minutes (or more if they are able) on a machine rather like a bike that pumps water up the hill. Not only does this improve their cardiovascular circulation, but in so doing helps reduce anxiety. It was a fantastic set up.

We also had 12 students from the University out in Uganda, and they were all starting their placements in different services, and so there was an opportunity to see them in action. They were all placed in different service provisions, regional centres, private hospitals, referral community services and missionary hospitals. They weren't there as volunteers but as part of their pre-registration professional education and training.

One of these placements was a referral centre outside of Fort Portal, again at the end of a red mud road. There I was able to meet 4 of our midwifery students, all of whom were busy putting their knowledge and skills into use working with mother’s pre and post-delivery of their babies. In some ways it was health care the raw, but I was impressed with the evident compassion and care being provided. In a resource challenged country, I felt we had a lot we could learn from the Ugandan approach.

The Goats – well everyone seemed to keep at least 1 pygmy goat if not more. For a goat lover, it was great to see so many at the side of the road everywhere I went – it was a added bonus that like so many things on the trip, was very unexpected.

Not least of which was the glass door in my toilet at one of the hotels I stayed at. I am not sure whose bright idea it was to provide the toilet with a glass door, I am sure there is paper to be written about this at some stage. I write this from Terminal 5 at Heathrow, and in a couple of hours I will be back into Manchester before driving up to the House in Scotland for a couple of days relaxation. I was glad of the experience of Uganda, but will be equally glad to get into my own bed and look out at the sea, watching the tide come in and go out again.